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Capital IconMinnesota Legislature

HF 4065

3rd Engrossment - 92nd Legislature (2021 - 2022) Posted on 11/08/2022 02:40pm

KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 2.35 2.36 2.37 2.38 2.39 2.40 2.41 2.42 2.43 2.44 2.45 2.46 2.47 2.48 2.49 2.50 2.51 2.52 2.53 2.54 2.55 2.56 2.57 2.58 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8
3.9 3.10
3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 3.34 3.35 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20
4.21
4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 6.1 6.2 6.3 6.4
6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31
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 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 8.32 8.33 8.34 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 9.34 9.35 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 10.34 10.35 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8
11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31
12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27
12.28 12.29 12.30 12.31 12.32 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 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 18.33 18.34 19.1 19.2 19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11
19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17
20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 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 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18
24.19
24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 27.1 27.2
27.3
27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23
27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 28.1 28.2 28.3 28.4 28.5 28.6
28.7
28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 28.32 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25
29.26
29.27 29.28 29.29 29.30 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21 30.22 30.23
30.24
30.25 30.26 30.27 30.28 30.29 30.30 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20
31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22
32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32
33.1 33.2 33.3 33.4
33.5
33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 33.32 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
35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 36.1 36.2 36.3
36.4
36.5 36.6 36.7 36.8 36.9 36.10 36.11
36.12
36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 37.1 37.2 37.3 37.4
37.5
37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27
37.28
37.29 37.30 37.31 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 39.1 39.2 39.3
39.4
39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 39.32 39.33 40.1 40.2 40.3 40.4 40.5 40.6 40.7
40.8
40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23
40.24
40.25 40.26 40.27 40.28 40.29 40.30 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14
41.15
41.16 41.17 41.18 41.19 41.20 41.21 41.22
41.23 41.24
41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 42.1 42.2 42.3
42.4
42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20
42.21
42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 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 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26
44.27
44.28 44.29 44.30 44.31 44.32 44.33 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21 46.22 46.23 46.24
46.25 46.26
46.27 46.28 46.29 46.30 46.31 47.1 47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21
47.22
47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16
48.17
48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14
49.15
49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12
50.13
50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25
51.26
51.27 51.28 51.29 51.30
51.31
52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17
52.18
52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30
53.1
53.2 53.3 53.4 53.5 53.6
53.7
53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16
53.17
53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27
53.28
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 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 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23
56.24
56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 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 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17
59.18
59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29
59.30
60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14
60.15
60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 60.31 61.1 61.2 61.3 61.4 61.5 61.6
61.7
61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 61.34 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24
62.25
62.26 62.27 62.28 62.29 62.30 62.31 62.32 62.33 63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9
63.10
63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25
63.26
63.27 63.28 63.29 63.30 63.31 64.1 64.2 64.3
64.4
64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22
64.23
64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31
65.32 65.33 65.34 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 66.34 66.35 67.1 67.2 67.3 67.4 67.5 67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 67.34 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 68.35 69.1 69.2 69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10 69.11 69.12 69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27 69.28 69.29 69.30 69.31 69.32 69.33 69.34 69.35 70.1 70.2 70.3 70.4 70.5 70.6 70.7 70.8 70.9 70.10 70.11 70.12 70.13 70.14 70.15 70.16 70.17 70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 70.32 70.33
71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17
71.18 71.19 71.20 71.21 71.22 71.23 71.24
71.25 71.26 71.27 71.28
71.29 71.30 71.31
72.1 72.2
72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21
72.22
72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 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 74.31 74.32 74.33 74.34 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 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 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19
77.20 77.21 77.22 77.23 77.24 77.25 77.26
77.27
77.28 77.29 77.30 77.31 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 78.32 78.33
78.34
79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27
79.28 79.29 79.30 79.31 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33
80.34
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 81.32 81.33 81.34 81.35 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 82.33 82.34 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 83.32 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13 84.14
84.15
84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26
84.27 84.28 84.29 84.30 84.31 84.32 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 85.33
86.1 86.2 86.3 86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26 86.27 86.28
86.29 86.30 86.31 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13 87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 87.31 87.32 88.1 88.2 88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26
89.27
89.28 89.29 89.30 89.31 90.1 90.2 90.3 90.4 90.5 90.6
90.7
90.8 90.9 90.10 90.11 90.12 90.13
90.14
90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22
90.23 90.24 90.25 90.26
90.27 90.28 90.29 90.30 90.31
91.1 91.2
91.3 91.4 91.5 91.6 91.7 91.8
91.9 91.10
91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 91.31 91.32 91.33 92.1 92.2 92.3 92.4 92.5
92.6 92.7
92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20
92.21 92.22
92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 92.31 92.32 93.1 93.2 93.3 93.4
93.5 93.6
93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19
93.20 93.21
93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8
94.9 94.10
94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 94.31 95.1 95.2 95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 96.1 96.2 96.3
96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14 96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 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
98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 99.1 99.2 99.3 99.4
99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28
99.29 99.30 99.31 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13
100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23
100.24 100.25 100.26 100.27 101.1 101.2 101.3 101.4
101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12 101.13
101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24
101.25 101.26 101.27 101.28 101.29 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9
102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 104.1 104.2 104.3 104.4 104.5
104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 105.1 105.2 105.3
105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27 105.28 105.29 105.30 105.31 105.32 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25
107.26 107.27 107.28 107.29 107.30 107.31 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28
108.29
108.30 108.31 108.32 108.33 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 109.33 109.34 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16
110.17
110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 113.33 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13
114.14
114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 115.1 115.2
115.3
115.4 115.5 115.6 115.7
115.8 115.9
115.10 115.11
115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27
116.28 116.29 116.30
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
118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25
120.26 120.27 120.28 120.29 120.30
121.1 121.2 121.3
121.4 121.5 121.6 121.7 121.8
121.9 121.10 121.11
121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27
121.28 121.29 121.30
122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12
122.13 122.14 122.15
122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24
122.25 122.26 122.27
122.28 122.29 122.30 122.31 122.32 122.33 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 125.1 125.2 125.3 125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16 125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 125.32 125.33 125.34 126.1 126.2 126.3 126.4 126.5
126.6 126.7 126.8
126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 126.34 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 127.32 127.33 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 128.34 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 129.33 129.34 129.35 130.1 130.2 130.3 130.4 130.5 130.6
130.7
130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31
130.32
131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 132.32 133.1 133.2
133.3 133.4 133.5 133.6 133.7
133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20
133.21
133.22 133.23 133.24 133.25 133.26 133.27 133.28 133.29 133.30 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13
134.14
134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23
134.24 134.25 134.26 134.27 134.28 134.29 134.30 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13
135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12
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
137.1 137.2 137.3
137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12
137.13 137.14 137.15
137.16 137.17 137.18 137.19 137.20 137.21
137.22 137.23 137.24
137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30
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
141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21 141.22 141.23
141.24 141.25 141.26
141.27 141.28 141.29 141.30 141.31 141.32 142.1 142.2 142.3
142.4 142.5 142.6
142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27
143.28 143.29 143.30
144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8
146.9 146.10 146.11
146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29
147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11
147.12 147.13 147.14
147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9 150.10 150.11 150.12 150.13 150.14 150.15 150.16 150.17
150.18 150.19 150.20
150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30 150.31 150.32 150.33 151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21
151.22 151.23 151.24
151.25 151.26 151.27 151.28 151.29 151.30 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 153.33 153.34
154.1 154.2 154.3
154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21
155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21
157.22 157.23 157.24
157.25 157.26 157.27 157.28 157.29 157.30 157.31 157.32 158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13 158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 158.33 158.34 159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2 161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 161.33 161.34 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 162.34 162.35 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10
163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 164.33 164.34 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10
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
166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20
167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 168.31 168.32 168.33 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9
169.10 169.11 169.12
169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21
171.22 171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21 172.22 172.23 172.24
172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 172.33 173.1 173.2 173.3 173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 174.1 174.2 174.3 174.4 174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 174.30 174.31 174.32 174.33 175.1 175.2 175.3 175.4 175.5 175.6
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
176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 177.1 177.2 177.3 177.4 177.5 177.6 177.7
177.8 177.9 177.10
177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18
177.19
177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19 178.20
178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23 179.24 179.25
179.26 179.27 179.28 179.29
179.30 179.31 179.32 180.1
180.2 180.3
180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31
183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 184.32 184.33 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 185.33 185.34
186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9
186.10 186.11
186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16
189.17
189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10 191.11
191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 191.31 191.32
192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12 193.13 193.14 193.15 193.16 193.17 193.18
193.19
193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 194.1 194.2 194.3 194.4 194.5 194.6
194.7
194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32 194.33 195.1 195.2 195.3 195.4 195.5
195.6
195.7 195.8 195.9 195.10 195.11 195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 195.33 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 196.33 196.34 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 197.34 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15
198.16 198.17 198.18 198.19 198.20 198.21
198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 198.32 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15
201.16 201.17 201.18
201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 201.33 202.1 202.2
202.3 202.4 202.5
202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 203.1
203.2 203.3 203.4
203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23 203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 204.33 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25
205.26 205.27 205.28
205.29 205.30 205.31 205.32 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10
206.11 206.12 206.13
206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 207.32 207.33 207.34 207.35 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32 208.33 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 209.33 210.1 210.2
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
210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31 212.1 212.2 212.3 212.4 212.5
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
212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 213.31 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 215.1 215.2 215.3
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
215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 215.32 215.33 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 216.32
217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19
217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32
217.33
218.1 218.2 218.3 218.4
218.5
218.6 218.7 218.8 218.9 218.10 218.11
218.12 218.13
218.14 218.15 218.16
218.17 218.18
218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28
219.29
220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9
220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27
220.28 220.29 220.30 221.1 221.2
221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17
221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12
222.13 222.14 222.15
222.16
222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 223.1 223.2
223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23
223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 224.1 224.2 224.3 224.4
224.5 224.6 224.7 224.8 224.9 224.10 224.11
224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19
224.20 224.21 224.22 224.23
224.24 224.25 224.26 224.27
224.28 224.29 224.30 225.1 225.2
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
226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13
226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30
226.31 226.32 226.33 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1 228.2 228.3 228.4
228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19
228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33
229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13
229.14 229.15 229.16 229.17 229.18 229.19 229.20
229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9
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
230.26 230.27 230.28 230.29 230.30 231.1 231.2
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
233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12
233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 235.1 235.2 235.3 235.4 235.5 235.6 235.7
235.8 235.9 235.10 235.11 235.12
235.13 235.14 235.15
235.16 235.17
235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13 236.14 236.15 236.16
236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 236.31 236.32 236.33 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 238.33 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 241.1 241.2 241.3 241.4
241.5 241.6 241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28 241.29 241.30 241.31 241.32 242.1 242.2 242.3 242.4 242.5 242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 242.33 242.34 243.1 243.2 243.3 243.4 243.5 243.6 243.7 243.8 243.9
243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23 243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32 244.1 244.2 244.3 244.4 244.5
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
245.1 245.2 245.3 245.4 245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20 245.21 245.22 245.23 245.24 245.25 245.26
245.27 245.28 245.29 245.30 245.31 245.32 245.33 245.34 246.1 246.2 246.3 246.4 246.5 246.6
246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 246.33 246.34 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18 247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 247.33 247.34 248.1 248.2 248.3 248.4 248.5 248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14 248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 248.32 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23
249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 249.33
250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27 250.28 250.29 250.30 250.31 250.32 250.33 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23
251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 252.31 252.32 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 253.33 253.34 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24 254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 254.33 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20
255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 255.32 255.33 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16 256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31 256.32 256.33 256.34 257.1 257.2 257.3 257.4 257.5 257.6 257.7 257.8 257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19 257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27
257.28 257.29 257.30 257.31 257.32 258.1 258.2 258.3 258.4 258.5 258.6 258.7 258.8 258.9 258.10 258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27 258.28
258.29 258.30 258.31 258.32 258.33 259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32 259.33 259.34 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25 260.26 260.27 260.28 260.29
261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17 261.18 261.19 261.20 261.21 261.22 261.23 261.24 261.25 261.26 261.27 261.28 261.29 261.30 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19 262.20 262.21 262.22 262.23 262.24 262.25 262.26 262.27 262.28 262.29 262.30 262.31 262.32 262.33 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9
263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17 263.18 263.19 263.20 263.21 263.22 263.23 263.24 263.25 263.26 263.27 263.28 263.29 263.30 263.31 263.32 263.33 263.34 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13 264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 264.30 264.31 264.32 264.33 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 265.32 265.33 265.34 265.35 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18
268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18
270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31 270.32 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21
271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 272.32 272.33 272.34 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28 273.29 273.30 273.31 273.32 273.33 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8 275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 275.32 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9 276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 276.31 276.32 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30 277.31 277.32 277.33 278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19
278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31 278.32 278.33 279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 279.32 279.33 279.34 279.35 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26
280.27 280.28 280.29 280.30 280.31 280.32 280.33 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10
281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 281.32 282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16
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
284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24 284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 284.33 284.34 285.1 285.2 285.3 285.4 285.5 285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 285.33 285.34 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30
286.31 286.32 286.33 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15
287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26
287.27 287.28 287.29 287.30 287.31 287.32 287.33 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22
288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 289.1 289.2 289.3
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
290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15 291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25 291.26 291.27 291.28 291.29 291.30 291.31 291.32 291.33 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8
292.9
292.10 292.11 292.12 292.13 292.14 292.15 292.16 292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 293.1 293.2 293.3 293.4
293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27
293.28 293.29 293.30 293.31 293.32 294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 296.1 296.2 296.3 296.4 296.5
296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26
296.27 296.28 296.29 296.30 296.31 296.32 297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 297.30 297.31 297.32 298.1 298.2 298.3 298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 298.33 298.34 298.35 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16 299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 299.31 299.32 300.1 300.2 300.3 300.4 300.5 300.6
300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14 300.15 300.16 300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 300.32 300.33 300.34 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33 301.34 301.35 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12 302.13 302.14 302.15 302.16 302.17 302.18 302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26 302.27 302.28 302.29 302.30 302.31 302.32 302.33 302.34 303.1 303.2 303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10 303.11
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
306.16 306.17 306.18 306.19 306.20 306.21 306.22 306.23 306.24 306.25 306.26 306.27 306.28 306.29 306.30 306.31 307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22 308.23 308.24 308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21 309.22 309.23 309.24 309.25 309.26 309.27 309.28 309.29 309.30
309.31 309.32 309.33 310.1 310.2 310.3 310.4
310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14
310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24 310.25 310.26 310.27 310.28 310.29 310.30 310.31 311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 311.33 312.1 312.2 312.3 312.4 312.5 312.6 312.7
312.8 312.9 312.10 312.11 312.12 312.13
312.14 312.15 312.16 312.17 312.18 312.19 312.20 312.21 312.22 312.23 312.24 312.25 312.26 312.27 312.28 312.29 312.30 312.31 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10 313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20
314.21 314.22
314.23
314.24 314.25 314.26 314.27 314.28 314.29 314.30 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 315.30 315.31 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13
316.14 316.15
316.16 316.17 316.18 316.19 316.20 316.21 316.22
316.23
316.24 316.25 316.26 316.27 316.28 316.29 316.30 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10
317.11
317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11
318.12 318.13 318.14 318.15 318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19 319.20 319.21
319.22
319.23 319.24 319.25 319.26 319.27 319.28 319.29 319.30 320.1 320.2 320.3 320.4 320.5 320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21 320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 320.31 320.32 320.33 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24
321.25 321.26 321.27 321.28 321.29 321.30
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
322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11
324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 324.30 324.31 324.32
325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28 325.29 325.30 325.31 325.32 325.33 325.34 326.1 326.2 326.3 326.4 326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 326.31 326.32 326.33 326.34 327.1 327.2 327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15
327.16 327.17 327.18
327.19 327.20
327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 327.32
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
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
329.28 329.29 329.30 329.31 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25 330.26 330.27 330.28 330.29 330.30 330.31 331.1 331.2 331.3 331.4 331.5
331.6
331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 333.1 333.2 333.3 333.4 333.5 333.6 333.7 333.8 333.9 333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31
333.32
334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 334.33 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21
335.22
335.23 335.24 335.25 335.26 335.27 335.28 335.29 335.30 335.31 336.1 336.2 336.3
336.4
336.5 336.6 336.7 336.8 336.9 336.10 336.11 336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26 336.27 336.28 336.29 336.30 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10
337.11
337.12 337.13 337.14 337.15
337.16
337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11
338.12
338.13 338.14 338.15 338.16 338.17 338.18
338.19
338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8
339.9
339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 339.30 339.31 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8
340.9
340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26 340.27 340.28 340.29 340.30 340.31 340.32 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19 341.20 341.21 341.22 341.23 341.24
341.25
341.26 341.27 341.28 341.29 341.30 341.31 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13
342.14
342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26
342.27
342.28 342.29 342.30 343.1 343.2 343.3 343.4 343.5
343.6
343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31 344.1 344.2 344.3 344.4 344.5 344.6 344.7 344.8 344.9 344.10 344.11 344.12 344.13 344.14
344.15
344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8
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
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
348.1 348.2
348.3 348.4 348.5 348.6 348.7 348.8
348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16 348.17 348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 348.29 348.30 348.31 348.32 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31 350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18 350.19 350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 351.1 351.2 351.3 351.4 351.5 351.6 351.7 351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 351.31 351.32 352.1 352.2
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
353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10
354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 355.1 355.2 355.3 355.4 355.5 355.6 355.7
355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 356.1 356.2 356.3 356.4 356.5 356.6 356.7 356.8 356.9 356.10 356.11 356.12 356.13
356.14 356.15 356.16 356.17 356.18 356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 357.1 357.2 357.3 357.4 357.5 357.6
357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 358.1 358.2 358.3 358.4 358.5 358.6 358.7 358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 359.1 359.2 359.3 359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 360.1 360.2 360.3 360.4 360.5 360.6 360.7 360.8 360.9 360.10 360.11 360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22 360.23 360.24 360.25 360.26 360.27 360.28 360.29 360.30 361.1 361.2 361.3 361.4 361.5 361.6 361.7 361.8 361.9 361.10 361.11 361.12 361.13 361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27 361.28 362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9 362.10 362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28 363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16 363.17 363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16 364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17 365.18 365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14 366.15 366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15 367.16 367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 367.32 368.1 368.2 368.3 368.4 368.5 368.6 368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25 368.26 368.27 368.28 368.29 368.30 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10 370.11 370.12 370.13 370.14 370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28 370.29 370.30 371.1 371.2 371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27 371.28 371.29 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10
372.11 372.12
372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17 373.18 373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31
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
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
376.25 376.26 376.27 376.28 376.29 376.30 376.31 377.1 377.2 377.3 377.4 377.5 377.6
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
377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 377.32 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16 378.17
378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 378.29 378.30 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11
379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29
380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21
380.22 380.23 380.24 380.25 380.26 380.27 380.28 380.29 380.30 380.31 380.32 380.33 380.34 381.1 381.2 381.3 381.4 381.5
381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17
381.18 381.19 381.20 381.21 381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29
382.1 382.2 382.3 382.4 382.5 382.6 382.7 382.8 382.9 382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19 382.20 382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 382.31 382.32 382.33 382.34 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10 383.11 383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24 383.25 383.26 383.27 383.28 383.29 383.30 383.31 383.32 383.33 383.34 384.1 384.2 384.3 384.4 384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17 384.18 384.19 384.20 384.21 384.22 384.23 384.24 384.25 384.26 384.27 384.28 384.29 384.30 384.31 384.32 384.33 384.34 385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19 385.20 385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 385.31
385.32 385.33 385.34 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24 386.25 386.26 386.27 386.28 386.29
386.30 386.31 386.32 387.1 387.2 387.3 387.4 387.5
387.6 387.7 387.8 387.9 387.10 387.11 387.12 387.13 387.14 387.15 387.16 387.17 387.18 387.19 387.20 387.21
387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 387.32 387.33 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12 388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 388.32 388.33 388.34 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9
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
390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14 390.15 390.16 390.17 390.18 390.19 390.20 390.21 390.22 390.23 390.24 390.25 390.26 390.27 390.28 390.29 390.30 391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28
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
392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 392.31 392.32 392.33 393.1 393.2 393.3
393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14 393.15 393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23 393.24 393.25 393.26 393.27 393.28 393.29 393.30 393.31 393.32 393.33 394.1 394.2 394.3 394.4 394.5 394.6 394.7
394.8 394.9 394.10 394.11 394.12
394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 395.1 395.2 395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12 395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28
395.29 395.30 395.31 395.32 395.33 396.1 396.2 396.3 396.4 396.5 396.6
396.7 396.8 396.9 396.10 396.11 396.12 396.13
396.14 396.15 396.16 396.17 396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28 396.29
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
398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16 398.17 398.18 398.19 398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27 398.28 398.29 398.30 398.31 399.1 399.2 399.3 399.4 399.5 399.6 399.7 399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25 399.26 399.27 399.28 399.29 400.1 400.2 400.3 400.4 400.5 400.6 400.7 400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22 400.23 400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 401.1 401.2 401.3 401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16 401.17 401.18 401.19
401.20 401.21 401.22 401.23 401.24
401.25 401.26
401.27 401.28 401.29 401.30 401.31 401.32 401.33 402.1 402.2 402.3 402.4 402.5 402.6
402.7 402.8 402.9 402.10 402.11 402.12 402.13 402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25 402.26 402.27 402.28 402.29 402.30 402.31 402.32 402.33 403.1 403.2 403.3 403.4
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
403.20 403.21 403.22 403.23 403.24 403.25 403.26 403.27 403.28 403.29 403.30 403.31 404.1 404.2 404.3 404.4 404.5 404.6 404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14 404.15 404.16 404.17 404.18 404.19 404.20 404.21 404.22 404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 404.32 404.33 404.34 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12 405.13 405.14 405.15 405.16
405.17
405.18 405.19 405.20 405.21 405.22 405.23 405.24 405.25 405.26 405.27 405.28 405.29 405.30 405.31 405.32 405.33 405.34 406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11
406.12
406.13 406.14 406.15 406.16 406.17 406.18 406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29 406.30 406.31
406.32
407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8 407.9 407.10 407.11 407.12 407.13 407.14 407.15 407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27 407.28 407.29 407.30 407.31 407.32 407.33 407.34 407.35 407.36 408.1 408.2 408.3 408.4 408.5
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
409.24 409.25 409.26 409.27 409.28 409.29 409.30 409.31 410.1 410.2 410.3 410.4
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
411.1
411.2 411.3 411.4 411.5 411.6 411.7 411.8 411.9 411.10 411.11 411.12 411.13 411.14 411.15 411.16
411.17
411.18 411.19
411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28 411.29 411.30 411.31 412.1 412.2 412.3 412.4 412.5 412.6 412.7
412.8 412.9 412.10 412.11 412.12 412.13 412.14 412.15 412.16 412.17 412.18 412.19 412.20 412.21 412.22 412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 412.31 412.32 413.1 413.2 413.3 413.4 413.5 413.6 413.7 413.8 413.9 413.10 413.11 413.12 413.13 413.14 413.15 413.16 413.17 413.18 413.19 413.20 413.21 413.22 413.23 413.24 413.25
413.26 413.27 413.28 413.29 413.30 414.1 414.2 414.3 414.4 414.5 414.6 414.7 414.8
414.9 414.10 414.11 414.12 414.13 414.14 414.15 414.16 414.17 414.18 414.19 414.20 414.21
414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29 414.30 414.31 415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8 415.9 415.10 415.11 415.12 415.13 415.14 415.15 415.16 415.17 415.18 415.19 415.20 415.21 415.22 415.23 415.24 415.25 415.26 415.27
415.28 415.29 415.30 415.31 416.1 416.2 416.3 416.4 416.5 416.6 416.7 416.8 416.9 416.10 416.11 416.12 416.13 416.14 416.15 416.16 416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24 416.25 416.26 416.27 416.28 416.29 416.30 416.31 417.1 417.2 417.3 417.4 417.5 417.6 417.7 417.8 417.9 417.10 417.11 417.12 417.13 417.14 417.15
417.16 417.17 417.18 417.19 417.20 417.21 417.22 417.23 417.24
417.25 417.26 417.27 417.28 417.29 417.30 418.1 418.2 418.3 418.4 418.5 418.6 418.7 418.8 418.9 418.10
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
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
421.21 421.22 421.23 421.24 421.25 421.26 421.27 421.28 421.29 421.30 421.31 421.32 421.33 422.1 422.2 422.3 422.4 422.5 422.6
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
422.24 422.25 422.26 422.27 422.28 422.29 422.30 423.1 423.2 423.3 423.4 423.5 423.6 423.7 423.8 423.9 423.10 423.11 423.12 423.13 423.14 423.15 423.16 423.17
423.18 423.19 423.20 423.21 423.22 423.23 423.24 423.25 423.26 423.27 423.28 423.29 423.30 423.31 423.32 424.1 424.2 424.3 424.4 424.5 424.6 424.7 424.8 424.9 424.10 424.11 424.12
424.13 424.14 424.15 424.16 424.17 424.18 424.19 424.20 424.21 424.22 424.23 424.24 424.25 424.26 424.27 424.28 424.29 424.30 424.31 424.32 425.1 425.2 425.3 425.4 425.5
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
427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 427.32 428.1 428.2 428.3 428.4 428.5 428.6 428.7 428.8 428.9 428.10 428.11 428.12 428.13 428.14
428.15 428.16 428.17 428.18 428.19 428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 428.30 429.1 429.2 429.3 429.4 429.5 429.6 429.7 429.8 429.9 429.10 429.11 429.12 429.13 429.14 429.15 429.16 429.17 429.18
429.19 429.20 429.21 429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30
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
430.23 430.24 430.25 430.26 430.27 430.28 430.29 430.30 430.31 430.32 431.1 431.2 431.3 431.4
431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17
431.18 431.19 431.20 431.21 431.22 431.23 431.24 431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11 432.12 432.13
432.14 432.15 432.16 432.17 432.18
432.19 432.20
432.21 432.22 432.23
432.24 432.25 432.26 432.27 432.28 432.29 432.30 432.31 433.1 433.2 433.3 433.4 433.5 433.6 433.7 433.8 433.9 433.10 433.11 433.12 433.13 433.14 433.15 433.16 433.17 433.18 433.19 433.20 433.21 433.22 433.23 433.24 433.25 433.26 433.27 433.28 433.29 433.30 433.31 434.1 434.2 434.3 434.4
434.5 434.6 434.7 434.8 434.9 434.10 434.11 434.12 434.13 434.14 434.15 434.16 434.17 434.18 434.19 434.20 434.21 434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29 434.30 434.31 435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8 435.9 435.10 435.11 435.12
435.13 435.14 435.15 435.16 435.17 435.18 435.19 435.20 435.21 435.22 435.23 435.24 435.25 435.26
435.27 435.28 435.29 435.30 435.31 435.32 436.1 436.2 436.3 436.4 436.5 436.6 436.7 436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21 436.22 436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 436.31 437.1 437.2 437.3 437.4 437.5 437.6
437.7 437.8 437.9 437.10 437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19 437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27 437.28 437.29 437.30 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16 438.17 438.18 438.19 438.20
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
440.16 440.17 440.18 440.19 440.20 440.21 440.22 440.23 440.24 440.25 440.26 440.27 440.28 440.29 440.30 440.31 440.32 441.1 441.2
441.3 441.4 441.5 441.6 441.7 441.8 441.9 441.10 441.11 441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19 441.20 441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 441.31 441.32 441.33 441.34
442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9 442.10 442.11 442.12 442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24 442.25 442.26 442.27 442.28 442.29 442.30 442.31 442.32 443.1 443.2 443.3 443.4 443.5 443.6 443.7 443.8 443.9 443.10 443.11 443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19 443.20 443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28 443.29 443.30 443.31 443.32 443.33 444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12
444.13 444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26 444.27 444.28 444.29 444.30 444.31 445.1 445.2 445.3 445.4 445.5 445.6 445.7 445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16 445.17 445.18 445.19 445.20 445.21 445.22 445.23 445.24 445.25 445.26 445.27 445.28 445.29 445.30 445.31 445.32 445.33 446.1 446.2 446.3 446.4 446.5 446.6
446.7 446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16
447.17 447.18 447.19 447.20 447.21 447.22 447.23 447.24 447.25 447.26 447.27 447.28 447.29 447.30 447.31 448.1 448.2 448.3 448.4 448.5 448.6 448.7 448.8 448.9 448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21 448.22
448.23 448.24 448.25 448.26 448.27 448.28 448.29
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
451.10 451.11 451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30 451.31 452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13 452.14 452.15 452.16 452.17 452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28 452.29 452.30 453.1 453.2 453.3 453.4 453.5 453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 453.31 454.1 454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 454.31 454.32 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 455.32 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8 456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19
456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 456.31 456.32 457.1 457.2 457.3 457.4 457.5 457.6 457.7 457.8 457.9 457.10 457.11 457.12
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
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

A bill for an act
relating to state government; modifying provisions governing the Department of
Health, health care, health-related licensing boards, health insurance, community
supports, behavioral health, continuing care for older adults, child and vulnerable
adult protection, economic assistance, direct care and treatment, preventing
homelessness, human services licensing and operations, the Minnesota Rare Disease
Advisory Council, nonintoxicating hemp regulation, organ donation regulation,
mandated reports, and long-term care consultation services; making forecast
adjustments; requiring reports; appropriating money; amending Minnesota Statutes
2020, sections 13.46, subdivision 7; 34A.01, subdivision 4; 62J.2930, subdivision
3; 62J.692, subdivision 5; 62Q.37, subdivision 7; 137.68; 144.057, subdivision 1;
144.0724, subdivision 11; 144.1201, subdivisions 2, 4; 144.1503; 144.1911,
subdivision 4; 144.193; 144.292, subdivision 6; 144.294, subdivision 2; 144.4199,
subdivision 8; 144.497; 144.565, subdivision 4; 144.6502, subdivision 1; 144A.01;
144A.03, subdivision 1; 144A.04, subdivisions 4, 6; 144A.06; 144A.10, subdivision
17; 144A.351, subdivision 1; 144A.4799, subdivisions 1, 3; 144A.483, subdivision
1; 144A.75, subdivision 12; 144G.08, by adding a subdivision; 144G.15; 144G.17;
144G.19, by adding a subdivision; 144G.20, subdivisions 1, 4, 5, 8, 9, 12, 15;
144G.30, subdivision 5; 144G.31, subdivisions 4, 8; 144G.41, subdivisions 7, 8;
144G.42, subdivision 10; 144G.45, subdivision 7; 144G.50, subdivision 2; 144G.52,
subdivisions 2, 8, 9; 144G.53; 144G.55, subdivisions 1, 3; 144G.56, subdivisions
3, 5; 144G.57, subdivisions 1, 3, 5; 144G.70, subdivisions 2, 4; 144G.80,
subdivision 2; 144G.90, subdivision 1, by adding a subdivision; 144G.91,
subdivisions 13, 21; 144G.92, subdivision 1; 144G.93; 144G.95; 145.4134; 145.928,
subdivision 13; 148B.33, by adding a subdivision; 148E.100, subdivision 3;
148E.105, subdivision 3, as amended; 148E.106, subdivision 3; 148E.110,
subdivision 7; 150A.06, subdivisions 1c, 2c, 6, by adding a subdivision; 150A.09;
150A.091, subdivisions 2, 5, 8, 9, by adding subdivisions; 150A.10, subdivision
1a; 150A.105, subdivision 8; 151.01, subdivision 27; 151.72, subdivisions 1, 2,
3, 4, 6, by adding a subdivision; 152.02, subdivision 2; 152.125; 153.16, subdivision
1; 242.19, subdivision 2; 245.462, subdivision 4; 245.4661, subdivision 10;
245.4889, subdivision 3, by adding a subdivision; 245.713, subdivision 2; 245A.02,
subdivision 5a; 245A.11, subdivisions 2, 2a, by adding a subdivision; 245A.14,
subdivision 14; 245A.1443; 245C.31, subdivisions 1, 2, by adding subdivisions;
245D.10, subdivision 3a; 245D.12; 245F.15, subdivision 1; 245F.16, subdivision
1; 245G.01, subdivisions 4, 17, by adding a subdivision; 245G.06, subdivision 3,
by adding subdivisions; 245G.07, by adding a subdivision; 245G.08, subdivision
5; 245G.09, subdivision 3; 245G.11, subdivisions 1, 10; 245G.12; 245G.13,
subdivision 1; 245G.20; 245G.22, subdivision 7; 253B.18, subdivision 6; 256.01,
subdivision 29; 256.021, subdivision 3; 256.042, subdivision 5, as amended;
256.045, subdivision 3; 256.9657, subdivision 8; 256.975, subdivisions 7a, 7b, 7c,
7d, 11, 12; 256B.051, subdivision 4; 256B.055, subdivision 2; 256B.056,
subdivisions 3b, 3c, 11; 256B.0561, subdivision 4; 256B.0595, subdivision 1;
256B.0625, subdivision 64; 256B.0646; 256B.0659, subdivisions 3a, 19;
256B.0911, subdivisions 1, 3c, 3d, 3e, 5, by adding subdivisions; 256B.0913,
subdivision 4; 256B.092, subdivisions 1a, 1b; 256B.0922, subdivision 1;
256B.0941, by adding a subdivision; 256B.0949, subdivisions 8, 17; 256B.49,
subdivisions 12, 13; 256B.493, subdivision 2; 256B.69, subdivision 9d; 256B.77,
subdivision 13; 256D.0515; 256E.28, subdivision 6; 256E.33, subdivisions 1, 2;
256E.36, subdivision 1; 256G.02, subdivision 6; 256I.03, subdivision 6; 256K.26,
subdivisions 2, 6, 7; 256K.45, subdivision 6, by adding a subdivision; 256P.04,
subdivision 11; 256Q.06, by adding a subdivision; 256R.02, subdivisions 4, 17,
18, 22, 29, 42a, 48a, by adding subdivisions; 256R.07, subdivisions 1, 2, 3;
256R.08, subdivision 1; 256R.09, subdivisions 2, 5; 256R.10, by adding a
subdivision; 256R.13, subdivision 4; 256R.16, subdivision 1; 256R.17, subdivision
3; 256R.18; 256R.26, subdivision 1; 256R.261, subdivision 13; 256R.37; 256R.39;
256S.02, subdivisions 15, 20; 256S.06, subdivisions 1, 2; 256S.10, subdivision 2;
257.0725; 260.012; 260.775; 260B.331, subdivision 1; 260C.001, subdivision 3;
260C.007, subdivision 27; 260C.151, subdivision 6; 260C.152, subdivision 5;
260C.175, subdivision 2; 260C.176, subdivision 2; 260C.178, subdivision 1;
260C.181, subdivision 2; 260C.193, subdivision 3; 260C.201, subdivisions 1, 2;
260C.202; 260C.203; 260C.204; 260C.212, subdivision 4a; 260C.221; 260C.331,
subdivision 1; 260C.513; 260C.607, subdivisions 2, 5; 260C.613, subdivisions 1,
5; 260E.22, subdivision 2; 260E.24, subdivisions 2, 6; 260E.38, subdivision 3;
268.19, subdivision 1; 477A.0126, subdivision 7, by adding a subdivision; 518.17,
subdivision 1; 518A.43, subdivision 1; 518A.77; 626.557, subdivisions 4, 9, 9b,
9c, 9d, 10, 10b, 12b; 626.5571, subdivisions 1, 2; 626.5572, subdivisions 2, 4, 17;
Minnesota Statutes 2021 Supplement, sections 62A.673, subdivision 2; 144.0724,
subdivisions 4, 12, as amended; 144.551, subdivision 1; 148B.5301, subdivision
2; 148F.11, subdivision 1; 151.72, subdivision 5; 245.467, subdivisions 2, 3;
245.4871, subdivision 21; 245.4876, subdivisions 2, 3; 245.4889, subdivision 1;
245.735, subdivision 3; 245A.03, subdivision 7; 245A.14, subdivision 4; 245C.03,
subdivision 5a; 245I.02, subdivisions 19, 36; 245I.03, subdivisions 5, 9; 245I.04,
subdivision 4; 245I.05, subdivision 3; 245I.08, subdivision 4; 245I.09, subdivision
2; 245I.10, subdivisions 2, 6; 245I.20, subdivision 5; 245I.23, subdivision 22;
254B.05, subdivision 5; 256.01, subdivision 42; 256.042, subdivision 4, as
amended; 256B.0371, subdivision 4, as amended; 256B.0622, subdivision 2;
256B.0625, subdivisions 3b, 5m; 256B.0638, subdivision 5; 256B.0671, subdivision
6; 256B.0911, subdivision 3a; 256B.0943, subdivisions 1, 3, 4, 6, 7, 9, 11;
256B.0946, subdivision 1; 256B.0947, subdivisions 2, 3, 5, 6; 256B.0949,
subdivisions 2, 13; 256B.49, subdivision 14; 256B.69, subdivision 9f; 256B.85,
subdivisions 2, 5; 256P.01, subdivision 6a; 256P.06, subdivision 3; 256S.05,
subdivision 2; 256S.205; 260C.212, subdivisions 1, 2; 260C.605, subdivision 1;
260C.607, subdivision 6; 260E.20, subdivision 2; 363A.50; Laws 2009, chapter
79, article 13, section 3, subdivision 10, as amended; Laws 2020, First Special
Session chapter 7, section 1, subdivisions 1, as amended, 5, as amended; Laws
2021, First Special Session chapter 7, article 10, sections 1; 3; article 11, section
38; article 16, sections 2, subdivisions 23, 24, 29, 31, 32, 33; 3, subdivision 2; 5;
article 17, sections 1, subdivision 2; 3; 6; 10; 11; 12; 17, subdivision 3; 19; Laws
2021, First Special Session chapter 8, article 6, section 1, subdivision 7; proposing
coding for new law in Minnesota Statutes, chapters 4; 144A; 145; 245A; 256B;
626; repealing Minnesota Statutes 2020, sections 62U.10, subdivision 3; 144.1911,
subdivision 10; 144.564, subdivision 3; 144A.483, subdivision 2; 150A.091,
subdivisions 3, 15, 17; 245.981; 245A.03, subdivision 5; 245F.15, subdivision 2;
245G.11, subdivision 2; 246.0136; 246.131; 246B.03, subdivision 2; 246B.035;
252.025, subdivision 7; 252.035; 254A.04; 254A.21; 254B.14, subdivisions 1, 2,
3, 4, 6; 256.01, subdivision 31; 256B.057, subdivision 7; 256B.0638, subdivision
7; 256B.0911, subdivisions 2b, 2c, 3, 3b, 3g, 4d, 4e, 5, 6; 256B.0943, subdivision
8a; 256B.69, subdivision 20; 256D.055; 256R.08, subdivision 2; 501C.0408,
subdivision 4; 501C.1206; Minnesota Statutes 2021 Supplement, sections 144G.07,
subdivision 6; 254B.14, subdivision 5; 256B.0911, subdivisions 1a, 3a, 3f; Laws
1998, chapter 382, article 1, section 23; Minnesota Rules, parts 2960.0460, subpart
2; 9530.6565, subpart 2; 9555.6255.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

ARTICLE 1

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2020, section 144.057, subdivision 1, is amended to read:


Subdivision 1.

Background studies required.

new text begin(a) Except as specified in paragraph (b),
new text end the commissioner of health shall contract with the commissioner of human services to
conduct background studies of:

(1) individuals providing services that have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;

(2) individuals specified in section 245C.03, subdivision 1, who perform direct contact
services in a nursing home or a home care agency licensed under chapter 144A; an assisted
living facility or assisted living facility with dementia care licensed under chapter 144G;
or a boarding care home licensed under sections 144.50 to 144.58. If the individual under
study resides outside Minnesota, the study must include a check for substantiated findings
of maltreatment of adults and children in the individual's state of residence when the
information is made available by that state, and must include a check of the National Crime
Information Center database;

(3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact or access to patients or residents receiving services. "Access" means physical access
to a client or the client's personal property without continuous, direct supervision as defined
in section 245C.02, subdivision 8, when the employee's employment responsibilities do not
include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; deleted text beginand
deleted text end

(5) controlling persons of a supplemental nursing services agency, as defined under
section 144A.70deleted text begin.deleted text endnew text begin; and
new text end

new text begin (6) license applicants, owners, managerial officials, and controlling individuals who are
required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
background study under chapter 245C, regardless of the licensure status of the license
applicant, owner, managerial official, or controlling individual.
new text end

new text begin (b) The commissioner of human services shall not conduct a background study on any
individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license
issued by a health-related licensing board as defined in section 214.01, subdivision 2, and
has completed the criminal background check as required in section 214.075. An entity that
is affiliated with individuals who meet the requirements of this paragraph must separate
those individuals from the entity's roster for NETStudy 2.0.
new text end

new text begin (c) new text endIf a facility or program is licensed by the Department of Human Services and subject
to the background study provisions of chapter 245C and is also licensed by the Department
of Health, the Department of Human Services is solely responsible for the background
studies of individuals in the jointly licensed programs.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2021 Supplement, section 144.0724, subdivision 4, is amended
to read:


Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and electronically
submit to the federal database MDS assessments that conform with the assessment schedule
defined by the Long Term Care Facility Resident Assessment Instrument User's Manual,
version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The
commissioner of health may substitute successor manuals or question and answer documents
published by the United States Department of Health and Human Services, Centers for
Medicare and Medicaid Services, to replace or supplement the current version of the manual
or document.

(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987
(OBRA) used to determine a case mix classification for reimbursement include deleted text beginthe followingdeleted text end:

(1) a new admission comprehensive assessment, which must have an assessment reference
date (ARD) within 14 calendar days after admission, excluding readmissions;

(2) an annual comprehensive assessment, which must have an ARD within 92 days of
a previous quarterly review assessment or a previous comprehensive assessment, which
must occur at least once every 366 days;

(3) a significant change in status comprehensive assessment, which must have an ARD
within 14 days after the facility determines, or should have determined, that there has been
a significant change in the resident's physical or mental condition, whether an improvement
or a decline, and regardless of the amount of time since the last comprehensive assessment
or quarterly review assessment;

(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the
previous quarterly review assessment or a previous comprehensive assessment;

(5) any significant correction to a prior comprehensive assessment, if the assessment
being corrected is the current one being used for RUG classification;

(6) any significant correction to a prior quarterly review assessment, if the assessment
being corrected is the current one being used for RUG classification;

(7) a required significant change in status assessment when:

(i) all speech, occupational, and physical therapies have ended. new text beginIf the most recent OBRA
comprehensive or quarterly assessment completed does not result in a rehabilitation case
mix classification, then the significant change in status assessment is not required.
new text endThe ARD
of this assessment must be set on day eight after all therapy services have ended; and

(ii) isolation for an infectious disease has ended. new text beginIf isolation was not coded on the most
recent OBRA comprehensive or quarterly assessment completed, then the significant change
in status assessment is not required.
new text endThe ARD of this assessment must be set on day 15 after
isolation has ended; and

(8) any modifications to the most recent assessments under clauses (1) to (7).

(c) In addition to the assessments listed in paragraph (b), the assessments used to
determine nursing facility level of care include the following:

(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
the Senior LinkAge Line or other organization under contract with the Minnesota Board on
Aging; and

(2) a nursing facility level of care determination as provided for under section 256B.0911,
subdivision 4e
, as part of a face-to-face long-term care consultation assessment completed
under section 256B.0911, by a county, tribe, or managed care organization under contract
with the Department of Human Services.

Sec. 3.

Minnesota Statutes 2020, section 144.1201, subdivision 2, is amended to read:


Subd. 2.

deleted text beginBy-product nucleardeleted text endnew text begin Byproductnew text end material.

"deleted text beginBy-product nucleardeleted text endnew text begin Byproductnew text end
material" means deleted text begina radioactive material, other than special nuclear material, yielded in or
made radioactive by exposure to radiation created incident to the process of producing or
utilizing special nuclear material.
deleted text endnew text begin:
new text end

new text begin (1) any radioactive material, except special nuclear material, yielded in or made
radioactive by exposure to the radiation incident to the process of producing or using special
nuclear material;
new text end

new text begin (2) the tailings or wastes produced by the extraction or concentration of uranium or
thorium from ore processed primarily for its source material content, including discrete
surface wastes resulting from uranium solution extraction processes. Underground ore
bodies depleted by these solution extraction operations do not constitute byproduct material
within this definition;
new text end

new text begin (3) any discrete source of radium-226 that is produced, extracted, or converted after
extraction for commercial, medical, or research activity, or any material that:
new text end

new text begin (i) has been made radioactive by use of a particle accelerator; and
new text end

new text begin (ii) is produced, extracted, or converted after extraction for commercial, medical, or
research activity; and
new text end

new text begin (4) any discrete source of naturally occurring radioactive material, other than source
nuclear material, that:
new text end

new text begin (i) the United States Nuclear Regulatory Commission, in consultation with the
Administrator of the Environmental Protection Agency, the Secretary of Energy, the Secretary
of Homeland Security, and the head of any other appropriate federal agency determines
would pose a threat similar to the threat posed by a discrete source of radium-226 to the
public health and safety or the common defense and security; and
new text end

new text begin (ii) is extracted or converted after extraction for use in a commercial, medical, or research
activity.
new text end

Sec. 4.

Minnesota Statutes 2020, section 144.1201, subdivision 4, is amended to read:


Subd. 4.

Radioactive material.

"Radioactive material" means a matter that emits
radiation. Radioactive material includes special nuclear material, source nuclear material,
and deleted text beginby-product nucleardeleted text endnew text begin byproductnew text end material.

Sec. 5.

Minnesota Statutes 2020, section 144.1503, is amended to read:


144.1503 HOME AND COMMUNITY-BASED SERVICES EMPLOYEE
SCHOLARSHIP new text beginAND LOAN FORGIVENESS new text endPROGRAM.

Subdivision 1.

Creation.

The home and community-based services employee scholarship
grant new text beginand loan forgiveness new text endprogram is established for the deleted text beginpurposedeleted text endnew text begin purposesnew text end of assisting
qualified provider applicants to fund employee scholarships for education in nursing and
other health care fieldsnew text begin; funding scholarships to individual home and community-based
services workers for education in nursing and other health care fields; and repaying qualified
educational loans secured by employees for education in nursing or other health care fields
new text end.

new text begin Subd. 1a. new text end

new text begin Definition. new text end

new text begin For purposes of this section, "qualified educational loan" means
a government, commercial, or foundation loan secured by an employee of a qualified provider
of home and community-based services for older adults for actual costs paid for tuition,
reasonable education expenses, and reasonable living expenses related to the employee's
graduate or undergraduate education.
new text end

Subd. 2.

Provision of grantsnew text begin; scholarships; loan forgivenessnew text end.

new text begin(a) new text endThe commissioner
shall make grants available to qualified providers of deleted text beginolder adultdeleted text endnew text begin home and community-basednew text end
servicesnew text begin for older adultsnew text end. Grants must be used by home and community-based service
providers to recruit and train staff through the establishment of an employee scholarship
fund.

new text begin (b) The commissioner may provide scholarships for qualified educational expenses to
individual home and community-based services workers who are employed in the home
and community-based services field.
new text end

new text begin (c) The commissioner may use up to one-third of the annual funding available for this
section to establish a loan forgiveness program for eligible home and community-based
services workers who provide home and community-based services to older adults and for
whom an eligible provider employer submits their names to the commissioner for
consideration. To the extent possible, the loan forgiveness program must meet the standards
of the loan forgiveness program in section 144.1501.
new text end

Subd. 3.

Eligibility.

(a) Eligible providers must primarily provide services to individuals
who are 65 years of age and older in home and community-based settings, including deleted text beginhousing
with services establishments as defined in section 144D.01, subdivision 4
deleted text endnew text begin assisted living
facilities as defined in section 144G.08, subdivision 7
new text end; adult day care as defined in section
245A.02, subdivision 2a; and home care services as defined in section 144A.43, subdivision
3
.

(b) new text beginUnder the scholarship program, new text endqualifying providers must establish a home and
community-based services employee scholarship program, as specified in subdivision 4.
Providers that receive funding under this section must use the funds to new text beginprovide educational
programs or
new text endaward scholarships to employees whonew text begin: (1) are enrolled in a course of study
that leads to career advancement with the provider or in the field of long-term care, including
home care, care of persons with disabilities, nursing, or as a licensed assisted living director;
and (2)
new text end work an average of at least deleted text begin16deleted text endnew text begin tennew text end hours per week for the provider.new text begin Employees who
receive a scholarship under this section must use the scholarship funds for eligible costs of
enrolling in a course of study that leads to career advancement in the facility or in the field
of long-term care, including home care, care of persons with disabilities, nursing, or as a
licensed assisted living director.
new text end

new text begin (c) Under the loan forgiveness program, qualifying providers that provide employee
names to the commissioner for consideration must be located in Minnesota. If necessary
due to the volume of applications for loan forgiveness, the commissioner, in collaboration
with home and community-based services stakeholders, shall determine priority areas for
loan forgiveness. Employees eligible for loan forgiveness include employees working as a
licensed assisted living director. Employees selected to receive loan forgiveness must agree
to work a minimum average of 32 hours per week for a minimum of two years for a
qualifying provider organization in order to maintain eligibility for loan forgiveness under
this section.
new text end

Subd. 4.

deleted text beginHome and community-based services employee scholarship programdeleted text endnew text begin Duties
of participating qualifying providers
new text end.

new text begin(a) new text endEach qualifying provider under this section must
propose a home and community-based services employee scholarship programnew text begin, propose to
provide contracted programming from a qualified educational institution, or submit employee
names for consideration for participation in the loan forgiveness program
new text end.

new text begin (b) For the scholarship program,new text end providers must establish criteria by which funds are to
be distributed among employees. At a minimum, the scholarship program must cover
employee costs related to a course of study that is expected to lead to career advancement
with the provider or in the field of long-term care, including home care, care of persons
with disabilities, deleted text beginordeleted text end nursingnew text begin, or as a licensed assisted living directornew text end.

Subd. 5.

deleted text beginParticipating providersdeleted text endnew text begin Request for proposalsnew text end.

The commissioner shall
publish a request for proposals in the State Register, specifying new text beginqualifying new text endprovider eligibility
requirements, criteria for a qualifying employee scholarship program, provider selection
criteria, documentation required for program participation, maximum award amount, and
methods of evaluation. The commissioner must publish additional requests for proposals
each year in which funding is available for this purpose.

Subd. 6.

Application requirements.

new text begin(a) new text endEligible providers seeking a grant new text beginto provide
scholarships and educational programming and eligible employees seeking a scholarship
new text end shall submit an application to the commissioner. Applications new text beginfrom eligible providers new text endmust
contain a complete description of the employee scholarship program being proposed by the
applicant, including the need for the organization to enhance the education of its workforce,
the process for determining which employees will be eligible for scholarships, any other
sources of funding for scholarships, the expected degrees or credentials eligible for
scholarships, the amount of funding sought for the scholarship program, a proposed budget
detailing how funds will be spent, and plans for retaining eligible employees after completion
of their scholarship.

new text begin (b) Eligible providers seeking loan forgiveness for employees shall submit to the
commissioner the names of their employees to be considered for loan forgiveness. An
employee whose name has been submitted to the commissioner and who wishes to apply
for loan forgiveness must submit an application to the commissioner. The employee is
responsible for securing the employee's qualified educational loans. The commissioner shall
select employees for participation based on their suitability for practice as indicated by
experience or training. The commissioner shall give preference to employees close to
completing their training. For each year that an employee meets the service obligation
required under subdivision 3, up to a maximum of four years, the commissioner shall make
annual disbursements directly to the employee equivalent to 15 percent of the average
educational debt for indebted graduates in their profession in the year closest to the
employee's selection for which information is available, not to exceed the balance of the
employee's qualified educational loans. Before receiving loan repayment disbursements
and as requested, the employee must complete and return to the commissioner a confirmation
of practice form provided by the commissioner verifying that the employee is practicing as
required under subdivision 3. The employee must provide the commissioner with verification
that the full amount of loan repayment disbursement received by the employee has been
applied toward the designated loans. After each disbursement, verification must be received
by the commissioner and approved before the next loan repayment disbursement is made.
Employees who move to a different eligible provider remain eligible for loan repayment as
long as they practice as required in subdivision 3. If an employee does not fulfill the required
minimum service commitment according to subdivision 3, the commissioner shall collect
from the employee the total amount paid to the employee under the loan forgiveness program,
plus interest at a rate established according to section 270C.40. The commissioner shall
deposit the money collected in an account in the special revenue fund and money in that
account is annually appropriated to the commissioner for purposes of this section. The
commissioner may allow waivers of all or part of the money owed to the commissioner as
a result of a nonfulfillment penalty if emergency circumstances prevented fulfillment of the
minimum service commitment.
new text end

Subd. 7.

Selection process.

The commissioner shall determine a maximum award for
grants new text beginand loan forgiveness, new text endand new text beginshall new text endmake deleted text begingrantdeleted text end selections based on the information
provided in the grant application, including the demonstrated need for an applicant provider
to enhance the education of its workforce, the proposed employee scholarship new text beginor loan
forgiveness
new text endselection process, the applicant's proposed budget, and other criteria as
determined by the commissioner. Notwithstanding any law or rule to the contrary, deleted text beginfunds
awarded to grantees in a grant agreement do not lapse until the grant agreement expires
deleted text endnew text begin
amounts appropriated for purposes of this section do not cancel and are available until
expended, except that at the end of each biennium, any remaining amount that is not
committed by contract and not needed to fulfill existing commitments shall cancel to the
general fund
new text end.

Subd. 8.

Reporting requirements.

new text begin(a) new text endParticipating providers new text beginwho receive a grant for
employee scholarships
new text endshall submit an invoice for reimbursement and a report to the
commissioner on a schedule determined by the commissioner and on a form supplied by
the commissioner. The report shall include the amount spent on scholarships; the number
of employees who received scholarships; and, for each scholarship recipient, the name of
the recipient, the current position of the recipient, the amount awarded, the educational
institution attended, the nature of the educational program, and the expected or actual
program completion date. During the grant period, the commissioner may require and collect
from grant recipients other information necessary to evaluate the program.

new text begin (b) Employees who receive scholarships from the commissioner shall report information
to the commissioner on a schedule determined by the commissioner and on a form supplied
by the commissioner.
new text end

new text begin (c) Participating providers whose employees receive loan forgiveness shall submit a
report to the commissioner on a schedule determined by the commissioner and on a form
supplied by the commissioner. The report must include the number of employees receiving
loan forgiveness, and for each employee receiving loan forgiveness, the employee's name,
current position, and average number of hours worked per week. During the loan forgiveness
period, the commissioner may require and collect from participating providers and employees
receiving loan forgiveness other information necessary to evaluate the program and ensure
ongoing eligibility.
new text end

Sec. 6.

Minnesota Statutes 2020, section 144.1911, subdivision 4, is amended to read:


Subd. 4.

Career guidance and support services.

deleted text begin(a)deleted text end The commissioner shall award
grants to eligible nonprofit organizations new text beginand eligible postsecondary educational institutions,
including the University of Minnesota,
new text endto provide career guidance and support services to
immigrant international medical graduates seeking to enter the Minnesota health workforce.
Eligible grant activities include the following:

(1) educational and career navigation, including information on training and licensing
requirements for physician and nonphysician health care professions, and guidance in
determining which pathway is best suited for an individual international medical graduate
based on the graduate's skills, experience, resources, and interests;

(2) support in becoming proficient in medical English;

(3) support in becoming proficient in the use of information technology, including
computer skills and use of electronic health record technology;

(4) support for increasing knowledge of and familiarity with the United States health
care system;

(5) support for other foundational skills identified by the commissioner;

(6) support for immigrant international medical graduates in becoming certified by the
Educational Commission on Foreign Medical Graduates, including help with preparation
for required licensing examinations and financial assistance for fees; and

(7) assistance to international medical graduates in registering with the program's
Minnesota international medical graduate roster.

deleted text begin (b) The commissioner shall award the initial grants under this subdivision by December
31, 2015.
deleted text end

Sec. 7.

Minnesota Statutes 2020, section 144.292, subdivision 6, is amended to read:


Subd. 6.

Cost.

(a) When a patient requests a copy of the patient's record for purposes of
reviewing current medical care, the provider must not charge a fee.

(b) When a provider or its representative makes copies of patient records upon a patient's
request under this section, the provider or its representative may charge the patient or the
patient's representative no more than 75 cents per page, plus $10 for time spent retrieving
and copying the records, unless other law or a rule or contract provide for a lower maximum
charge. This limitation does not apply to x-rays. The provider may charge a patient no more
than the actual cost of reproducing x-rays, plus no more than $10 for the time spent retrieving
and copying the x-rays.

(c) The respective maximum charges of 75 cents per page and $10 for time provided in
this subdivision are in effect for calendar year 1992 and may be adjusted annually each
calendar year as provided in this subdivision. The permissible maximum charges shall
change each year by an amount that reflects the change, as compared to the previous year,
in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
published by the Department of Labor.

(d) A provider or its representative may charge the $10 retrieval fee, but must not charge
a per page fee to provide copies of records requested by a patient or the patient's authorized
representative if the request for copies of records is for purposes of appealing a denial of
Social Security disability income or Social Security disability benefits under title II or title
XVI of the Social Security Act; except that no fee shall be charged to a deleted text beginpersondeleted text endnew text begin patientnew text end who
is receiving public assistance, new text beginor to a patient new text endwho is represented by an attorney on behalf
of a civil legal services program or a volunteer attorney program based on indigency. For
the purpose of further appeals, a patient may receive no more than two medical record
updates without charge, but only for medical record information previously not provided.
For purposes of this paragraph, a patient's authorized representative does not include units
of state government engaged in the adjudication of Social Security disability claims.

Sec. 8.

Minnesota Statutes 2020, section 144.497, is amended to read:


144.497 ST ELEVATION MYOCARDIAL INFARCTION.

The commissioner of health shall assess and report on the quality of care provided in
the state for ST elevation myocardial infarction response and treatment. The commissioner
shall:

(1) utilize and analyze data provided by ST elevation myocardial infarction receiving
centers to the ACTION Registry-Get with the guidelines or an equivalent data platform that
does not identify individuals or associate specific ST elevation myocardial infarction heart
attack events with an identifiable individual;

(2) deleted text beginquarterlydeleted text endnew text begin annuallynew text end post a summary report of the data in aggregate form on the
Department of Health website;new text begin and
new text end

deleted text begin (3) annually inform the legislative committees with jurisdiction over public health of
progress toward improving the quality of care and patient outcomes for ST elevation
myocardial infarctions; and
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end coordinate to the extent possible with national voluntary health organizations
involved in ST elevation myocardial infarction heart attack quality improvement to encourage
ST elevation myocardial infarction receiving centers to report data consistent with nationally
recognized guidelines on the treatment of individuals with confirmed ST elevation myocardial
infarction heart attacks within the state and encourage sharing of information among health
care providers on ways to improve the quality of care of ST elevation myocardial infarction
patients in Minnesota.

Sec. 9.

Minnesota Statutes 2021 Supplement, section 144.551, subdivision 1, is amended
to read:


Subdivision 1.

Restricted construction or modification.

(a) The following construction
or modification may not be commenced:

(1) any erection, building, alteration, reconstruction, modernization, improvement,
extension, lease, or other acquisition by or on behalf of a hospital that increases the bed
capacity of a hospital, relocates hospital beds from one physical facility, complex, or site
to another, or otherwise results in an increase or redistribution of hospital beds within the
state; and

(2) the establishment of a new hospital.

(b) This section does not apply to:

(1) construction or relocation within a county by a hospital, clinic, or other health care
facility that is a national referral center engaged in substantial programs of patient care,
medical research, and medical education meeting state and national needs that receives more
than 40 percent of its patients from outside the state of Minnesota;

(2) a project for construction or modification for which a health care facility held an
approved certificate of need on May 1, 1984, regardless of the date of expiration of the
certificate;

(3) a project for which a certificate of need was denied before July 1, 1990, if a timely
appeal results in an order reversing the denial;

(4) a project exempted from certificate of need requirements by Laws 1981, chapter 200,
section 2;

(5) a project involving consolidation of pediatric specialty hospital services within the
Minneapolis-St. Paul metropolitan area that would not result in a net increase in the number
of pediatric specialty hospital beds among the hospitals being consolidated;

(6) a project involving the temporary relocation of pediatric-orthopedic hospital beds to
an existing licensed hospital that will allow for the reconstruction of a new philanthropic,
pediatric-orthopedic hospital on an existing site and that will not result in a net increase in
the number of hospital beds. Upon completion of the reconstruction, the licenses of both
hospitals must be reinstated at the capacity that existed on each site before the relocation;

(7) the relocation or redistribution of hospital beds within a hospital building or
identifiable complex of buildings provided the relocation or redistribution does not result
in: (i) an increase in the overall bed capacity at that site; (ii) relocation of hospital beds from
one physical site or complex to another; or (iii) redistribution of hospital beds within the
state or a region of the state;

(8) relocation or redistribution of hospital beds within a hospital corporate system that
involves the transfer of beds from a closed facility site or complex to an existing site or
complex provided that: (i) no more than 50 percent of the capacity of the closed facility is
transferred; (ii) the capacity of the site or complex to which the beds are transferred does
not increase by more than 50 percent; (iii) the beds are not transferred outside of a federal
health systems agency boundary in place on July 1, 1983; (iv) the relocation or redistribution
does not involve the construction of a new hospital building; and (v) the transferred beds
are used first to replace within the hospital corporate system the total number of beds
previously used in the closed facility site or complex for mental health services and substance
use disorder services. Only after the hospital corporate system has fulfilled the requirements
of this item may the remainder of the available capacity of the closed facility site or complex
be transferred for any other purpose;

(9) a construction project involving up to 35 new beds in a psychiatric hospital in Rice
County that primarily serves adolescents and that receives more than 70 percent of its
patients from outside the state of Minnesota;

(10) a project to replace a hospital or hospitals with a combined licensed capacity of
130 beds or less if: (i) the new hospital site is located within five miles of the current site;
and (ii) the total licensed capacity of the replacement hospital, either at the time of
construction of the initial building or as the result of future expansion, will not exceed 70
licensed hospital beds, or the combined licensed capacity of the hospitals, whichever is less;

(11) the relocation of licensed hospital beds from an existing state facility operated by
the commissioner of human services to a new or existing facility, building, or complex
operated by the commissioner of human services; from one regional treatment center site
to another; or from one building or site to a new or existing building or site on the same
campus;

(12) the construction or relocation of hospital beds operated by a hospital having a
statutory obligation to provide hospital and medical services for the indigent that does not
result in a net increase in the number of hospital beds, notwithstanding section 144.552, 27
beds, of which 12 serve mental health needs, may be transferred from Hennepin County
Medical Center to Regions Hospital under this clause;

(13) a construction project involving the addition of up to 31 new beds in an existing
nonfederal hospital in Beltrami County;

(14) a construction project involving the addition of up to eight new beds in an existing
nonfederal hospital in Otter Tail County with 100 licensed acute care beds;

(15) a construction project involving the addition of 20 new hospital beds in an existing
hospital in Carver County serving the southwest suburban metropolitan area;

(16) a project for the construction or relocation of up to 20 hospital beds for the operation
of up to two psychiatric facilities or units for children provided that the operation of the
facilities or units have received the approval of the commissioner of human services;

(17) a project involving the addition of 14 new hospital beds to be used for rehabilitation
services in an existing hospital in Itasca County;

(18) a project to add 20 licensed beds in existing space at a hospital in Hennepin County
that closed 20 rehabilitation beds in 2002, provided that the beds are used only for
rehabilitation in the hospital's current rehabilitation building. If the beds are used for another
purpose or moved to another location, the hospital's licensed capacity is reduced by 20 beds;

(19) a critical access hospital 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
delicensed beds since enactment of the Balanced Budget Act of 1997, Public Law 105-33,
to the extent that the critical access hospital does not seek to exceed the maximum number
of beds permitted such hospital under federal law;

(20) notwithstanding section 144.552, a project for the construction of a new hospital
in the city of Maple Grove with a licensed capacity of up to 300 beds provided that:

(i) the project, including each hospital or health system that will own or control the entity
that will hold the new hospital license, is approved by a resolution of the Maple Grove City
Council as of March 1, 2006;

(ii) the entity that will hold the new hospital license will be owned or controlled by one
or more not-for-profit hospitals or health systems that have previously submitted a plan or
plans for a project in Maple Grove as required under section 144.552, and the plan or plans
have been found to be in the public interest by the commissioner of health as of April 1,
2005;

(iii) the new hospital's initial inpatient services must include, but are not limited to,
medical and surgical services, obstetrical and gynecological services, intensive care services,
orthopedic services, pediatric services, noninvasive cardiac diagnostics, behavioral health
services, and emergency room services;

(iv) the new hospital:

(A) will have the ability to provide and staff sufficient new beds to meet the growing
needs of the Maple Grove service area and the surrounding communities currently being
served by the hospital or health system that will own or control the entity that will hold the
new hospital license;

(B) will provide uncompensated care;

(C) will provide mental health services, including inpatient beds;

(D) will be a site for workforce development for a broad spectrum of health-care-related
occupations and have a commitment to providing clinical training programs for physicians
and other health care providers;

(E) will demonstrate a commitment to quality care and patient safety;

(F) will have an electronic medical records system, including physician order entry;

(G) will provide a broad range of senior services;

(H) will provide emergency medical services that will coordinate care with regional
providers of trauma services and licensed emergency ambulance services in order to enhance
the continuity of care for emergency medical patients; and

(I) will be completed by December 31, 2009, unless delayed by circumstances beyond
the control of the entity holding the new hospital license; and

(v) as of 30 days following submission of a written plan, the commissioner of health
has not determined that the hospitals or health systems that will own or control the entity
that will hold the new hospital license are unable to meet the criteria of this clause;

(21) a project approved under section 144.553;

(22) a project for the construction of a hospital with up to 25 beds in Cass County within
a 20-mile radius of the state Ah-Gwah-Ching facility, provided the hospital's license holder
is approved by the Cass County Board;

(23) a project for an acute care hospital in Fergus Falls that will increase the bed capacity
from 108 to 110 beds by increasing the rehabilitation bed capacity from 14 to 16 and closing
a separately licensed 13-bed skilled nursing facility;

(24) notwithstanding section 144.552, a project for the construction and expansion of a
specialty psychiatric hospital in Hennepin County for up to 50 beds, exclusively for patients
who are under 21 years of age on the date of admission. The commissioner conducted a
public interest review of the mental health needs of Minnesota and the Twin Cities
metropolitan area in 2008. No further public interest review shall be conducted for the
construction or expansion project under this clause;

(25) a project for a 16-bed psychiatric hospital in the city of Thief River Falls, if the
commissioner finds the project is in the public interest after the public interest review
conducted under section 144.552 is complete;

(26)(i) a project for a 20-bed psychiatric hospital, within an existing facility in the city
of Maple Grove, exclusively for patients who are under 21 years of age on the date of
admission, if the commissioner finds the project is in the public interest after the public
interest review conducted under section 144.552 is complete;

(ii) this project shall serve patients in the continuing care benefit program under section
256.9693. The project may also serve patients not in the continuing care benefit program;
and

(iii) if the project ceases to participate in the continuing care benefit program, the
commissioner must complete a subsequent public interest review under section 144.552. If
the project is found not to be in the public interest, the license must be terminated six months
from the date of that finding. If the commissioner of human services terminates the contract
without cause or reduces per diem payment rates for patients under the continuing care
benefit program below the rates in effect for services provided on December 31, 2015, the
project may cease to participate in the continuing care benefit program and continue to
operate without a subsequent public interest review;

(27) a project involving the addition of 21 new beds in an existing psychiatric hospital
in Hennepin County that is exclusively for patients who are under 21 years of age on the
date of admission;

(28) a project to add 55 licensed beds in an existing safety net, level I trauma center
hospital in Ramsey County as designated under section 383A.91, subdivision 5, of which
15 beds are to be used for inpatient mental health and 40 are to be used for other services.
In addition, five unlicensed observation mental health beds shall be added;

(29) upon submission of a plan to the commissioner for public interest review under
section 144.552 and the addition of the 15 inpatient mental health beds specified in clause
(28), to its bed capacity, a project to add 45 licensed beds in an existing safety net, level I
trauma center hospital in Ramsey County as designated under section 383A.91, subdivision
5. Five of the 45 additional beds authorized under this clause must be designated for use
for inpatient mental health and must be added to the hospital's bed capacity before the
remaining 40 beds are added. Notwithstanding section 144.552, the hospital may add licensed
beds under this clause prior to completion of the public interest review, provided the hospital
submits its plan by the 2021 deadline and adheres to the timelines for the public interest
review described in section 144.552; deleted text beginor
deleted text end

(30) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add up to 30 licensed beds in an existing psychiatric hospital
in Hennepin County that exclusively provides care to patients who are under 21 years of
age on the date of admission. Notwithstanding section 144.552, the psychiatric hospital
may add licensed beds under this clause prior to completion of the public interest review,
provided the hospital submits its plan by the 2021 deadline and adheres to the timelines for
the public interest review described in section 144.552deleted text begin.deleted text endnew text begin;
new text end

new text begin (31) any project to add licensed beds in a hospital located in Cook County or Mahnomen
County that: (i) is designated as a critical access hospital under section 144.1483, clause
(9), and United States Code, title 42, section 1395i-4; (ii) has a licensed bed capacity of
fewer than 25 beds; and (iii) has an attached nursing home, so long as the total number of
licensed beds in the hospital after the bed addition does not exceed 25 beds. Notwithstanding
section 144.552, a public interest review is not required for a project authorized under this
clause; or
new text end

new text begin (32) upon submission of a plan to the commissioner for public interest review under
section 144.552, a project to add 22 licensed beds at a Minnesota freestanding children's
hospital in St. Paul that is part of an independent pediatric health system with freestanding
inpatient hospitals located in Minneapolis and St. Paul. The beds shall be utilized for pediatric
inpatient behavioral health services. Notwithstanding section 144.552, the hospital may add
licensed beds under this clause prior to completion of the public interest review, provided
the hospital submits its plan by the 2022 deadline and adheres to the timelines for the public
interest review described in section 144.552.
new text end

Sec. 10.

Minnesota Statutes 2020, section 144.565, subdivision 4, is amended to read:


Subd. 4.

Definitions.

(a) For purposes of this section, the following terms have the
meanings givendeleted text begin:deleted text endnew text begin.
new text end

(b) "Diagnostic imaging facility" means a health care facility that is not a hospital or
location licensed as a hospital which offers diagnostic imaging services in Minnesota,
regardless of whether the equipment used to provide the service is owned or leased. For the
purposes of this section, diagnostic imaging facility includes, but is not limited to, facilities
such as a physician's office, clinic, mobile transport vehicle, outpatient imaging center, or
surgical center.new text begin A dental clinic or office is not considered a diagnostic imaging facility for
the purpose of this section when the clinic or office performs diagnostic imaging through
dental cone beam computerized tomography.
new text end

(c) "Diagnostic imaging service" means the use of ionizing radiation or other imaging
technique on a human patient includingdeleted text begin,deleted text end but not limited todeleted text begin,deleted text end magnetic resonance imaging
(MRI) or computerized tomography (CT)new text begin other than dental cone beam computerized
tomography
new text end, positron emission tomography (PET), or single photon emission computerized
tomography (SPECT) scans using fixed, portable, or mobile equipment.

(d) "Financial or economic interest" means a direct or indirect:

(1) equity or debt security issued by an entity, including, but not limited to, shares of
stock in a corporation, membership in a limited liability company, beneficial interest in a
trust, units or other interests in a partnership, bonds, debentures, notes or other equity
interests or debt instruments, or any contractual arrangements;

(2) membership, proprietary interest, or co-ownership with an individual, group, or
organization to which patients, clients, or customers are referred to; or

(3) employer-employee or independent contractor relationship, including, but not limited
to, those that may occur in a limited partnership, profit-sharing arrangement, or other similar
arrangement with any facility to which patients are referred, including any compensation
between a facility and a health care provider, the group practice of which the provider is a
member or employee or a related party with respect to any of them.

(e) "Fixed equipment" means a stationary diagnostic imaging machine installed in a
permanent location.

(f) "Mobile equipment" means a diagnostic imaging machine in a self-contained transport
vehicle designed to be brought to a temporary deleted text beginoffsitedeleted text endnew text begin off-sitenew text end location to perform diagnostic
imaging services.

(g) "Portable equipment" means a diagnostic imaging machine designed to be temporarily
transported within a permanent location to perform diagnostic imaging services.

(h) "Provider of diagnostic imaging services" means a diagnostic imaging facility or an
entity that offers and bills for diagnostic imaging services at a facility owned or leased by
the entity.

Sec. 11.

Minnesota Statutes 2020, section 144.6502, 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) "Commissioner" means the commissioner of health.

(c) "Department" means the Department of Health.

(d) "Electronic monitoring" means the placement and use of an electronic monitoring
device deleted text beginby a residentdeleted text end in the resident's room or private living unit in accordance with this
section.

(e) "Electronic monitoring device" means a camera or other device that captures, records,
or broadcasts audio, video, or both, that is placed in a resident's room or private living unit
and is used to monitor the resident or activities in the room or private living unit.

(f) "Facility" means a facility that is:

(1) licensed as a nursing home under chapter 144A;

(2) licensed as a boarding care home under sections 144.50 to 144.56;

(3) until August 1, 2021, a housing with services establishment registered under chapter
144D that is either subject to chapter 144G or has a disclosed special unit under section
325F.72; or

(4) on or after August 1, 2021, an assisted living facility.

(g) "Resident" means a person 18 years of age or older residing in a facility.

(h) "Resident representative" means one of the following in the order of priority listed,
to the extent the person may reasonably be identified and located:

(1) a court-appointed guardian;

(2) a health care agent as defined in section 145C.01, subdivision 2; or

(3) a person who is not an agent of a facility or of a home care provider designated in
writing by the resident and maintained in the resident's records on file with the facility.

Sec. 12.

Minnesota Statutes 2020, section 144A.01, is amended to read:


144A.01 DEFINITIONS.

Subdivision 1.

Scope.

For the purposes of sections 144A.01 to 144A.27, the terms
defined in this section have the meanings given them.

Subd. 2.

Commissioner of health.

"Commissioner of health" means the state
commissioner of health established by section 144.011.

Subd. 3.

Board of Executivesnew text begin for Long Term Services and Supportsnew text end.

"Board of
Executivesnew text begin for Long Term Services and Supportsnew text end" means the Board of Executives for Long
Term Services and Supports established by section 144A.19.

Subd. 3a.

Certified.

"Certified" means certified for participation as a provider in the
Medicare or Medicaid programs under title XVIII or XIX of the Social Security Act.

Subd. 4.

Controlling person.

(a) "Controlling person" means deleted text beginany public body,
governmental agency, business entity,
deleted text endnew text begin an owner and the following individuals and entities,
if applicable:
new text end

new text begin (1) eachnew text end officernew text begin of the organizationnew text end, new text beginincluding the chief executive officer and the chief
financial officer;
new text end

new text begin (2) the new text endnursing home administratordeleted text begin, or director whose responsibilities include the direction
of the management or policies of a nursing home
deleted text endnew text begin; and
new text end

new text begin (3) any managerial officialnew text end.

new text begin (b) new text end"Controlling person" also means any new text beginentity or natural new text endperson whodeleted text begin, directly or
indirectly, beneficially owns any
deleted text endnew text begin has any direct or indirect ownershipnew text end interest in:

(1) any corporation, partnership or other business association which is a controlling
person;

(2) the land on which a nursing home is located;

(3) the structure in which a nursing home is located;

(4) any new text beginentity with at least a five percent new text endmortgage, contract for deed, new text begindeed of trust, new text endor
other deleted text beginobligation secured in whole or part bydeleted text endnew text begin security interest innew text end the land or structure
comprising a nursing home; or

(5) any lease or sublease of the land, structure, or facilities comprising a nursing home.

deleted text begin (b)deleted text endnew text begin (c)new text end "Controlling person" does not include:

(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
directly or through a subsidiary operates a nursing home;

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

deleted text begin (2)deleted text endnew text begin (3)new text end an individual new text beginwho is a new text endstate new text beginor federal new text endofficial deleted text beginordeleted text endnew text begin, anew text end state new text beginor federal new text endemployee, or
a member or employee of the governing body of a political subdivision of the state deleted text beginwhichdeleted text endnew text begin
or federal government that
new text end operates one or more nursing homes, unless the individual is
also an officer deleted text beginor director of adeleted text endnew text begin, owner, or managerial official of thenew text end nursing home, receives
any remuneration from a nursing home, or deleted text beginowns any of the beneficial interestsdeleted text endnew text begin who is a
controlling person
new text end not new text beginotherwise new text endexcluded in this subdivision;

deleted text begin (3)deleted text endnew text begin (4)new text end a natural person who is a member of a tax-exempt organization under section
290.05, subdivision 2, unless the individual is also deleted text beginan officer or director of a nursing home,
or owns any of the beneficial interests
deleted text endnew text begin a controlling personnew text end not new text beginotherwise new text endexcluded in this
subdivision; and

deleted text begin (4)deleted text endnew text begin (5)new text end a natural person who owns less than five percent of the outstanding common
shares of a corporation:

(i) whose securities are exempt by virtue of section 80A.45, clause (6); or

(ii) whose transactions are exempt by virtue of section 80A.46, clause (7).

Subd. 4a.

Emergency.

"Emergency" means a situation or physical condition that creates
or probably will create an immediate and serious threat to a resident's health or safety.

Subd. 5.

Nursing home.

"Nursing home" means a facility or that part of a facility which
provides nursing care to five or more persons. "Nursing home" does not include a facility
or that part of a facility which is a hospital, a hospital with approved swing beds as defined
in section 144.562, clinic, doctor's office, diagnostic or treatment center, or a residential
program licensed pursuant to sections 245A.01 to 245A.16 or 252.28.

Subd. 6.

Nursing care.

"Nursing care" means health evaluation and treatment of patients
and residents who are not in need of an acute care facility but who require nursing supervision
on an inpatient basis. The commissioner of health may by rule establish levels of nursing
care.

Subd. 7.

Uncorrected violation.

"Uncorrected violation" means a violation of a statute
or rule or any other deficiency for which a notice of noncompliance has been issued and
fine assessed and allowed to be recovered pursuant to section 144A.10, subdivision 8.

Subd. 8.

Managerial deleted text beginemployeedeleted text endnew text begin officialnew text end.

"Managerial deleted text beginemployeedeleted text endnew text begin officialnew text end" means an
deleted text begin employee of adeleted text endnew text begin individual who has the decision-making authority related to the operation of
the
new text end nursing home deleted text beginwhose duties includedeleted text endnew text begin and the responsibility for either: (1) the ongoing
management of the nursing home; or (2)
new text end the direction of deleted text beginsome or all of the management ordeleted text end
policiesnew text begin, services, or employeesnew text end of the nursing home.

Subd. 9.

Nursing home administrator.

"Nursing home administrator" means a person
who administers, manages, supervises, or is in general administrative charge of a nursing
home, whether or not the individual has an ownership interest in the home, and whether or
not the person's functions and duties are shared with one or more individuals, and who is
licensed pursuant to section 144A.21.

Subd. 10.

Repeated violation.

"Repeated violation" means the issuance of two or more
correction orders, within a 12-month period, for a violation of the same provision of a statute
or rule.

new text begin Subd. 11. new text end

new text begin Change of ownership. new text end

new text begin "Change of ownership" means a change in the licensee.
new text end

new text begin Subd. 12. new text end

new text begin Direct ownership interest. new text end

new text begin "Direct ownership interest" means an individual
or legal entity with the possession of at least five percent equity in capital, stock, or profits
of the licensee or who is a member of a limited liability company of the licensee.
new text end

new text begin Subd. 13. new text end

new text begin Indirect ownership interest. new text end

new text begin "Indirect ownership interest" means an individual
or legal entity with a direct ownership interest in an entity that has a direct or indirect
ownership interest of at least five percent in an entity that is a licensee.
new text end

new text begin Subd. 14. new text end

new text begin Licensee. new text end

new text begin "Licensee" means a person or legal entity to whom the commissioner
issues a license for a nursing home and who is responsible for the management, control,
and operation of the nursing home.
new text end

new text begin Subd. 15. new text end

new text begin Management agreement. new text end

new text begin "Management agreement" means a written, executed
agreement between a licensee and manager regarding the provision of certain services on
behalf of the licensee.
new text end

new text begin Subd. 16. new text end

new text begin Manager. new text end

new text begin "Manager" means an individual or legal entity designated by the
licensee through a management agreement to act on behalf of the licensee in the on-site
management of the nursing home.
new text end

new text begin Subd. 17. new text end

new text begin Owner. new text end

new text begin "Owner" means: (1) an individual or legal entity that has a direct or
indirect ownership interest of five percent or more in a licensee; and (2) for purposes of this
chapter, owner of a nonprofit corporation means the president and treasurer of the board of
directors; and (3) for an entity owned by an employee stock ownership plan, owner means
the president and treasurer of the entity. A government entity that is issued a license under
this chapter shall be designated the owner.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 13.

Minnesota Statutes 2020, section 144A.03, subdivision 1, is amended to read:


Subdivision 1.

Form; requirements.

new text begin(a) new text endThe commissioner of health by rule shall
establish forms and procedures for the processing of nursing home license applications.

new text begin (b) new text endAn application for a nursing home license shall include deleted text beginthe following informationdeleted text end:

(1) the deleted text beginnamesdeleted text endnew text begin business namenew text end and deleted text beginaddresses of all controlling persons and managerial
employees of the facility to be licensed
deleted text endnew text begin legal entity name of the licenseenew text end;

(2) the new text beginstreet new text endaddressnew text begin, mailing address,new text end and legal property description of the facility;

new text begin (3) the names, e-mail addresses, telephone numbers, and mailing addresses of all owners,
controlling persons, managerial officials, and the nursing home administrator;
new text end

new text begin (4) the name and e-mail address of the managing agent and manager, if applicable;
new text end

new text begin (5) the licensed bed capacity;
new text end

new text begin (6) the license fee in the amount specified in section 144.122;
new text end

new text begin (7) documentation of compliance with the background study requirements in section
144.057 for the owner, controlling persons, and managerial officials. Each application for
a new license must include documentation for the applicant and for each individual with
five percent or more direct or indirect ownership in the applicant;
new text end

deleted text begin (3)deleted text endnew text begin (8)new text end a copy of the architectural and engineering plans and specifications of the facility
as prepared and certified by an architect or engineer registered to practice in this state; deleted text beginand
deleted text end

new text begin (9) a representative copy of the executed lease agreement between the landlord and the
licensee, if applicable;
new text end

new text begin (10) a representative copy of the management agreement, if applicable;
new text end

new text begin (11) a representative copy of the operations transfer agreement or similar agreement, if
applicable;
new text end

new text begin (12) an organizational chart that identifies all organizations and individuals with an
ownership interest in the licensee of five percent or greater and that specifies their relationship
with the licensee and with each other;
new text end

new text begin (13) whether the applicant, owner, controlling person, managerial official, or nursing
home administrator of the facility has ever been convicted of:
new text end

new text begin (i) a crime or found civilly liable for a federal or state felony-level offense that was
detrimental to the best interests of the facility and its residents within the last ten years
preceding submission of the license application. Offenses include: (A) felony crimes against
persons and other similar crimes for which the individual was convicted, including guilty
pleas and adjudicated pretrial diversions; (B) financial crimes such as extortion,
embezzlement, income tax evasion, insurance fraud, and other similar crimes for which the
individual was convicted, including guilty pleas and adjudicated pretrial diversions; (C)
any felonies involving malpractice that resulted in a conviction of criminal neglect or
misconduct; and (D) any felonies that would result in a mandatory exclusion under section
1128(a) of the Social Security Act;
new text end

new text begin (ii) any misdemeanor under federal or state law related to the delivery of an item or
service under Medicaid or a state health care program or the abuse or neglect of a patient
in connection with the delivery of a health care item or service;
new text end

new text begin (iii) any misdemeanor under federal or state law related to theft, fraud, embezzlement,
breach of fiduciary duty, or other financial misconduct in connection with the delivery of
a health care item or service;
new text end

new text begin (iv) any felony or misdemeanor under federal or state law relating to the interference
with or obstruction of any investigation into any criminal offense described in Code of
Federal Regulations, title 42, section 1001.101 or 1001.201; or
new text end

new text begin (v) any felony or misdemeanor under federal or state law relating to the unlawful
manufacture, distribution, prescription, or dispensing of a controlled substance;
new text end

new text begin (14) whether the applicant, owner, controlling person, managerial official, or nursing
home administrator of the facility has had:
new text end

new text begin (i) any revocation or suspension of a license to provide health care by any state licensing
authority. This includes the surrender of the license while a formal disciplinary proceeding
was pending before a state licensing authority;
new text end

new text begin (ii) any revocation or suspension of accreditation; or
new text end

new text begin (iii) any suspension or exclusion from participation in, or any sanction imposed by, a
federal or state health care program or any debarment from participation in any federal
executive branch procurement or nonprocurement program;
new text end

new text begin (15) whether in the preceding three years the applicant or any owner, controlling person,
managerial official, or nursing home administrator of the facility has a record of defaulting
in the payment of money collected for others, including the discharge of debts through
bankruptcy proceedings;
new text end

new text begin (16) the signature of the owner of the licensee or an authorized agent of the licensee;
new text end

new text begin (17) identification of all states where the applicant or individual having a five percent
or more ownership currently or previously has been licensed as an owner or operator of a
long-term care, community-based, or health care facility or agency where the applicant's or
individual's license or federal certification has been denied, suspended, restricted, conditioned,
refused, not renewed, or revoked under a private or state-controlled receivership or where
these same actions are pending under the laws of any state or federal authority; and
new text end

deleted text begin (4)deleted text endnew text begin (18)new text end any other relevant information which the commissioner of health by rule or
otherwise may determine is necessary to properly evaluate an application for license.

new text begin (c) new text endA controlling person which is a corporation shall submit copies of its articles of
incorporation and bylaws and any amendments thereto as they occur, together with the
names and addresses of its officers and directors. A controlling person which is a foreign
corporation shall furnish the commissioner of health with a copy of its certificate of authority
to do business in this state. deleted text beginAn application on behalf of a controlling person which is a
corporation, association or a governmental unit or instrumentality shall be signed by at least
two officers or managing agents of that entity.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 14.

Minnesota Statutes 2020, section 144A.04, subdivision 4, is amended to read:


Subd. 4.

Controlling person restrictions.

(a) The new text begincommissioner has discretion to bar
any
new text endcontrolling persons of a nursing home deleted text beginmay not include anydeleted text endnew text begin if thenew text end person deleted text beginwhodeleted text end was a
controlling person of deleted text beginanotherdeleted text endnew text begin any othernew text end nursing home deleted text beginduring any period of timedeleted text endnew text begin, assisted
living facility, long-term care or health care facility, or agency
new text end in the previous two-year
periodnew text begin andnew text end:

(1) during deleted text beginwhichdeleted text endnew text begin that period ofnew text end time deleted text beginof control that other nursing homedeleted text endnew text begin the facility or
agency
new text end incurred deleted text beginthe following number of uncorrected or repeated violations:
deleted text end

deleted text begin (i)deleted text end two or more uncorrected violations or one or more repeated violations which created
an imminent risk to direct resident new text beginor client new text endcare or safety; or

deleted text begin (ii) four or more uncorrected violations or two or more repeated violations of any nature
for which the fines are in the four highest daily fine categories prescribed in rule; or
deleted text end

(2) deleted text beginwhodeleted text endnew text begin during that period of time,new text end was convicted of a felony or gross misdemeanor that
deleted text begin relatesdeleted text endnew text begin relatednew text end to operation of the deleted text beginnursing homedeleted text endnew text begin facility or agencynew text end or directly deleted text beginaffectsdeleted text endnew text begin affectednew text end
resident safety or caredeleted text begin, during that perioddeleted text end.

(b) The provisions of this subdivision shall not apply to any controlling person who had
no legal authority to affect or change decisions related to the operation of the nursing home
which incurred the uncorrected violations.

new text begin (c) When the commissioner bars a controlling person under this subdivision, the
controlling person has the right to appeal under chapter 14.
new text end

Sec. 15.

Minnesota Statutes 2020, section 144A.04, subdivision 6, is amended to read:


Subd. 6.

Managerial deleted text beginemployeedeleted text endnew text begin officialnew text end or licensed administrator; employment
prohibitions.

A nursing home may not employ as a managerial deleted text beginemployeedeleted text endnew text begin officialnew text end or as its
licensed administrator any person who was a managerial deleted text beginemployeedeleted text endnew text begin officialnew text end or the licensed
administrator of another facility during any period of time in the previous two-year period:

(1) during which time of employment that other nursing home incurred the following
number of uncorrected violations which were in the jurisdiction and control of the managerial
deleted text begin employeedeleted text endnew text begin officialnew text end or the administrator:

(i) two or more uncorrected violations deleted text beginor one or more repeated violations which created
an imminent risk to direct resident care or safety
deleted text end; or

(ii) four or more uncorrected violations or two or more repeated violations of any nature
for which the fines are in the four highest daily fine categories prescribed in rule; or

(2) who was convicted of a felony or gross misdemeanor that relates to operation of the
nursing home or directly affects resident safety or care, during that period.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 16.

Minnesota Statutes 2020, section 144A.06, is amended to read:


144A.06 TRANSFER OF deleted text beginINTERESTSdeleted text endnew text begin LICENSE PROHIBITEDnew text end.

Subdivision 1.

deleted text beginNotice; expiration of licensedeleted text endnew text begin Transfers prohibitednew text end.

deleted text begin Any controlling
person who makes any transfer of a beneficial interest in a nursing home shall notify the
commissioner of health of the transfer within 14 days of its occurrence. The notification
shall identify by name and address the transferor and transferee and shall specify the nature
and amount of the transferred interest. On determining that the transferred beneficial interest
exceeds ten percent of the total beneficial interest in the nursing home facility, the structure
in which the facility is located, or the land upon which the structure is located, the
commissioner may, and on determining that the transferred beneficial interest exceeds 50
percent of the total beneficial interest in the facility, the structure in which the facility is
located, or the land upon which the structure is located, the commissioner shall require that
the license of the nursing home expire 90 days after the date of transfer. The commissioner
of health shall notify the nursing home by certified mail of the expiration of the license at
least 60 days prior to the date of expiration.
deleted text end new text begin A nursing home license may not be transferred.
new text end

Subd. 2.

deleted text beginRelicensuredeleted text endnew text begin New license required; change of ownershipnew text end.

new text begin(a) new text endThe
commissioner of health by rule shall prescribe procedures for deleted text beginrelicensuredeleted text endnew text begin licensurenew text end under
this section. deleted text beginThe commissioner of health shall relicense a nursing home if the facility satisfies
the requirements for license renewal established by section 144A.05. A facility shall not be
relicensed by the commissioner if at the time of transfer there are any uncorrected violations.
The commissioner of health may temporarily waive correction of one or more violations if
the commissioner determines that:
deleted text end

deleted text begin (1) temporary noncorrection of the violation will not create an imminent risk of harm
to a nursing home resident; and
deleted text end

deleted text begin (2) a controlling person on behalf of all other controlling persons:
deleted text end

deleted text begin (i) has entered into a contract to obtain the materials or labor necessary to correct the
violation, but the supplier or other contractor has failed to perform the terms of the contract
and the inability of the nursing home to correct the violation is due solely to that failure; or
deleted text end

deleted text begin (ii) is otherwise making a diligent good faith effort to correct the violation.
deleted text end

new text begin (b) A new license is required and the prospective licensee must apply for a license prior
to operating a currently licensed nursing home. The licensee must change whenever one of
the following events occur:
new text end

new text begin (1) the form of the licensee's legal entity structure is converted or changed to a different
type of legal entity structure;
new text end

new text begin (2) the licensee dissolves, consolidates, or merges with another legal organization and
the licensee's legal organization does not survive;
new text end

new text begin (3) within the previous 24 months, 50 percent or more of the licensee's ownership interest
is transferred, whether by a single transaction or multiple transactions to:
new text end

new text begin (i) a different person; or
new text end

new text begin (ii) a person who had less than a five percent ownership interest in the facility at the
time of the first transaction; or
new text end

new text begin (4) any other event or combination of events that results in a substitution, elimination,
or withdrawal of the licensee's responsibility for the facility.
new text end

new text begin Subd. 3. new text end

new text begin Compliance. new text end

new text begin The commissioner must consult with the commissioner of human
services regarding the history of financial and cost reporting compliance of the prospective
licensee and prospective licensee's financial operations in any nursing home that the
prospective licensee or any controlling person listed in the license application has had an
interest in.
new text end

new text begin Subd. 4. new text end

new text begin Facility operation. new text end

new text begin The current licensee remains responsible for the operation
of the nursing home until the nursing home is licensed to the prospective licensee.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 17.

new text begin [144A.32] CONSIDERATION OF APPLICATIONS.
new text end

new text begin (a) Before issuing a license or renewing an existing license, the commissioner shall
consider an applicant's compliance history in providing care in a facility that provides care
to children, the elderly, ill individuals, or individuals with disabilities.
new text end

new text begin (b) The applicant's compliance history shall include repeat violations, rule violations,
and any license or certification involuntarily suspended or terminated during an enforcement
process.
new text end

new text begin (c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
or impose conditions if:
new text end

new text begin (1) the applicant fails to provide complete and accurate information on the application
and the commissioner concludes that the missing or corrected information is needed to
determine if a license is granted;
new text end

new text begin (2) the applicant, knowingly or with reason to know, made a false statement of a material
fact in an application for the license or any data attached to the application or in any matter
under investigation by the department;
new text end

new text begin (3) the applicant refused to allow agents of the commissioner to inspect the applicant's
books, records, files related to the license application, or any portion of the premises;
new text end

new text begin (4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
new text end

new text begin (i) the work of any authorized representative of the commissioner, the ombudsman for
long-term care, or the ombudsman for mental health and developmental disabilities; or
new text end

new text begin (ii) the duties of the commissioner, local law enforcement, city or county attorneys, adult
protection, county case managers, or other local government personnel;
new text end

new text begin (5) the applicant has a history of noncompliance with federal or state regulations that
were detrimental to the health, welfare, or safety of a resident or a client; or
new text end

new text begin (6) the applicant violates any requirement in this chapter or chapter 256R.
new text end

new text begin (d) If a license is denied, the applicant has the reconsideration rights available under
chapter 14.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 18.

Minnesota Statutes 2020, section 144A.4799, subdivision 1, is amended to read:


Subdivision 1.

Membership.

The commissioner of health shall appoint deleted text begineightdeleted text endnew text begin 13new text end persons
to a home care and assisted living program advisory council consisting of the following:

(1) deleted text beginthreedeleted text endnew text begin twonew text end public members as defined in section 214.02 who shall be persons who
are currently receiving home care services, persons who have received home care services
within five years of the application date, persons who have family members receiving home
care services, or persons who have family members who have received home care services
within five years of the application date;

(2) deleted text beginthreedeleted text endnew text begin twonew text end Minnesota home care licensees representing basic and comprehensive
levels of licensure who may be a managerial official, an administrator, a supervising
registered nurse, or an unlicensed personnel performing home care tasks;

(3) one member representing the Minnesota Board of Nursing;

(4) one member representing the Office of Ombudsman for Long-Term Care; deleted text beginand
deleted text end

new text begin (5) one member representing the Office of Ombudsman for Mental Health and
Developmental Disabilities;
new text end

deleted text begin (5)deleted text endnew text begin (6)new text end beginning July 1, 2021, one member of a county health and human services or
county adult protection officedeleted text begin.deleted text endnew text begin;
new text end

new text begin (7) two Minnesota assisted living facility licensees representing assisted living facilities
and assisted living facilities with dementia care levels of licensure who may be the facility's
assisted living director, managerial official, or clinical nurse supervisor;
new text end

new text begin (8) one organization representing long-term care providers, home care providers, and
assisted living providers in Minnesota; and
new text end

new text begin (9) two public members as defined in section 214.02. One public member shall be a
person who either is or has been a resident in an assisted living facility and one public
member shall be a person who has or had a family member living in an assisted living
facility setting.
new text end

Sec. 19.

Minnesota Statutes 2020, section 144A.4799, subdivision 3, is amended to read:


Subd. 3.

Duties.

(a) At the commissioner's request, the advisory council shall provide
advice regarding regulations of Department of Health licensed new text beginassisted living and new text endhome
care providers in this chapter, including advice on the following:

(1) community standards for home care practices;

(2) enforcement of licensing standards and whether certain disciplinary actions are
appropriate;

(3) ways of distributing information to licensees and consumers of home care and assisted
livingnew text begin services defined under chapter 144Gnew text end;

(4) training standards;

(5) identifying emerging issues and opportunities in home care and assisted livingnew text begin services
defined under chapter 144G
new text end;

(6) identifying the use of technology in home and telehealth capabilities;

(7) allowable home care licensing modifications and exemptions, including a method
for an integrated license with an existing license for rural licensed nursing homes to provide
limited home care services in an adjacent independent living apartment building owned by
the licensed nursing home; and

(8) recommendations for studies using the data in section 62U.04, subdivision 4, including
but not limited to studies concerning costs related to dementia and chronic disease among
an elderly population over 60 and additional long-term care costs, as described in section
62U.10, subdivision 6.

(b) The advisory council shall perform other duties as directed by the commissioner.

(c) The advisory council shall annually make recommendations to the commissioner for
the purposes in section 144A.474, subdivision 11, paragraph (i). The recommendations shall
address ways the commissioner may improve protection of the public under existing statutes
and laws and include but are not limited to projects that create and administer training of
licensees and their employees to improve residents' lives, supporting ways that licensees
can improve and enhance quality care and ways to provide technical assistance to licensees
to improve compliance; information technology and data projects that analyze and
communicate information about trends of violations or lead to ways of improving client
care; communications strategies to licensees and the public; and other projects or pilots that
benefit clients, families, and the public.

Sec. 20.

Minnesota Statutes 2020, section 144A.75, subdivision 12, is amended to read:


Subd. 12.

Palliative care.

"Palliative care" means deleted text beginthe total active care of patients whose
disease is not responsive to curative treatment. Control of pain, of other symptoms, and of
psychological, social, and spiritual problems is paramount
deleted text endnew text begin specialized medical care for
individuals living with a serious illness or life-limiting condition
new text end. new text beginThis type of care is focused
on reducing the pain, symptoms, and stress of a serious illness or condition. Palliative care
is a team-based approach to care, providing essential support at any age or stage of a serious
illness or condition, and is often provided together with curative treatment.
new text endThe goal of
palliative care is deleted text beginthe achievement of the best quality of life for patients and their familiesdeleted text endnew text begin
to improve quality of life for both the patient and the patient's family or care partner
new text end.

Sec. 21.

Minnesota Statutes 2020, section 144G.08, is amended by adding a subdivision
to read:


new text begin Subd. 62a. new text end

new text begin Serious injury. new text end

new text begin "Serious injury" has the meaning given in section 245.91,
subdivision 6.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 22.

Minnesota Statutes 2020, section 144G.15, is amended to read:


144G.15 CONSIDERATION OF APPLICATIONS.

(a) Before issuing a provisional license or license or renewing a license, the commissioner
shall consider an applicant's compliance history in providing care in new text beginthis state or any other
state in
new text enda facility that provides care to children, the elderly, ill individuals, or individuals
with disabilities.

(b) The applicant's compliance history shall include repeat violation, rule violations, and
any license or certification involuntarily suspended or terminated during an enforcement
process.

(c) The commissioner may deny, revoke, suspend, restrict, or refuse to renew the license
or impose conditions if:

(1) the applicant fails to provide complete and accurate information on the application
and the commissioner concludes that the missing or corrected information is needed to
determine if a license shall be granted;

(2) the applicant, knowingly or with reason to know, made a false statement of a material
fact in an application for the license or any data attached to the application or in any matter
under investigation by the department;

(3) the applicant refused to allow agents of the commissioner to inspect its books, records,
and files related to the license application, or any portion of the premises;

(4) the applicant willfully prevented, interfered with, or attempted to impede in any way:
(i) the work of any authorized representative of the commissioner, the ombudsman for
long-term care, or the ombudsman for mental health and developmental disabilities; or (ii)
the duties of the commissioner, local law enforcement, city or county attorneys, adult
protection, county case managers, or other local government personnel;

(5) the applicantnew text begin, owner, controlling individual, managerial official, or assisted living
director for the facility
new text end has a history of noncompliance with federal or state regulations that
were detrimental to the health, welfare, or safety of a resident or a client; or

(6) the applicant violates any requirement in this chapter.

(d) If a license is denied, the applicant has the reconsideration rights available under
section 144G.16, subdivision 4.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 23.

Minnesota Statutes 2020, section 144G.17, is amended to read:


144G.17 LICENSE RENEWAL.

A license that is not a provisional license may be renewed for a period of up to one year
if the licensee:

(1) submits an application for renewal in the format provided by the commissioner at
least 60 calendar days before expiration of the license;

(2) submits the renewal fee under section 144G.12, subdivision 3;

(3) submits the late fee under section 144G.12, subdivision 4, if the renewal application
is received less than 30 days before the expiration date of the license or after the expiration
of the license;

(4) provides information sufficient to show that the applicant meets the requirements of
licensure, including items required under section 144G.12, subdivision 1; deleted text beginand
deleted text end

new text begin (5) provides information sufficient to show the licensee provided assisted living services
to at least one resident during the immediately preceding license year and at the assisted
living facility listed on the license; and
new text end

deleted text begin (5)deleted text endnew text begin (6)new text end provides any other information deemed necessary by the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 24.

Minnesota Statutes 2020, section 144G.19, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Change of licensee. new text end

new text begin Notwithstanding any other provision of law, a change of
licensee under subdivision 2 does not require the facility to meet the design requirements
of section 144G.45, subdivisions 4 to 6, or 144G.81, subdivision 3.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 25.

Minnesota Statutes 2020, section 144G.20, subdivision 1, is amended to read:


Subdivision 1.

Conditions.

(a) The commissioner may refuse to grant a provisional
license, refuse to grant a license as a result of a change in ownership, refuse to renew a
license, suspend or revoke a license, or impose a conditional license if the owner, controlling
individual, or employee of an assisted living facility:

(1) is in violation of, or during the term of the license has violated, any of the requirements
in this chapter or adopted rules;

(2) permits, aids, or abets the commission of any illegal act in the provision of assisted
living services;

(3) performs any act detrimental to the health, safety, and welfare of a resident;

(4) obtains the license by fraud or misrepresentation;

(5) knowingly makes a false statement of a material fact in the application for a license
or in any other record or report required by this chapter;

(6) denies representatives of the department access to any part of the facility's books,
records, files, or employees;

(7) interferes with or impedes a representative of the department in contacting the facility's
residents;

(8) interferes with or impedes ombudsman access according to section 256.9742,
subdivision 4new text begin, or interferes with or impedes access by the Office of Ombudsman for Mental
Health and Developmental Disabilities according to section 245.94, subdivision 1
new text end;

(9) interferes with or impedes a representative of the department in the enforcement of
this chapter or fails to fully cooperate with an inspection, survey, or investigation by the
department;

(10) destroys or makes unavailable any records or other evidence relating to the assisted
living facility's compliance with this chapter;

(11) refuses to initiate a background study under section 144.057 or 245A.04;

(12) fails to timely pay any fines assessed by the commissioner;

(13) violates any local, city, or township ordinance relating to housing or assisted living
services;

(14) has repeated incidents of personnel performing services beyond their competency
level; or

(15) has operated beyond the scope of the assisted living facility's license category.

(b) A violation by a contractor providing the assisted living services of the facility is a
violation by the facility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 26.

Minnesota Statutes 2020, section 144G.20, subdivision 4, is amended to read:


Subd. 4.

Mandatory revocation.

Notwithstanding the provisions of subdivision 13,
paragraph (a), the commissioner must revoke a license if a controlling individual of the
facility is convicted of a felony or gross misdemeanor that relates to operation of the facility
or directly affects resident safety or care. The commissioner shall notify the facility and the
Office of Ombudsman for Long-Term Care new text beginand the Office of Ombudsman for Mental Health
and Developmental Disabilities
new text end30 calendar days in advance of the date of revocation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 27.

Minnesota Statutes 2020, section 144G.20, subdivision 5, is amended to read:


Subd. 5.

Owners and managerial officials; refusal to grant license.

(a) The owners
and managerial officials of a facility whose Minnesota license has not been renewed or
whose deleted text beginMinnesotadeleted text end license new text beginin this state or any other state new text endhas been revoked because of
noncompliance with applicable laws or rules shall not be eligible to apply for nor will be
granted an assisted living facility license under this chapter or a home care provider license
under chapter 144A, or be given status as an enrolled personal care assistance provider
agency or personal care assistant by the Department of Human Services under section
256B.0659, for five years following the effective date of the nonrenewal or revocation. If
the owners or managerial officials already have enrollment status, the Department of Human
Services shall terminate that enrollment.

(b) The commissioner shall not issue a license to a facility for five years following the
effective date of license nonrenewal or revocation if the owners or managerial officials,
including any individual who was an owner or managerial official of another licensed
provider, had a deleted text beginMinnesotadeleted text end license new text beginin this state or any other state new text endthat was not renewed or
was revoked as described in paragraph (a).

(c) Notwithstanding subdivision 1, the commissioner shall not renew, or shall suspend
or revoke, the license of a facility that includes any individual as an owner or managerial
official who was an owner or managerial official of a facility whose deleted text beginMinnesotadeleted text end license new text beginin
this state or any other state
new text endwas not renewed or was revoked as described in paragraph (a)
for five years following the effective date of the nonrenewal or revocation.

(d) The commissioner shall notify the facility 30 calendar days in advance of the date
of nonrenewal, suspension, or revocation of the license.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 28.

Minnesota Statutes 2020, section 144G.20, subdivision 8, is amended to read:


Subd. 8.

Controlling individual restrictions.

(a) The commissioner has discretion to
bar any controlling individual of a facility if the person was a controlling individual of any
other nursing homenew text begin, home care provider licensed under chapter 144A, or given status as an
enrolled personal care assistance provider agency or personal care assistant by the Department
of Human Services under section 256B.0659,
new text end or assisted living facility in the previous
two-year period and:

(1) during that period of time the nursing homenew text begin, home care provider licensed under
chapter 144A, or given status as an enrolled personal care assistance provider agency or
personal care assistant by the Department of Human Services under section 256B.0659,
new text end or
assisted living facility incurred the following number of uncorrected or repeated violations:

(i) two or more repeated violations that created an imminent risk to direct resident care
or safety; or

(ii) four or more uncorrected violations that created an imminent risk to direct resident
care or safety; or

(2) during that period of time, was convicted of a felony or gross misdemeanor that
related to the operation of the nursing homenew text begin, home care provider licensed under chapter
144A, or given status as an enrolled personal care assistance provider agency or personal
care assistant by the Department of Human Services under section 256B.0659,
new text end or assisted
living facility, or directly affected resident safety or care.

(b) When the commissioner bars a controlling individual under this subdivision, the
controlling individual may appeal the commissioner's decision under chapter 14.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 29.

Minnesota Statutes 2020, section 144G.20, subdivision 9, is amended to read:


Subd. 9.

Exception to controlling individual restrictions.

Subdivision 8 does not apply
to any controlling individual of the facility who had no legal authority to affect or change
decisions related to the operation of the nursing home deleted text beginordeleted text endnew text begin,new text end assisted living facilitynew text begin, or home
care
new text end that incurred the uncorrected new text beginor repeated new text endviolations.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 30.

Minnesota Statutes 2020, section 144G.20, subdivision 12, is amended to read:


Subd. 12.

Notice to residents.

(a) Within five business days after proceedings are initiated
by the commissioner to revoke or suspend a facility's license, or a decision by the
commissioner not to renew a living facility's license, the controlling individual of the facility
or a designee must provide to the commissioner deleted text beginanddeleted text endnew text begin,new text end the ombudsman for long-term carenew text begin,
and the Office of Ombudsman for Mental Health and Developmental Disabilities
new text end the names
of residents and the names and addresses of the residents' designated representatives and
legal representatives, and family or other contacts listed in the assisted living contract.

(b) The controlling individual or designees of the facility must provide updated
information each month until the proceeding is concluded. If the controlling individual or
designee of the facility fails to provide the information within this time, the facility is subject
to the issuance of:

(1) a correction order; and

(2) a penalty assessment by the commissioner in rule.

(c) Notwithstanding subdivisions 21 and 22, any correction order issued under this
subdivision must require that the facility immediately comply with the request for information
and that, as of the date of the issuance of the correction order, the facility shall forfeit to the
state a $500 fine the first day of noncompliance and an increase in the $500 fine by $100
increments for each day the noncompliance continues.

(d) Information provided under this subdivision may be used by the commissioner deleted text beginordeleted text endnew text begin,new text end
the ombudsman for long-term carenew text begin, or the Office of Ombudsman for Mental Health and
Developmental Disabilities
new text end only for the purpose of providing affected consumers information
about the status of the proceedings.

(e) Within ten business days after the commissioner initiates proceedings to revoke,
suspend, or not renew a facility license, the commissioner must send a written notice of the
action and the process involved to each resident of the facility, legal representatives and
designated representatives, and at the commissioner's discretion, additional resident contacts.

(f) The commissioner shall provide the ombudsman for long-term care new text beginand the Office
of Ombudsman for Mental Health and Developmental Disabilities
new text endwith monthly information
on the department's actions and the status of the proceedings.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 31.

Minnesota Statutes 2020, section 144G.20, subdivision 15, is amended to read:


Subd. 15.

Plan required.

(a) The process of suspending, revoking, or refusing to renew
a license must include a plan for transferring affected residents' cares to other providers by
the facility. The commissioner shall monitor the transfer plan. Within three calendar days
of being notified of the final revocation, refusal to renew, or suspension, the licensee shall
provide the commissioner, the lead agencies as defined in section 256B.0911, county adult
protection and case managers, deleted text beginanddeleted text end the ombudsman for long-term carenew text begin, and the Office of
Ombudsman for Mental Health and Developmental Disabilities
new text end with the following
information:

(1) a list of all residents, including full names and all contact information on file;

(2) a list of the resident's legal representatives and designated representatives and family
or other contacts listed in the assisted living contract, including full names and all contact
information on file;

(3) the location or current residence of each resident;

(4) the deleted text beginpayordeleted text endnew text begin payernew text end sources for each resident, including deleted text beginpayordeleted text endnew text begin payernew text end source identification
numbers; and

(5) for each resident, a copy of the resident's service plan and a list of the types of services
being provided.

(b) The revocation, refusal to renew, or suspension notification requirement is satisfied
by mailing the notice to the address in the license record. The licensee shall cooperate with
the commissioner and the lead agencies, county adult protection and case managers, deleted text beginanddeleted text end
the ombudsman for long-term carenew text begin, and the Office of Ombudsman for Mental Health and
Developmental Disabilities
new text end during the process of transferring care of residents to qualified
providers. Within three calendar days of being notified of the final revocation, refusal to
renew, or suspension action, the facility must notify and disclose to each of the residents,
or the resident's legal and designated representatives or emergency contact persons, that the
commissioner is taking action against the facility's license by providing a copy of the
revocation, refusal to renew, or suspension notice issued by the commissioner. If the facility
does not comply with the disclosure requirements in this section, the commissioner shall
notify the residents, legal and designated representatives, or emergency contact persons
about the actions being taken. Lead agencies, county adult protection and case managers,
and the Office of Ombudsman for Long-Term Care may also provide this information. The
revocation, refusal to renew, or suspension notice is public data except for any private data
contained therein.

(c) A facility subject to this subdivision may continue operating while residents are being
transferred to other service providers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 32.

Minnesota Statutes 2020, section 144G.30, subdivision 5, is amended to read:


Subd. 5.

Correction orders.

(a) A correction order may be issued whenever the
commissioner finds upon survey or during a complaint investigation that a facility, a
managerial official, new text beginan agent of the facility, new text endor an employee of the facility is not in compliance
with this chapter. The correction order shall cite the specific statute and document areas of
noncompliance and the time allowed for correction.

(b) The commissioner shall mail or e-mail copies of any correction order to the facility
within 30 calendar days after the survey exit date. A copy of each correction order and
copies of any documentation supplied to the commissioner shall be kept on file by the
facility and public documents shall be made available for viewing by any person upon
request. Copies may be kept electronically.

(c) By the correction order date, the facility must document in the facility's records any
action taken to comply with the correction order. The commissioner may request a copy of
this documentation and the facility's action to respond to the correction order in future
surveys, upon a complaint investigation, and as otherwise needed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 33.

Minnesota Statutes 2020, section 144G.31, subdivision 4, is amended to read:


Subd. 4.

Fine amounts.

(a) Fines and enforcement actions under this subdivision may
be assessed based on the level and scope of the violations described in subdivisions 2 and
3 as follows and may be imposed immediately with no opportunity to correct the violation
prior to imposition:

(1) Level 1, no fines or enforcement;

(2) Level 2, a fine of $500 per violation, in addition to any enforcement mechanism
authorized in section 144G.20 for widespread violations;

(3) Level 3, a fine of $3,000 per violation deleted text beginper incidentdeleted text end, in addition to any enforcement
mechanism authorized in section 144G.20;

(4) Level 4, a fine of $5,000 per deleted text beginincidentdeleted text endnew text begin violationnew text end, in addition to any enforcement
mechanism authorized in section 144G.20; and

(5) for maltreatment violations for which the licensee was determined to be responsible
for the maltreatment under section 626.557, subdivision 9c, paragraph (c), a fine of $1,000
new text begin per incidentnew text end. A fine of $5,000 new text beginper incidentnew text end may be imposed if the commissioner determines
the licensee is responsible for maltreatment consisting of sexual assault, death, or abuse
resulting in serious injury.

(b) When a fine is assessed against a facility for substantiated maltreatment, the
commissioner shall not also impose an immediate fine under this chapter for the same
circumstance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 34.

Minnesota Statutes 2020, section 144G.31, subdivision 8, is amended to read:


Subd. 8.

Deposit of fines.

Fines collected under this section shall be deposited in a
dedicated special revenue account. On an annual basis, the balance in the special revenue
account shall be appropriated to the commissioner for special projects to improve deleted text beginhome
care
deleted text endnew text begin resident quality of care and outcomes in assisted living facilities licensed under this
chapter
new text end in Minnesota as recommended by the advisory council established in section
144A.4799.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively for fines collected on or
after August 1, 2021.
new text end

Sec. 35.

Minnesota Statutes 2020, section 144G.41, subdivision 7, is amended to read:


Subd. 7.

Resident grievances; reporting maltreatment.

All facilities must post in a
conspicuous place information about the facilities' grievance procedure, and the name,
telephone number, and e-mail contact information for the individuals who are responsible
for handling resident grievances. The notice must also have the contact information for the
deleted text begin state and applicable regionaldeleted text end Office of Ombudsman for Long-Term Care and the Office of
Ombudsman for Mental Health and Developmental Disabilities, and must have information
for reporting suspected maltreatment to the Minnesota Adult Abuse Reporting Center.new text begin The
notice must also state that if an individual has a complaint about the facility or person
providing services, the individual may contact the Office of Health Facility Complaints at
the Minnesota Department of Health.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 36.

Minnesota Statutes 2020, section 144G.41, subdivision 8, is amended to read:


Subd. 8.

Protecting resident rights.

All facilities shall ensure that every resident has
access to consumer advocacy or legal services by:

(1) providing names and contact information, including telephone numbers and e-mail
addresses of at least three organizations that provide advocacy or legal services to residentsnew text begin,
one of which must include the designated protection and advocacy organization in Minnesota
that provides advice and representation to individuals with disabilities
new text end;

(2) providing the name and contact information for the Minnesota Office of Ombudsman
for Long-Term Care and the Office of Ombudsman for Mental Health and Developmental
Disabilitiesdeleted text begin, including both the state and regional contact informationdeleted text end;

(3) assisting residents in obtaining information on whether Medicare or medical assistance
under chapter 256B will pay for services;

(4) making reasonable accommodations for people who have communication disabilities
and those who speak a language other than English; and

(5) providing all information and notices in plain language and in terms the residents
can understand.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 37.

Minnesota Statutes 2020, section 144G.42, subdivision 10, is amended to read:


Subd. 10.

Disaster planning and emergency preparedness plan.

(a) The facility must
meet the following requirements:

(1) have a written emergency disaster plan that contains a plan for evacuation, addresses
elements of sheltering in place, identifies temporary relocation sites, and details staff
assignments in the event of a disaster or an emergency;

(2) post an emergency disaster plan prominently;

(3) provide building emergency exit diagrams to all residents;

(4) post emergency exit diagrams on each floor; and

(5) have a written policy and procedure regarding missing deleted text begintenantdeleted text end residents.

(b) The facility must provide emergency and disaster training to all staff during the initial
staff orientation and annually thereafter and must make emergency and disaster training
annually available to all residents. Staff who have not received emergency and disaster
training are allowed to work only when trained staff are also working on site.

(c) The facility must meet any additional requirements adopted in rule.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 38.

Minnesota Statutes 2020, section 144G.45, subdivision 7, is amended to read:


Subd. 7.

Variance or waiver.

(a) A facility may request that the commissioner grant a
variance or waiver from the provisions of this section or section 144G.81, subdivision 5. A
request for a waiver must be submitted to the commissioner in writing. Each request must
contain:

(1) the specific requirement for which the variance or waiver is requested;

(2) the reasons for the request;

(3) the alternative measures that will be taken if a variance or waiver is granted;

(4) the length of time for which the variance or waiver is requested; and

(5) other relevant information deemed necessary by the commissioner to properly evaluate
the request for the waiver.

(b) The decision to grant or deny a variance or waiver must be based on the
commissioner's evaluation of the following criteria:

(1) whether the waiver will adversely affect the health, treatment, comfort, safety, or
well-being of a resident;

(2) whether the alternative measures to be taken, if any, are equivalent to or superior to
those permitted under section 144G.81, subdivision 5; deleted text beginand
deleted text end

(3) whether compliance with the requirements would impose an undue burden on the
facilitynew text begin; and
new text end

new text begin (4) notwithstanding clause (1), for construction existing as of August 1, 2021, the
commissioner's evaluation of a variance from the requirement to provide an option for a
bath under subdivision 4, paragraph (a), must be based on clauses (2) and (3) and whether
the variance will adversely affect the health, treatment, or safety of a resident
new text end.

(c) The commissioner must notify the facility in writing of the decision. If a variance or
waiver is granted, the notification must specify the period of time for which the variance
or waiver is effective and the alternative measures or conditions, if any, to be met by the
facility.

(d) Alternative measures or conditions attached to a variance or waiver have the force
and effect of this chapter and are subject to the issuance of correction orders and fines in
accordance with sections 144G.30, subdivision 7, and 144G.31. The amount of fines for a
violation of this subdivision is that specified for the specific requirement for which the
variance or waiver was requested.

(e) A request for renewal of a variance or waiver must be submitted in writing at least
45 days before its expiration date. Renewal requests must contain the information specified
in paragraph (b). A variance or waiver must be renewed by the commissioner if the facility
continues to satisfy the criteria in paragraph (a) and demonstrates compliance with the
alternative measures or conditions imposed at the time the original variance or waiver was
granted.

(f) The commissioner must deny, revoke, or refuse to renew a variance or waiver if it
is determined that the criteria in paragraph (a) are not met. The facility must be notified in
writing of the reasons for the decision and informed of the right to appeal the decision.

(g) A facility may contest the denial, revocation, or refusal to renew a variance or waiver
by requesting a contested case hearing under chapter 14. The facility must submit, within
15 days of the receipt of the commissioner's decision, a written request for a hearing. The
request for hearing must set forth in detail the reasons why the facility contends the decision
of the commissioner should be reversed or modified. At the hearing, the facility has the
burden of proving by a preponderance of the evidence that the facility satisfied the criteria
specified in paragraph (b), except in a proceeding challenging the revocation of a variance
or waiver.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 39.

Minnesota Statutes 2020, section 144G.50, subdivision 2, is amended to read:


Subd. 2.

Contract information.

(a) The contract must include in a conspicuous place
and manner on the contract the legal name and the deleted text beginlicense numberdeleted text endnew text begin health facility identificationnew text end
of the facility.

(b) The contract must include the name, telephone number, and physical mailing address,
which may not be a public or private post office box, of:

(1) the facility and contracted service provider when applicable;

(2) the licensee of the facility;

(3) the managing agent of the facility, if applicable; and

(4) the authorized agent for the facility.

(c) The contract must include:

(1) a disclosure of the category of assisted living facility license held by the facility and,
if the facility is not an assisted living facility with dementia care, a disclosure that it does
not hold an assisted living facility with dementia care license;

(2) a description of all the terms and conditions of the contract, including a description
of and any limitations to the housing or assisted living services to be provided for the
contracted amount;

(3) a delineation of the cost and nature of any other services to be provided for an
additional fee;

(4) a delineation and description of any additional fees the resident may be required to
pay if the resident's condition changes during the term of the contract;

(5) a delineation of the grounds under which the resident may be deleted text begindischarged, evicted,
or
deleted text end transferred or have new text beginhousing or new text endservices terminatednew text begin or be subject to an emergency
relocation
new text end;

(6) billing and payment procedures and requirements; and

(7) disclosure of the facility's ability to provide specialized diets.

(d) The contract must include a description of the facility's complaint resolution process
available to residents, including the name and contact information of the person representing
the facility who is designated to handle and resolve complaints.

(e) The contract must include a clear and conspicuous notice of:

(1) the right under section 144G.54 to appeal the termination of an assisted living contract;

(2) the facility's policy regarding transfer of residents within the facility, under what
circumstances a transfer may occur, and the circumstances under which resident consent is
required for a transfer;

(3) contact information for the Office of Ombudsman for Long-Term Care, the
Ombudsman for Mental Health and Developmental Disabilities, and the Office of Health
Facility Complaints;

(4) the resident's right to obtain services from an unaffiliated service provider;

(5) a description of the facility's policies related to medical assistance waivers under
chapter 256S and section 256B.49 and the housing support program under chapter 256I,
including:

(i) whether the facility is enrolled with the commissioner of human services to provide
customized living services under medical assistance waivers;

(ii) whether the facility has an agreement to provide housing support under section
256I.04, subdivision 2, paragraph (b);

(iii) whether there is a limit on the number of people residing at the facility who can
receive customized living services or participate in the housing support program at any
point in time. If so, the limit must be provided;

(iv) whether the facility requires a resident to pay privately for a period of time prior to
accepting payment under medical assistance waivers or the housing support program, and
if so, the length of time that private payment is required;

(v) a statement that medical assistance waivers provide payment for services, but do not
cover the cost of rent;

(vi) a statement that residents may be eligible for assistance with rent through the housing
support program; and

(vii) a description of the rent requirements for people who are eligible for medical
assistance waivers but who are not eligible for assistance through the housing support
program;

(6) the contact information to obtain long-term care consulting services under section
256B.0911; and

(7) the toll-free phone number for the Minnesota Adult Abuse Reporting Center.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022, and applies to assisted
living contracts executed on or after that date.
new text end

Sec. 40.

Minnesota Statutes 2020, section 144G.52, subdivision 2, is amended to read:


Subd. 2.

Prerequisite to termination of a contract.

(a) Before issuing a notice of
termination of an assisted living contract, a facility must schedule and participate in a meeting
with the resident and the resident's legal representative and designated representative. The
purposes of the meeting are to:

(1) explain in detail the reasons for the proposed termination; and

(2) identify and offer reasonable accommodations or modifications, interventions, or
alternatives to avoid the termination or enable the resident to remain in the facility, including
but not limited to securing services from another provider of the resident's choosing that
may allow the resident to avoid the termination. A facility is not required to offer
accommodations, modifications, interventions, or alternatives that fundamentally alter the
nature of the operation of the facility.

(b) The meeting must be scheduled to take place at least seven days before a notice of
termination is issued. The facility must make reasonable efforts to ensure that the resident,
legal representative, and designated representative are able to attend the meeting.

(c) The facility must notify the resident that the resident may invite family members,
relevant health professionals, a representative of the Office of Ombudsman for Long-Term
Care, new text begina representative of the Office of Ombudsman for Mental Health and Developmental
Disabilities,
new text endor other persons of the resident's choosing to participate in the meeting. For
residents who receive home and community-based waiver services under chapter 256S and
section 256B.49, the facility must notify the resident's case manager of the meeting.

(d) In the event of an emergency relocation under subdivision 9, where the facility intends
to issue a notice of termination and an in-person meeting is impractical or impossible, the
facility deleted text beginmay attempt to schedule and participate in a meeting under this subdivision viadeleted text endnew text begin must
use
new text end telephone, video, or other new text beginelectronic new text endmeansnew text begin to conduct and participate in the meeting
required under this subdivision and rules within Minnesota Rules, chapter 4659
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 41.

Minnesota Statutes 2020, section 144G.52, subdivision 8, is amended to read:


Subd. 8.

Content of notice of termination.

The notice required under subdivision 7
must contain, at a minimum:

(1) the effective date of the termination of the assisted living contract;

(2) a detailed explanation of the basis for the termination, including the clinical or other
supporting rationale;

(3) a detailed explanation of the conditions under which a new or amended contract may
be executed;

(4) a statement that the resident has the right to appeal the termination by requesting a
hearing, and information concerning the time frame within which the request must be
submitted and the contact information for the agency to which the request must be submitted;

(5) a statement that the facility must participate in a coordinated move to another provider
or caregiver, as required under section 144G.55;

(6) the name and contact information of the person employed by the facility with whom
the resident may discuss the notice of termination;

(7) information on how to contact the Office of Ombudsman for Long-Term Care new text beginand
the Office of Ombudsman for Mental Health and Developmental Disabilities
new text endto request an
advocate to assist regarding the termination;

(8) information on how to contact the Senior LinkAge Line under section 256.975,
subdivision 7, and an explanation that the Senior LinkAge Line may provide information
about other available housing or service options; and

(9) if the termination is only for services, a statement that the resident may remain in
the facility and may secure any necessary services from another provider of the resident's
choosing.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 42.

Minnesota Statutes 2020, section 144G.52, subdivision 9, is amended to read:


Subd. 9.

Emergency relocation.

(a) A facility may remove a resident from the facility
in an emergency if necessary due to a resident's urgent medical needs or an imminent risk
the resident poses to the health or safety of another facility resident or facility staff member.
An emergency relocation is not a termination.

(b) In the event of an emergency relocation, the facility must provide a written notice
that contains, at a minimum:

(1) the reason for the relocation;

(2) the name and contact information for the location to which the resident has been
relocated and any new service provider;

(3) contact information for the Office of Ombudsman for Long-Term Carenew text begin and the Office
of Ombudsman for Mental Health and Developmental Disabilities
new text end;

(4) if known and applicable, the approximate date or range of dates within which the
resident is expected to return to the facility, or a statement that a return date is not currently
known; and

(5) a statement that, if the facility refuses to provide housing or services after a relocation,
the resident has the right to appeal under section 144G.54. The facility must provide contact
information for the agency to which the resident may submit an appeal.

(c) The notice required under paragraph (b) must be delivered as soon as practicable to:

(1) the resident, legal representative, and designated representative;

(2) for residents who receive home and community-based waiver services under chapter
256S and section 256B.49, the resident's case manager; and

(3) the Office of Ombudsman for Long-Term Care if the resident has been relocated
and has not returned to the facility within four days.

(d) Following an emergency relocation, a facility's refusal to provide housing or services
constitutes a termination and triggers the termination process in this section.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 43.

Minnesota Statutes 2020, section 144G.53, is amended to read:


144G.53 NONRENEWAL OF HOUSING.

(a) If a facility decides to not renew a resident's housing under a contract, the facility
must either (1) provide the resident with 60 calendar days' notice of the nonrenewal and
assistance with relocation planning, or (2) follow the termination procedure under section
144G.52.

(b) The notice must include the reason for the nonrenewal and contact information of
the Office of Ombudsman for Long-Term Carenew text begin and the Office of Ombudsman for Mental
Health and Developmental Disabilities
new text end.

(c) A facility must:

(1) provide notice of the nonrenewal to the Office of Ombudsman for Long-Term Care;

(2) for residents who receive home and community-based waiver services under chapter
256S and section 256B.49, provide notice to the resident's case manager;

(3) ensure a coordinated move to a safe location, as defined in section 144G.55,
subdivision 2, that is appropriate for the resident;

(4) ensure a coordinated move to an appropriate service provider identified by the facility,
if services are still needed and desired by the resident;

(5) consult and cooperate with the resident, legal representative, designated representative,
case manager for a resident who receives home and community-based waiver services under
chapter 256S and section 256B.49, relevant health professionals, and any other persons of
the resident's choosing to make arrangements to move the resident, including consideration
of the resident's goals; and

(6) prepare a written plan to prepare for the move.

(d) A resident may decline to move to the location the facility identifies or to accept
services from a service provider the facility identifies, and may instead choose to move to
a location of the resident's choosing or receive services from a service provider of the
resident's choosing within the timeline prescribed in the nonrenewal notice.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 44.

Minnesota Statutes 2020, section 144G.55, subdivision 1, is amended to read:


Subdivision 1.

Duties of facility.

(a) If a facility terminates an assisted living contract,
reduces services to the extent that a resident needs to movenew text begin or obtain a new service provider
or the facility has its license restricted under section 144G.20
new text end, or new text beginthe facility new text endconducts a
planned closure under section 144G.57, the facility:

(1) must ensure, subject to paragraph (c), a coordinated move to a safe location that is
appropriate for the resident and that is identified by the facility prior to any hearing under
section 144G.54;

(2) must ensure a coordinated move of the resident to an appropriate service provider
identified by the facility prior to any hearing under section 144G.54, provided services are
still needed and desired by the resident; and

(3) must consult and cooperate with the resident, legal representative, designated
representative, case manager for a resident who receives home and community-based waiver
services under chapter 256S and section 256B.49, relevant health professionals, and any
other persons of the resident's choosing to make arrangements to move the resident, including
consideration of the resident's goals.

(b) A facility may satisfy the requirements of paragraph (a), clauses (1) and (2), by
moving the resident to a different location within the same facility, if appropriate for the
resident.

(c) A resident may decline to move to the location the facility identifies or to accept
services from a service provider the facility identifies, and may choose instead to move to
a location of the resident's choosing or receive services from a service provider of the
resident's choosing within the timeline prescribed in the termination notice.

(d) Sixty days before the facility plans to reduce or eliminate one or more services for
a particular resident, the facility must provide written notice of the reduction that includes:

(1) a detailed explanation of the reasons for the reduction and the date of the reduction;

(2) the contact information for the Office of Ombudsman for Long-Term Carenew text begin, the Office
of Ombudsman for Mental Health and Developmental Disabilities,
new text end and the name and contact
information of the person employed by the facility with whom the resident may discuss the
reduction of services;

(3) a statement that if the services being reduced are still needed by the resident, the
resident may remain in the facility and seek services from another provider; and

(4) a statement that if the reduction makes the resident need to move, the facility must
participate in a coordinated move of the resident to another provider or caregiver, as required
under this section.

(e) In the event of an unanticipated reduction in services caused by extraordinary
circumstances, the facility must provide the notice required under paragraph (d) as soon as
possible.

(f) If the facility, a resident, a legal representative, or a designated representative
determines that a reduction in services will make a resident need to move to a new location,
the facility must ensure a coordinated move in accordance with this section, and must provide
notice to the Office of Ombudsman for Long-Term Care.

(g) Nothing in this section affects a resident's right to remain in the facility and seek
services from another provider.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 45.

Minnesota Statutes 2020, section 144G.55, subdivision 3, is amended to read:


Subd. 3.

Relocation plan required.

The facility must prepare a relocation plan to prepare
for the move to deleted text beginthedeleted text endnew text begin anew text end new new text beginsafe new text endlocation or new text beginappropriate new text endservice providernew text begin, as required by this
section
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 46.

Minnesota Statutes 2020, section 144G.56, subdivision 3, is amended to read:


Subd. 3.

Notice required.

(a) A facility must provide at least 30 calendar days' advance
written notice to the resident and the resident's legal and designated representative of a
facility-initiated transfer. The notice must include:

(1) the effective date of the proposed transfer;

(2) the proposed transfer location;

(3) a statement that the resident may refuse the proposed transfer, and may discuss any
consequences of a refusal with staff of the facility;

(4) the name and contact information of a person employed by the facility with whom
the resident may discuss the notice of transfer; and

(5) contact information for the Office of Ombudsman for Long-Term Carenew text begin and the Office
of Ombudsman for Mental Health and Developmental Disabilities
new text end.

(b) Notwithstanding paragraph (a), a facility may conduct a facility-initiated transfer of
a resident with less than 30 days' written notice if the transfer is necessary due to:

(1) conditions that render the resident's room or private living unit uninhabitable;

(2) the resident's urgent medical needs; or

(3) a risk to the health or safety of another resident of the facility.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 47.

Minnesota Statutes 2020, section 144G.56, subdivision 5, is amended to read:


Subd. 5.

Changes in facility operations.

(a) In situations where there is a curtailment,
reduction, or capital improvement within a facility necessitating transfers, the facility must:

(1) minimize the number of transfers it initiates to complete the project or change in
operations;

(2) consider individual resident needs and preferences;

(3) provide reasonable accommodations for individual resident requests regarding the
transfers; and

(4) in advance of any notice to any residents, legal representatives, or designated
representatives, provide notice to the Office of Ombudsman for Long-Term Care anddeleted text begin, when
appropriate,
deleted text end the Office of Ombudsman for Mental Health and Developmental Disabilities
of the curtailment, reduction, or capital improvement and the corresponding needed transfers.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 48.

Minnesota Statutes 2020, section 144G.57, subdivision 1, is amended to read:


Subdivision 1.

Closure plan required.

In the event that an assisted living facility elects
to voluntarily close the facility, the facility must notify the commissioner deleted text beginanddeleted text endnew text begin,new text end the Office
of Ombudsman for Long-Term Carenew text begin, and the Office of Ombudsman for Mental Health and
Developmental Disabilities
new text end in writing by submitting a proposed closure plan.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 49.

Minnesota Statutes 2020, section 144G.57, subdivision 3, is amended to read:


Subd. 3.

Commissioner's approval required prior to implementation.

(a) The plan
shall be subject to the commissioner's approval and subdivision 6. The facility shall take
no action to close the residence prior to the commissioner's approval of the plan. The
commissioner shall approve or otherwise respond to the plan as soon as practicable.

(b) The commissioner may require the facility to work with a transitional team comprised
of department staff, staff of the Office of Ombudsman for Long-Term Care, new text beginthe Office of
Ombudsman for Mental Health and Developmental Disabilities,
new text endand other professionals the
commissioner deems necessary to assist in the proper relocation of residents.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 50.

Minnesota Statutes 2020, section 144G.57, subdivision 5, is amended to read:


Subd. 5.

Notice to residents.

After the commissioner has approved the relocation plan
and at least 60 calendar days before closing, except as provided under subdivision 6, the
facility must notify residents, designated representatives, and legal representatives of the
closure, the proposed date of closure, the contact information of the ombudsman for long-term
carenew text begin and the ombudsman for mental health and developmental disabilitiesnew text end, and that the
facility will follow the termination planning requirements under section 144G.55, and final
accounting and return requirements under section 144G.42, subdivision 5. For residents
who receive home and community-based waiver services under chapter 256S and section
256B.49, the facility must also provide this information to the resident's case manager.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 51.

Minnesota Statutes 2020, section 144G.70, subdivision 2, is amended to read:


Subd. 2.

Initial reviews, assessments, and monitoring.

(a) Residents who are not
receiving any new text beginassisted living new text endservices shall not be required to undergo an initial nursing
assessment.

(b) An assisted living facility shall conduct a nursing assessment by a registered nurse
of the physical and cognitive needs of the prospective resident and propose a temporary
service plan prior to the date on which a prospective resident executes a contract with a
facility or the date on which a prospective resident moves in, whichever is earlier. If
necessitated by either the geographic distance between the prospective resident and the
facility, or urgent or unexpected circumstances, the assessment may be conducted using
telecommunication methods based on practice standards that meet the resident's needs and
reflect person-centered planning and care delivery.

(c) Resident reassessment and monitoring must be conducted no more than 14 calendar
days after initiation of services. Ongoing resident reassessment and monitoring must be
conducted as needed based on changes in the needs of the resident and cannot exceed 90
calendar days from the last date of the assessment.

(d) For residents only receiving assisted living services specified in section 144G.08,
subdivision 9, clauses (1) to (5), the facility shall complete an individualized initial review
of the resident's needs and preferences. The initial review must be completed within 30
calendar days of the start of services. Resident monitoring and review must be conducted
as needed based on changes in the needs of the resident and cannot exceed 90 calendar days
from the date of the last review.

(e) A facility must inform the prospective resident of the availability of and contact
information for long-term care consultation services under section 256B.0911, prior to the
date on which a prospective resident executes a contract with a facility or the date on which
a prospective resident moves in, whichever is earlier.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 52.

Minnesota Statutes 2020, section 144G.70, subdivision 4, is amended to read:


Subd. 4.

Service plan, implementation, and revisions to service plan.

(a) No later
than 14 calendar days after the date that services are first provided, an assisted living facility
shall finalize a current written service plan.

(b) The service plan and any revisions must include a signature or other authentication
by the facility and by the resident documenting agreement on the services to be provided.
The service plan must be revised, if needed, based on resident reassessment under subdivision
2. The facility must provide information to the resident about changes to the facility's fee
for services and how to contact the Office of Ombudsman for Long-Term Carenew text begin and the
Office of Ombudsman for Mental Health and Developmental Disabilities
new text end.

(c) The facility must implement and provide all services required by the current service
plan.

(d) The service plan and the revised service plan must be entered into the resident record,
including notice of a change in a resident's fees when applicable.

(e) Staff providing services must be informed of the current written service plan.

(f) The service plan must include:

(1) a description of the services to be provided, the fees for services, and the frequency
of each service, according to the resident's current assessment and resident preferences;

(2) the identification of staff or categories of staff who will provide the services;

(3) the schedule and methods of monitoring assessments of the resident;

(4) the schedule and methods of monitoring staff providing services; and

(5) a contingency plan that includes:

(i) the action to be taken if the scheduled service cannot be provided;

(ii) information and a method to contact the facility;

(iii) the names and contact information of persons the resident wishes to have notified
in an emergency or if there is a significant adverse change in the resident's condition,
including identification of and information as to who has authority to sign for the resident
in an emergency; and

(iv) the circumstances in which emergency medical services are not to be summoned
consistent with chapters 145B and 145C, and declarations made by the resident under those
chapters.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 53.

Minnesota Statutes 2020, section 144G.80, subdivision 2, is amended to read:


Subd. 2.

Demonstrated capacity.

(a) An applicant for licensure as an assisted living
facility with dementia care must have the ability to provide services in a manner that is
consistent with the requirements in this section. The commissioner shall consider the
following criteria, including, but not limited to:

(1) the experience of the deleted text beginapplicant indeleted text endnew text begin applicant's assisted living director, managerial
official, and clinical nurse supervisor
new text end managing residents with dementia or previous long-term
care experience; and

(2) the compliance history of the applicant in the operation of any care facility licensed,
certified, or registered under federal or state law.

(b) If the deleted text beginapplicant doesdeleted text endnew text begin applicant's assisted living director and clinical nurse supervisor
do
new text end not have experience in managing residents with dementia, the applicant must employ a
consultant for at least the first six months of operation. The consultant must meet the
requirements in paragraph (a), clause (1), and make recommendations on providing dementia
care services consistent with the requirements of this chapter. The consultant must (1) have
two years of work experience related to dementia, health care, gerontology, or a related
field, and (2) have completed at least the minimum core training requirements in section
144G.64. The applicant must document an acceptable plan to address the consultant's
identified concerns and must either implement the recommendations or document in the
plan any consultant recommendations that the applicant chooses not to implement. The
commissioner must review the applicant's plan upon request.

(c) The commissioner shall conduct an on-site inspection prior to the issuance of an
assisted living facility with dementia care license to ensure compliance with the physical
environment requirements.

(d) The label "Assisted Living Facility with Dementia Care" must be identified on the
license.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 54.

Minnesota Statutes 2020, section 144G.90, subdivision 1, is amended to read:


Subdivision 1.

Assisted living bill of rights; notification to resident.

(a) An assisted
living facility must provide the resident a written notice of the rights under section 144G.91
before the initiation of services to that resident. The facility shall make all reasonable efforts
to provide notice of the rights to the resident in a language the resident can understand.

(b) In addition to the text of the assisted living bill of rights in section 144G.91, the
notice shall also contain the following statement describing how to file a complaint or report
suspected abuse:

"If you want to report suspected abuse, neglect, or financial exploitation, you may contact
the Minnesota Adult Abuse Reporting Center (MAARC). If you have a complaint about
the facility or person providing your services, you may contact the Office of Health Facility
Complaints, Minnesota Department of Health. new text beginIf you would like to request advocacy services,
new text end you may deleted text beginalsodeleted text end contact the Office of Ombudsman for Long-Term Care or the Office of
Ombudsman for Mental Health and Developmental Disabilities."

(c) The statement must include contact information for the Minnesota Adult Abuse
Reporting Center and the telephone number, website address, e-mail address, mailing
address, and street address of the Office of Health Facility Complaints at the Minnesota
Department of Health, the Office of Ombudsman for Long-Term Care, and the Office of
Ombudsman for Mental Health and Developmental Disabilities. The statement must include
the facility's name, address, e-mail, telephone number, and name or title of the person at
the facility to whom problems or complaints may be directed. It must also include a statement
that the facility will not retaliate because of a complaint.

(d) A facility must obtain written acknowledgment from the resident of the resident's
receipt of the assisted living bill of rights or shall document why an acknowledgment cannot
be obtained. Acknowledgment of receipt shall be retained in the resident's record.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 55.

Minnesota Statutes 2020, section 144G.90, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Notice to residents. new text end

new text begin For any notice to a resident, legal representative, or
designated representative provided under this chapter or under Minnesota Rules, chapter
4659, that is required to include information regarding the Office of Ombudsman for
Long-Term Care and the Office of Ombudsman for Mental Health and Developmental
Disabilities, the notice must contain the following language: "You may contact the
Ombudsman for Long-Term Care for questions about your rights as an assisted living facility
resident and to request advocacy services. As an assisted living facility resident, you may
contact the Ombudsman for Mental Health and Developmental Disabilities to request
advocacy regarding your rights, concerns, or questions on issues relating to services for
mental health, developmental disabilities, or chemical dependency."
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 56.

Minnesota Statutes 2020, section 144G.91, subdivision 13, is amended to read:


Subd. 13.

Personal and treatment privacy.

(a) Residents have the right to consideration
of their privacy, individuality, and cultural identity as related to their social, religious, and
psychological well-being. Staff must respect the privacy of a resident's space by knocking
on the door and seeking consent before entering, except in an emergency or deleted text beginwhere clearly
inadvisable or
deleted text end unless otherwise documented in the resident's service plan.

(b) Residents have the right to have and use a lockable door to the resident's unit. The
facility shall provide locks on the resident's unit. Only a staff member with a specific need
to enter the unit shall have keys. This right may be restricted in certain circumstances if
necessary for a resident's health and safety and documented in the resident's service plan.

(c) Residents have the right to respect and privacy regarding the resident's service plan.
Case discussion, consultation, examination, and treatment are confidential and must be
conducted discreetly. Privacy must be respected during toileting, bathing, and other activities
of personal hygiene, except as needed for resident safety or assistance.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 57.

Minnesota Statutes 2020, section 144G.91, subdivision 21, is amended to read:


Subd. 21.

Access to counsel and advocacy services.

Residents have the right to the
immediate access by:

(1) the resident's legal counsel;

(2) any representative of the protection and advocacy system designated by the state
under Code of Federal Regulations, title 45, section 1326.21; or

(3) any representative of the Office of Ombudsman for Long-Term Carenew text begin or the Office
of Ombudsman for Mental Health and Developmental Disabilities
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 58.

Minnesota Statutes 2020, section 144G.92, subdivision 1, is amended to read:


Subdivision 1.

Retaliation prohibited.

A facility or agent of a facility may not retaliate
against a resident or employee if the resident, employee, or any person acting on behalf of
the resident:

(1) files a good faith complaint or grievance, makes a good faith inquiry, or asserts any
right;

(2) indicates a good faith intention to file a complaint or grievance, make an inquiry, or
assert any right;

(3) files, in good faith, or indicates an intention to file a maltreatment report, whether
mandatory or voluntary, under section 626.557;

(4) seeks assistance from or reports a reasonable suspicion of a crime or systemic
problems or concerns to the director or manager of the facility, the Office of Ombudsman
for Long-Term Care, new text beginthe Office of Ombudsman for Mental Health and Developmental
Disabilities,
new text enda regulatory or other government agency, or a legal or advocacy organization;

(5) advocates or seeks advocacy assistance for necessary or improved care or services
or enforcement of rights under this section or other law;

(6) takes or indicates an intention to take civil action;

(7) participates or indicates an intention to participate in any investigation or
administrative or judicial proceeding;

(8) contracts or indicates an intention to contract to receive services from a service
provider of the resident's choice other than the facility; or

(9) places or indicates an intention to place a camera or electronic monitoring device in
the resident's private space as provided under section 144.6502.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 59.

Minnesota Statutes 2020, section 144G.93, is amended to read:


144G.93 CONSUMER ADVOCACY AND LEGAL SERVICES.

Upon execution of an assisted living contract, every facility must provide the resident
with the names and contact information, including telephone numbers and e-mail addresses,
of:

(1) nonprofit organizations that provide advocacy or legal services to residents including
but not limited to the designated protection and advocacy organization in Minnesota that
provides advice and representation to individuals with disabilities; and

(2) the Office of Ombudsman for Long-Term Caredeleted text begin, including both the state and regional
contact information
deleted text endnew text begin and the Office of Ombudsman for Mental Health and Developmental
Disabilities
new text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 60.

Minnesota Statutes 2020, section 144G.95, is amended to read:


144G.95 OFFICE OF OMBUDSMAN FOR LONG-TERM CAREnew text begin AND OFFICE
OF OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL
DISABILITIES
new text end.

Subdivision 1.

Immunity from liability.

new text begin(a) new text endThe Office of Ombudsman for Long-Term
Care and representatives of the office are immune from liability for conduct described in
section 256.9742, subdivision 2.

new text begin (b) The Office of Ombudsman for Mental Health and Developmental Disabilities and
representatives of the office are immune from liability for conduct described in section
245.96.
new text end

Subd. 2.

Data classification.

new text begin(a) new text endAll forms and notices received by the Office of
Ombudsman for Long-Term Care under this chapter are classified under section 256.9744.

new text begin (b) All data collected or received by the Office of Ombudsman for Mental Health and
Developmental Disabilities are classified under section 245.94.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 61.

new text begin [145.267] FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION
GRANTS.
new text end

new text begin (a) The commissioner of health shall award a grant to a statewide organization that
focuses solely on prevention of and intervention with fetal alcohol spectrum disorders. The
grant recipient must make subgrants to eligible regional collaboratives in rural and urban
areas of the state for the purposes specified in paragraph (c).
new text end

new text begin (b) "Eligible regional collaboratives" means a partnership between at least one local
government or Tribal government and at least one community-based organization and,
where available, a family home visiting program. For purposes of this paragraph, a local
government includes a county or a multicounty organization, a county-based purchasing
entity, or a community health board.
new text end

new text begin (c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of
fetal alcohol spectrum disorders and other prenatal drug-related effects in children in
Minnesota by identifying and serving pregnant women suspected of or known to use or
abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services
to chemically dependent women to increase positive birth outcomes.
new text end

new text begin (d) An eligible regional collaborative that receives a subgrant under this section must
report to the grant recipient by January 15 of each year on the services and programs funded
by the subgrant. The report must include measurable outcomes for the previous year,
including the number of pregnant women served and the number of toxin-free babies born.
The grant recipient must compile the information in the subgrant reports and submit a
summary report to the commissioner of health by February 15 of each year.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023.
new text end

Sec. 62.

Minnesota Statutes 2021 Supplement, section 245C.03, subdivision 5a, is amended
to read:


Subd. 5a.

Facilities serving children or adults licensed or regulated by the
Department of Health.

(a) new text beginExcept as specified in paragraph (b), new text endthe commissioner shall
conduct background studies of:

(1) individuals providing services who have direct contact, as defined under section
245C.02, subdivision 11, with patients and residents in hospitals, boarding care homes,
outpatient surgical centers licensed under sections 144.50 to 144.58; nursing homes and
home care agencies licensed under chapter 144A; assisted living facilities and assisted living
facilities with dementia care licensed under chapter 144G; and board and lodging
establishments that are registered to provide supportive or health supervision services under
section 157.17;

(2) individuals specified in subdivision 2 who provide direct contact services in a nursing
home or a home care agency licensed under chapter 144A; an assisted living facility or
assisted living facility with dementia care licensed under chapter 144G; or a boarding care
home licensed under sections 144.50 to 144.58. If the individual undergoing a study resides
outside of Minnesota, the study must include a check for substantiated findings of
maltreatment of adults and children in the individual's state of residence when the state
makes the information available;

(3) all other employees in assisted living facilities or assisted living facilities with
dementia care licensed under chapter 144G, nursing homes licensed under chapter 144A,
and boarding care homes licensed under sections 144.50 to 144.58. A disqualification of
an individual in this section shall disqualify the individual from positions allowing direct
contact with or access to patients or residents receiving services. "Access" means physical
access to a client or the client's personal property without continuous, direct supervision as
defined in section 245C.02, subdivision 8, when the employee's employment responsibilities
do not include providing direct contact services;

(4) individuals employed by a supplemental nursing services agency, as defined under
section 144A.70, who are providing services in health care facilities; deleted text beginand
deleted text end

(5) controlling persons of a supplemental nursing services agency, as defined by section
144A.70deleted text begin.deleted text endnew text begin; and
new text end

new text begin (6) license applicants, owners, managerial officials, and controlling individuals who are
required under section 144A.476, subdivision 1, or 144G.13, subdivision 1, to undergo a
background study under this chapter, regardless of the licensure status of the license applicant,
owner, managerial official, or controlling individual.
new text end

(b) new text beginThe commissioner of human services shall not conduct a background study on any
individual identified in paragraph (a), clauses (1) to (5), if the individual has a valid license
issued by a health-related licensing board as defined in section 214.01, subdivision 2, and
has completed the criminal background check as required in section 214.075. An entity that
is affiliated with individuals who meet the requirements of this paragraph must separate
those individuals from the entity's roster for NETStudy 2.0.
new text end

new text begin (c) new text endIf a facility or program is licensed by the Department of Human Services and the
Department of Health and is subject to the background study provisions of this chapter, the
Department of Human Services is solely responsible for the background studies of individuals
in the jointly licensed program.

deleted text begin (c)deleted text endnew text begin (d)new text end The commissioner of health shall review and make decisions regarding
reconsideration requests, including whether to grant variances, according to the procedures
and criteria in this chapter. The commissioner of health shall inform the requesting individual
and the Department of Human Services of the commissioner of health's decision regarding
the reconsideration. The commissioner of health's decision to grant or deny a reconsideration
of a disqualification is a final administrative agency action.

new text begin EFFECTIVE DATE. new text end

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

Sec. 63.

Minnesota Statutes 2020, section 245C.31, subdivision 1, is amended to read:


Subdivision 1.

Board determines disciplinary or corrective action.

(a) deleted text beginWhen the
subject of a background study is regulated by a health-related licensing board as defined in
chapter
deleted text enddeleted text begin214deleted text enddeleted text begin, and the commissioner determines that the regulated individual is responsible
for substantiated maltreatment under section 626.557 or chapter
deleted text enddeleted text begin260Edeleted text enddeleted text begin, instead of the
commissioner making a decision regarding disqualification, the board shall make a
determination whether to impose disciplinary or corrective action under chapter
deleted text enddeleted text begin214deleted text endnew text begin The
commissioner shall notify a health-related licensing board as defined in section 214.01,
subdivision 2, if the commissioner determines that an individual who is licensed by the
health-related licensing board and who is included on the board's roster list provided in
accordance with subdivision 3a is responsible for substantiated maltreatment under section
626.557 or chapter 260E, in accordance with subdivision 2. Upon receiving notification,
the health-related licensing board shall make a determination as to whether to impose
disciplinary or corrective action under chapter 214
new text end.

(b) This section does not apply to a background study of an individual regulated by a
health-related licensing board if the individual's study is related to child foster care, adult
foster care, or family child care licensure.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 1, 2023.
new text end

Sec. 64.

Minnesota Statutes 2020, section 245C.31, subdivision 2, is amended to read:


Subd. 2.

Commissioner's notice to board.

deleted text begin(a)deleted text end The commissioner shall notify deleted text beginthedeleted text endnew text begin anew text end
health-related licensing board:

(1) deleted text beginupon completion of a background study that producesdeleted text endnew text begin ofnew text end a record showing that the
individual new text beginlicensed by the board new text endwas determined to have been responsible for substantiated
maltreatment;

(2) upon the commissioner's completion of an investigation that determined deleted text beginthedeleted text endnew text begin annew text end
individual new text beginlicensed by the board new text endwas responsible for substantiated maltreatment; or

(3) upon receipt from another agency of a finding of substantiated maltreatment for
which deleted text beginthedeleted text endnew text begin annew text end individual new text beginlicensed by the board new text endwas responsible.

deleted text begin (b) The commissioner's notice to the health-related licensing board shall indicate whether
deleted text end deleted text begin the commissioner would have disqualified the individual for the substantiated maltreatment
deleted text end deleted text begin if the individual were not regulated by the board.
deleted text end

deleted text begin (c) The commissioner shall concurrently send the notice under this subdivision to the
deleted text end deleted text begin individual who is the subject of the deleted text end deleted text begin background study deleted text end deleted text begin .
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective February 1, 2023.
new text end

Sec. 65.

Minnesota Statutes 2020, section 245C.31, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Agreements with health-related licensing boards. new text end

new text begin The commissioner and
each health-related licensing board shall enter into an agreement in order for each board to
provide the commissioner with a daily roster list of individuals who have a license issued
by the board in active status. The list must include for each licensed individual the individual's
name, aliases, date of birth, and license number; the date the license was issued; status of
the license; and the last four digits of the individual's Social Security number.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 66.

Minnesota Statutes 2020, section 245C.31, is amended by adding a subdivision
to read:


new text begin Subd. 3b. new text end

new text begin Maltreatment study; fees. new text end

new text begin (a) The administrative service unit for the
health-related licensing boards shall apportion between the health-related licensing boards
that are required to submit a daily roster list in accordance with subdivision 3a an amount
to be paid through an additional fee collected by each board in accordance with paragraph
(b). The amount apportioned to each health-related licensing board must equal the board's
share of the annual appropriation from the state government special revenue fund to the
commissioner of human services to conduct the maltreatment studies on licensees who are
listed on the daily roster lists and to comply with the notification requirement under
subdivision 2. Each board's apportioned share must be based on the number of licensees
that each health-related licensing board licenses as a percentage of the total number of
licensees licensed collectively by all health-related licensing boards.
new text end

new text begin (b) Each health-related licensing board may collect an additional fee from a licensee at
the time the initial license fee is collected to compensate for the amount apportioned to each
board by the administrative services unit. If an additional fee is collected by the health-related
licensing board under this paragraph, the fee 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 August 1, 2022.
new text end

Sec. 67.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:


Subd. 33.

Grant Programs; Chemical
Dependency Treatment Support Grants

Appropriations by Fund
General
4,273,000
4,274,000
Lottery Prize
1,733,000
1,733,000
Opiate Epidemic
Response
500,000
500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
are from the lottery prize fund for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants.
$2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders. The general fund base for this
appropriation is $2,000,000 in fiscal year 2024
and $0 in fiscal year 2025

(c) Base Level Adjustment. The general fund
base is deleted text begin$4,636,000deleted text endnew text begin $3,886,000new text end in fiscal year
2024 and deleted text begin$2,636,000deleted text endnew text begin $1,886,000new text end in fiscal year
2025. The opiate epidemic response fund base
is $500,000 in fiscal year 2024 and $0 in fiscal
year 2025.

Sec. 68.

Laws 2021, First Special Session chapter 7, article 16, section 3, subdivision 2,
is amended to read:


Subd. 2.

Health Improvement

Appropriations by Fund
General
123,714,000
124,000,000
State Government
Special Revenue
11,967,000
11,290,000
Health Care Access
37,512,000
36,832,000
Federal TANF
11,713,000
11,713,000

(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2022 and $3,579,000 in fiscal year
2023 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;

(2) $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7
;

(3) $4,978,000 in fiscal year 2022 and
$4,978,000 in fiscal year 2023 are from the
TANF fund for the family home visiting grant
program according to Minnesota Statutes,
section 145A.17. $4,000,000 of the funding
in each fiscal year must be distributed to
community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1
. $978,000 of the funding in each
fiscal year must be distributed to tribal
governments according to Minnesota Statutes,
section 145A.14, subdivision 2a;

(4) $1,156,000 in fiscal year 2022 and
$1,156,000 in fiscal year 2023 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and

(5) the commissioner may use up to 6.23
percent of the 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 as required
under Minnesota Statutes, section 145A.17,
subdivisions 4
and 5.

(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.

(c) Tribal Public Health Grants. $500,000
in fiscal year 2022 and $500,000 in fiscal year
2023 are from the general fund for Tribal
public health grants under Minnesota Statutes,
section 145A.14, for public health
infrastructure projects as defined by the Tribal
government.

(d) Public Health Infrastructure Funds.
$6,000,000 in fiscal year 2022 and $6,000,000
in fiscal year 2023 are from the general fund
for public health infrastructure funds to
distribute to community health boards and
Tribal governments to support their ability to
meet national public health standards.

(e) Public Health System Assessment and
Oversight.
$1,500,000 in fiscal year 2022 and
$1,500,000 in fiscal year 2023 are from the
general fund for the commissioner to assess
the capacity of the public health system to
meet national public health standards and
oversee public health system improvement
efforts.

(f) Health Professional Education Loan
Forgiveness.
Notwithstanding the priorities
and distribution requirements under Minnesota
Statutes, section 144.1501, $3,000,000 in
fiscal year 2022 and $3,000,000 in fiscal year
2023 are from the general fund for loan
forgiveness under article 3, section 43, for
individuals who are eligible alcohol and drug
counselors, eligible medical residents, or
eligible mental health professionals, as defined
in article 3, section 43. The general fund base
for this appropriation is $2,625,000 in fiscal
year 2024 and $0 in fiscal year 2025. The
health care access fund base for this
appropriation is $875,000 in fiscal year 2024,
$3,500,000 in fiscal year 2025, and $0 in fiscal
year 2026. The general fund amounts in this
paragraph are available until March 31, 2024.
This paragraph expires on April 1, 2024.

(g) Mental Health Cultural Community
Continuing Education Grant Program.

$500,000 in fiscal year 2022 and $500,000 in
fiscal year 2023 are from the general fund for
the mental health cultural community
continuing education grant program. This is
a onetime appropriation

(h) Birth Records; Homeless Youth. $72,000
in fiscal year 2022 and $32,000 in fiscal year
2023 are from the state government special
revenue fund for administration and issuance
of certified birth records and statements of no
vital record found to homeless youth under
Minnesota Statutes, section 144.2255.

(i) Supporting Healthy Development of
Babies During Pregnancy and Postpartum.

$260,000 in fiscal year 2022 and $260,000 in
fiscal year 2023 are from the general fund for
a grant to the Amherst H. Wilder Foundation
for the African American Babies Coalition
initiative for community-driven training and
education on best practices to support healthy
development of babies during pregnancy and
postpartum. Grant funds must be used to build
capacity in, train, educate, or improve
practices among individuals, from youth to
elders, serving families with members who
are Black, indigenous, or people of color,
during pregnancy and postpartum. This is a
onetime appropriation and is available until
June 30, 2023.

(j) Dignity in Pregnancy and Childbirth.
$494,000 in fiscal year 2022 and $200,000 in
fiscal year 2023 are from the general fund for
purposes of Minnesota Statutes, section
144.1461. Of this appropriation: (1) $294,000
in fiscal year 2022 is for a grant to the
University of Minnesota School of Public
Health's Center for Antiracism Research for
Health Equity, to develop a model curriculum
on anti-racism and implicit bias for use by
hospitals with obstetric care and birth centers
to provide continuing education to staff caring
for pregnant or postpartum women. The model
curriculum must be evidence-based and must
meet the criteria in Minnesota Statutes, section
144.1461, subdivision 2, paragraph (a); and
(2) $200,000 in fiscal year 2022 and $200,000
in fiscal year 2023 are for purposes of
Minnesota Statutes, section 144.1461,
subdivision 3
.

(k) Congenital Cytomegalovirus (CMV). (1)
$196,000 in fiscal year 2022 and $196,000 in
fiscal year 2023 are from the general fund for
outreach and education on congenital
cytomegalovirus (CMV) under Minnesota
Statutes, section 144.064.

(2) Contingent on the Advisory Committee on
Heritable and Congenital Disorders
recommending and the commissioner of health
approving inclusion of CMV in the newborn
screening panel in accordance with Minnesota
Statutes, section 144.065, subdivision 3,
paragraph (d), $656,000 in fiscal year 2023 is
from the state government special revenue
fund for follow-up services.

(l) Nonnarcotic Pain Management and
Wellness.
$649,000 in fiscal year 2022 is from
the general fund for nonnarcotic pain
management and wellness in accordance with
Laws 2019, chapter 63, article 3, section 1,
paragraph (n).

(m) Base Level Adjustments. The general
fund base is deleted text begin$120,451,000deleted text end new text begin$121,201,000 new text endin
fiscal year 2024 and deleted text begin$115,594,000deleted text end
new text begin $116,344,000 new text endin fiscal year 2025new text begin, of which
$750,000 in fiscal year 2024 and $750,000 in
fiscal year 2025 are for fetal alcohol spectrum
disorders prevention grants under Minnesota
Statutes, section 145.267
new text end. The health care
access fund base is $38,385,000 in fiscal year
2024 and $40,644,000 in fiscal year 2025.

Sec. 69. new text beginDIRECTION TO COMMISSIONER OF HEALTH; J-1 VISA WAIVER
PROGRAM RECOMMENDATION.
new text end

new text begin (a) For purposes of this section:
new text end

new text begin (1) "Department of Health recommendation" means a recommendation from the state
Department of Health that a foreign medical graduate should be considered for a J-1 visa
waiver under the J-1 visa waiver program; and
new text end

new text begin (2) "J-1 visa waiver program" means a program administered by the United States
Department of State under United States Code, title 8, section 1184(l), in which a waiver
is sought for the requirement that a foreign medical graduate with a J-1 visa must return to
the graduate's home country for two years at the conclusion of the graduate's medical study
before applying for employment authorization in the United States.
new text end

new text begin (b) In administering the program to issue Department of Health recommendations for
purposes of the J-1 visa waiver program, the commissioner of health shall allow an applicant
to submit to the commissioner evidence that the foreign medical graduate for whom the
waiver is sought is licensed to practice medicine in Minnesota in place of evidence that the
foreign medical graduate has passed steps 1, 2, and 3 of the United States Medical Licensing
Examination.
new text end

Sec. 70. new text beginAPPROPRIATION; ELIMINATION OF DUPLICATIVE BACKGROUND
STUDIES.
new text end

new text begin $522,000 in fiscal year 2023 is appropriated from the state government special revenue
fund to the commissioner of human services to implement provisions to eliminate duplicative
background studies. The state government special revenue fund base for this appropriation
is $334,000 in fiscal year 2024, $574,000 in fiscal year 2025, $170,000 in fiscal year 2026,
and $170,000 in fiscal year 2027.
new text end

Sec. 71. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall make any necessary cross-reference changes required as a
result of the amendments in this article to Minnesota Statutes, sections 144A.01; 144A.03,
subdivision 1; 144A.04, subdivisions 4 and 6; and 144A.06.
new text end

Sec. 72. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, section 254A.21, new text end new text begin is repealed effective July 1, 2023.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2021 Supplement, section 144G.07, subdivision 6, new text end new text begin is repealed.
new text end

ARTICLE 2

HEALTH CARE

Section 1.

Minnesota Statutes 2020, section 62J.2930, subdivision 3, is amended to read:


Subd. 3.

Consumer information.

(a) The information clearinghouse or another entity
designated by the commissioner shall provide consumer information to health plan company
enrollees to:

(1) assist enrollees in understanding their rights;

(2) explain and assist in the use of all available complaint systems, including internal
complaint systems within health carriers, community integrated service networks, and the
Departments of Health and Commerce;

(3) provide information on coverage options in each region of the state;

(4) provide information on the availability of purchasing pools and enrollee subsidies;
and

(5) help consumers use the health care system to obtain coverage.

(b) The information clearinghouse or other entity designated by the commissioner for
the purposes of this subdivision shall not:

(1) provide legal services to consumers;

(2) represent a consumer or enrollee; or

(3) serve as an advocate for consumers in disputes with health plan companies.

(c) Nothing in this subdivision shall interfere with the ombudsman program established
under section deleted text begin256B.69, subdivision 20deleted text endnew text begin 256B.6903new text end, or other existing ombudsman programs.

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2020, section 152.125, is amended to read:


152.125 INTRACTABLE PAIN.

Subdivision 1.

deleted text beginDefinitiondeleted text endnew text begin Definitionsnew text end.

new text begin(a) new text endFor purposes of this section, new text beginthe terms in this
subdivision have the meanings given.
new text end

new text begin (b) "Drug diversion" means the unlawful transfer of prescription drugs from their licit
medical purpose to the illicit marketplace.
new text end

new text begin (c) new text end"Intractable pain" means a pain state in which the cause of the pain cannot be removed
or otherwise treated with the consent of the patient and in which, in the generally accepted
course of medical practice, no relief or cure of the cause of the pain is possible, or none has
been found after reasonable efforts. new text beginConditions associated with intractable pain may include
cancer and the recovery period, sickle cell disease, noncancer pain, rare diseases, orphan
diseases, severe injuries, and health conditions requiring the provision of palliative care or
hospice care.
new text endReasonable efforts for relieving or curing the cause of the pain may be
determined on the basis of, but are not limited to, the following:

(1) when treating a nonterminally ill patient for intractable pain, new text beginan new text endevaluation new text beginconducted
new text end by the attending physiciannew text begin, advanced practice registered nurse, or physician assistantnew text end and
one or more physiciansnew text begin, advanced practice registered nurses, or physician assistantsnew text end
specializing in pain medicine or the treatment of the area, system, or organ of the body
new text begin confirmed or new text endperceived as the source of the new text beginintractable new text endpain; or

(2) when treating a terminally ill patient, new text beginan new text endevaluation new text beginconducted new text endby the attending
physiciannew text begin, advanced practice registered nurse, or physician assistantnew text end who does so in
accordance with new text beginthe standard of care and new text endthe level of care, skill, and treatment that would
be recognized by a reasonably prudent physiciannew text begin, advanced practice registered nurse, or
physician assistant
new text end under similar conditions and circumstances.

new text begin (d) "Palliative care" has the meaning given in section 144A.75, subdivision 12.
new text end

new text begin (e) "Rare disease" means a disease, disorder, or condition that affects fewer than 200,000
individuals in the United States and is chronic, serious, life altering, or life threatening.
new text end

new text begin Subd. 1a. new text end

new text begin Criteria for the evaluation and treatment of intractable pain. new text end

new text begin The evaluation
and treatment of intractable pain when treating a nonterminally ill patient is governed by
the following criteria:
new text end

new text begin (1) a diagnosis of intractable pain by the treating physician, advanced practice registered
nurse, or physician assistant and either by a physician, advanced practice registered nurse,
or physician assistant specializing in pain medicine or a physician, advanced practice
registered nurse, or physician assistant treating the area, system, or organ of the body that
is the source of the pain is sufficient to meet the definition of intractable pain; and
new text end

new text begin (2) the cause of the diagnosis of intractable pain must not interfere with medically
necessary treatment, including but not limited to prescribing or administering a controlled
substance in Schedules II to V of section 152.02.
new text end

Subd. 2.

Prescription and administration of controlled substances for intractable
pain.

new text begin(a) new text endNotwithstanding any other provision of this chapter, a physiciannew text begin, advanced practice
registered nurse, or physician assistant
new text end may prescribe or administer a controlled substance
in Schedules II to V of section 152.02 to deleted text beginan individualdeleted text endnew text begin a patientnew text end in the course of the
physician'snew text begin, advanced practice registered nurse's, or physician assistant'snew text end treatment of the
deleted text begin individualdeleted text endnew text begin patientnew text end for a diagnosed condition causing intractable pain. No physiciannew text begin, advanced
practice registered nurse, or physician assistant
new text end shall be subject to disciplinary action by
the Board of Medical Practice new text beginor Board of Nursing new text endfor appropriately prescribing or
administering a controlled substance in Schedules II to V of section 152.02 in the course
of treatment of deleted text beginan individualdeleted text endnew text begin a patientnew text end for intractable pain, provided the physiciannew text begin, advanced
practice registered nurse, or physician assistant:
new text end

new text begin (1) new text endkeeps accurate records of the purpose, use, prescription, and disposal of controlled
substances, writes accurate prescriptions, and prescribes medications in conformance with
chapter 147deleted text begin.deleted text endnew text begin or 148 or in accordance with the current standard of care; and
new text end

new text begin (2) enters into a patient-provider agreement that meets the criteria in subdivision 5.
new text end

new text begin (b) No physician, advanced practice registered nurse, or physician assistant, acting in
good faith and based on the needs of the patient, shall be subject to disenrollment or
termination by the commissioner of health solely for prescribing a dosage that equates to
an upward deviation from morphine milligram equivalent dosage recommendations or
thresholds specified in state or federal opioid prescribing guidelines or policies, including
but not limited to the Guideline for Prescribing Opioids for Chronic Pain issued by the
Centers for Disease Control and Prevention and Minnesota opioid prescribing guidelines.
new text end

new text begin (c) A physician, advanced practice registered nurse, or physician assistant treating
intractable pain by prescribing, dispensing, or administering a controlled substance in
Schedules II to V of section 152.02 that includes but is not limited to opioid analgesics must
not taper a patient's medication dosage solely to meet a predetermined morphine milligram
equivalent dosage recommendation or threshold if the patient is stable and compliant with
the treatment plan, is experiencing no serious harm from the level of medication currently
being prescribed or previously prescribed, and is in compliance with the patient-provider
agreement as described in subdivision 5.
new text end

new text begin (d) A physician's, advanced practice registered nurse's, or physician assistant's decision
to taper a patient's medication dosage must be based on factors other than a morphine
milligram equivalent recommendation or threshold.
new text end

new text begin (e) No pharmacist, health plan company, or pharmacy benefit manager shall refuse to
fill a prescription for an opiate issued by a licensed practitioner with the authority to prescribe
opiates solely based on the prescription exceeding a predetermined morphine milligram
equivalent dosage recommendation or threshold. Health plan companies that participate in
Minnesota health care programs under chapters 256B and 256L, and pharmacy benefit
managers under contract with these health plan companies, must comply with section 1004
of the federal SUPPORT Act, Public Law 115-271, when providing services to medical
assistance and MinnesotaCare enrollees.
new text end

Subd. 3.

Limits on applicability.

This section does not apply to:

(1) a physician'snew text begin, advanced practice registered nurse's, or physician assistant'snew text end treatment
of deleted text beginan individualdeleted text endnew text begin a patientnew text end for chemical dependency resulting from the use of controlled
substances in Schedules II to V of section 152.02;

(2) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 to deleted text beginan individualdeleted text endnew text begin a patientnew text end whom the physiciannew text begin, advanced practice registered
nurse, or physician assistant
new text end knows to be using the controlled substances for nontherapeutic
new text begin or drug diversion new text endpurposes;

(3) the prescription or administration of controlled substances in Schedules II to V of
section 152.02 for the purpose of terminating the life of deleted text beginan individualdeleted text endnew text begin a patientnew text end having
intractable pain; or

(4) the prescription or administration of a controlled substance in Schedules II to V of
section 152.02 that is not a controlled substance approved by the United States Food and
Drug Administration for pain relief.

Subd. 4.

Notice of risks.

Prior to treating deleted text beginan individualdeleted text endnew text begin a patientnew text end for intractable pain in
accordance with subdivision 2, a physiciannew text begin, advanced practice registered nurse, or physician
assistant
new text end shall discuss with the deleted text beginindividualdeleted text endnew text begin patient or the patient's legal guardian, if applicable,new text end
the risks associated with the controlled substances in Schedules II to V of section 152.02
to be prescribed or administered in the course of the physician'snew text begin, advanced practice registered
nurse's, or physician assistant's
new text end treatment of deleted text beginan individualdeleted text endnew text begin a patientnew text end, and document the
discussion in the deleted text beginindividual'sdeleted text endnew text begin patient'snew text end recordnew text begin as required in the patient-provider agreement
described in subdivision 5
new text end.

new text begin Subd. 5. new text end

new text begin Patient-provider agreement. new text end

new text begin (a) Before treating a patient for intractable pain,
a physician, advanced practice registered nurse, or physician assistant and the patient or the
patient's legal guardian, if applicable, must mutually agree to the treatment and enter into
a provider-patient agreement. The agreement must include a description of the prescriber's
and the patient's expectations, responsibilities, and rights according to best practices and
current standards of care.
new text end

new text begin (b) The agreement must be signed by the patient or the patient's legal guardian, if
applicable, and the physician, advanced practice registered nurse, or physician assistant and
included in the patient's medical records. A copy of the signed agreement must be provided
to the patient.
new text end

new text begin (c) The agreement must be reviewed by the patient and the physician, advanced practice
registered nurse, or physician assistant annually. If there is a change in the patient's treatment
plan, the agreement must be updated and a revised agreement must be signed by the patient
or the patient's legal guardian. A copy of the revised agreement must be included in the
patient's medical record and a copy must be provided to the patient.
new text end

new text begin (d) Absent clear evidence of drug diversion, nonadherence with the agreement must not
be used as the sole reason to stop a patient's treatment with scheduled drugs. If a patient
experiences difficulty adhering to the agreement, the prescriber must evaluate the patient
for other conditions, including but not limited to substance use disorder, and must ensure
that the patient's course of treatment is appropriately adjusted to reflect any change in
diagnosis.
new text end

new text begin (e) A patient-provider agreement is not required in an emergency or inpatient hospital
setting.
new text end

Sec. 3.

Minnesota Statutes 2021 Supplement, section 256B.0371, subdivision 4, as amended
by Laws 2022, chapter 55, article 1, section 128, is amended to read:


Subd. 4.

Dental utilization report.

(a) The commissioner shall submit an annual report
beginning March 15, 2022, and ending March 15, 2026, to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance that includes the percentage for adults and children one through 20 years
of age for the most recent complete calendar year receiving at least one dental visit for both
fee-for-service and the prepaid medical assistance program. The report must include:

(1) statewide utilization for both fee-for-service and for the prepaid medical assistance
program;

(2) utilization by county;

(3) utilization by children receiving dental services through fee-for-service and through
a managed care plan or county-based purchasing plan; and

(4) utilization by adults receiving dental services through fee-for-service and through a
managed care plan or county-based purchasing plan.

(b) The report must also include a description of any corrective action plans required to
be submitted under subdivision 2.

(c) The initial report due on March 15, 2022, must include the utilization metrics described
in paragraph (a) for each of the following calendar years: 2017, 2018, 2019, and 2020.

new text begin (d) In the annual report due on March 15, 2023, and in each report due thereafter, the
commissioner shall include the following:
new text end

new text begin (1) the number of dentists enrolled with the commissioner as a medical assistance dental
provider and the congressional district or districts in which the dentist provides services;
new text end

new text begin (2) the number of enrolled dentists who provided fee-for-service dental services to
medical assistance or MinnesotaCare patients within the previous calendar year in the
following increments: one to nine patients, ten to 100 patients, and over 100 patients;
new text end

new text begin (3) the number of enrolled dentists who provided dental services to medical assistance
or MinnesotaCare patients through a managed care plan or county-based purchasing plan
within the previous calendar year in the following increments: one to nine patients, ten to
100 patients, and over 100 patients; and
new text end

new text begin (4) the number of dentists who provided dental services to a new patient who was enrolled
in medical assistance or MinnesotaCare within the previous calendar year.
new text end

new text begin (e) The report due on March 15, 2023, must include the metrics described in paragraph
(d) for each of the following years: 2017, 2018, 2019, 2020, and 2021.
new text end

Sec. 4.

Minnesota Statutes 2020, section 256B.055, subdivision 2, is amended to read:


Subd. 2.

Subsidized foster children.

Medical assistance may be paid for a child eligible
for or receiving foster care maintenance payments under Title IV-E of the Social Security
Act, United States Code, title 42, sections 670 to 676, and for a child who is not eligible for
Title IV-E of the Social Security Act but who is deleted text begindetermined eligible fordeleted text endnew text begin placed innew text end foster
carenew text begin as determined by Minnesota Statutesnew text end or new text beginreceiving new text endkinship assistance under chapter
256N.

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 2020, section 256B.056, subdivision 3b, is amended to read:


Subd. 3b.

Treatment of trusts.

new text begin (a) It is the public policy of this state that individuals
use all available resources to pay for the cost of long-term care services, as defined in section
256B.0595, before turning to Minnesota health care program funds, and that trust instruments
should not be permitted to shield available resources of an individual or an individual's
spouse from such use.
new text end

deleted text begin (a)deleted text endnew text begin (b)new text end A "medical assistance qualifying trust" is a revocable or irrevocable trust, or
similar legal device, established on or before August 10, 1993, by a person or the person's
spouse under the terms of which the person receives or could receive payments from the
trust principal or income and the trustee has discretion in making payments to the person
from the trust principal or income. Notwithstanding that definition, a medical assistance
qualifying trust does not include: (1) a trust set up by will; (2) a trust set up before April 7,
1986, solely to benefit a person with a developmental disability living in an intermediate
care facility for persons with developmental disabilities; or (3) a trust set up by a person
with payments made by the Social Security Administration pursuant to the United States
Supreme Court decision in Sullivan v. Zebley, 110 S. Ct. 885 (1990). The maximum amount
of payments that a trustee of a medical assistance qualifying trust may make to a person
under the terms of the trust is considered to be available assets to the person, without regard
to whether the trustee actually makes the maximum payments to the person and without
regard to the purpose for which the medical assistance qualifying trust was established.

deleted text begin (b)deleted text endnew text begin (c)new text end Trusts established after August 10, 1993, are treated according to United States
Code, title 42, section 1396p(d).

deleted text begin (c)deleted text endnew text begin (d)new text end For purposes of paragraph deleted text begin(d)deleted text endnew text begin (e)new text end, a pooled trust means a trust established under
United States Code, title 42, section 1396p(d)(4)(C).

deleted text begin (d)deleted text endnew text begin (e)new text end A beneficiary's interest in a pooled trust is considered an available asset unless
the trust provides that upon the death of the beneficiary or termination of the trust during
the beneficiary's lifetime, whichever is sooner, the department receives any amount, up to
the amount of medical assistance benefits paid on behalf of the beneficiary, remaining in
the beneficiary's trust account after a deduction for reasonable administrative fees and
expenses, and an additional remainder amount. The retained remainder amount of the
subaccount must not exceed ten percent of the account value at the time of the beneficiary's
death or termination of the trust, and must only be used for the benefit of disabled individuals
who have a beneficiary interest in the pooled trust.

deleted text begin (e)deleted text endnew text begin (f)new text end Trusts may be established on or after December 12, 2016, by a person who has
been determined to be disabled, according to United States Code, title 42, section
1396p(d)(4)(A), as amended by section 5007 of the 21st Century Cures Act, Public Law
114-255.

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 2020, section 256B.056, subdivision 3c, is amended to read:


Subd. 3c.

Asset limitations for families and children.

(a) A household of two or more
persons must not own more than $20,000 in total net assets, and a household of one person
must not own more than $10,000 in total net assets. In addition to these maximum amounts,
an eligible individual or family may accrue interest on these amounts, but they must be
reduced to the maximum at the time of an eligibility redetermination. The value of assets
that are not considered in determining eligibility for medical assistance for families and
children is the value of those assets excluded under the AFDC state plan as of July 16, 1996,
as required by the Personal Responsibility and Work Opportunity Reconciliation Act of
1996 (PRWORA), Public Law 104-193, with the following exceptions:

(1) household goods and personal effects are not considered;

(2) capital and operating assets of a trade or business up to $200,000 are not considered;

(3) one motor vehicle is excluded for each person of legal driving age who is employed
or seeking employment;

(4) assets designated as burial expenses are excluded to the same extent they are excluded
by the Supplemental Security Income program;

(5) court-ordered settlements up to $10,000 are not considered;

(6) individual retirement accounts and funds are not considered;

(7) assets owned by children are not considered; and

(8) deleted text begineffective July 1, 2009,deleted text end certain assets owned by American Indians are excluded as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(b) deleted text beginBeginning January 1, 2014, this subdivisiondeleted text endnew text begin Paragraph (a)new text end applies only to parents
and caretaker relatives who qualify for medical assistance under subdivision 5.

new text begin (c) Eligibility for children under age 21 must be determined without regard to the asset
limitations described in paragraphs (a) and (b) and subdivision 3.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256B.056, subdivision 11, is amended to read:


Subd. 11.

Treatment of annuities.

(a) Any person requesting medical assistance payment
of long-term care services shall provide a complete description of any interest either the
person or the person's spouse has in annuities on a form designated by the department. The
form shall include a statement that the state becomes a preferred remainder beneficiary of
annuities or similar financial instruments by virtue of the receipt of medical assistance
payment of long-term care services. The person and the person's spouse shall furnish the
agency responsible for determining eligibility with complete current copies of their annuities
and related documents and complete the form designating the state as the preferred remainder
beneficiary for each annuity in which the person or the person's spouse has an interest.

(b) The department shall provide notice to the issuer of the department's right under this
section as a preferred remainder beneficiary under the annuity or similar financial instrument
for medical assistance furnished to the person or the person's spouse, and provide notice of
the issuer's responsibilities as provided in paragraph (c).

(c) An issuer of an annuity or similar financial instrument who receives notice of the
state's right to be named a preferred remainder beneficiary as described in paragraph (b)
shall provide confirmation to the requesting agency that the state has been made a preferred
remainder beneficiary. The issuer shall also notify the county agency when a change in the
amount of income or principal being withdrawn from the annuity or other similar financial
instrument or a change in the state's preferred remainder beneficiary designation under the
annuity or other similar financial instrument occurs. The county agency shall provide the
issuer with the name, address, and telephone number of a unit within the department that
the issuer can contact to comply with this paragraph.

(d) "Preferred remainder beneficiary" for purposes of this subdivision and sections
256B.0594 and 256B.0595 means the state is a remainder beneficiary in the first position
in an amount equal to the amount of medical assistance paid on behalf of the institutionalized
person, or is a remainder beneficiary in the second position if the institutionalized person
designates and is survived by a remainder beneficiary who is (1) a spouse who does not
reside in a medical institution, (2) a minor child, or (3) a child of any age who is blind or
permanently and totally disabled as defined in the Supplemental Security Income program.
Notwithstanding this paragraph, the state is the remainder beneficiary in the first position
if the spouse or child disposes of the remainder for less than fair market value.

(e) For purposes of this subdivision, "institutionalized person" and "long-term care
services" have the meanings given in section 256B.0595, subdivision 1, paragraph deleted text begin(g)deleted text endnew text begin (f)new text end.

(f) For purposes of this subdivision, "medical institution" means a skilled nursing facility,
intermediate care facility, intermediate care facility for persons with developmental
disabilities, nursing facility, or inpatient hospital.

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2020, section 256B.0595, subdivision 1, is amended to read:


Subdivision 1.

Prohibited transfers.

(a) Effective for transfers made after August 10,
1993, an institutionalized person, an institutionalized person's spouse, or any person, court,
or administrative body with legal authority to act in place of, on behalf of, at the direction
of, or upon the request of the institutionalized person or institutionalized person's spouse,
may not give away, sell, or dispose of, for less than fair market value, any asset or interest
therein, except assets other than the homestead that are excluded under the Supplemental
Security Income program, for the purpose of establishing or maintaining medical assistance
eligibility. This applies to all transfers, including those made by a community spouse after
the month in which the institutionalized spouse is determined eligible for medical assistance.
For purposes of determining eligibility for long-term care services, any transfer of such
assets within 36 months before or any time after an institutionalized person requests medical
assistance payment of long-term care services, or 36 months before or any time after a
medical assistance recipient becomes an institutionalized person, for less than fair market
value may be considered. Any such transfer is presumed to have been made for the purpose
of establishing or maintaining medical assistance eligibility and the institutionalized person
is ineligible for long-term care services for the period of time determined under subdivision
2, unless the institutionalized person furnishes convincing evidence to establish that the
transaction was exclusively for another purpose, or unless the transfer is permitted under
subdivision 3 or 4. In the case of payments from a trust or portions of a trust that are
considered transfers of assets under federal law, or in the case of any other disposal of assets
made on or after February 8, 2006, any transfers made within 60 months before or any time
after an institutionalized person requests medical assistance payment of long-term care
services and within 60 months before or any time after a medical assistance recipient becomes
an institutionalized person, may be considered.

(b) This section applies to transfers, for less than fair market value, of income or assets,
including assets that are considered income in the month received, such as inheritances,
court settlements, and retroactive benefit payments or income to which the institutionalized
person or the institutionalized person's spouse is entitled but does not receive due to action
by the institutionalized person, the institutionalized person's spouse, or any person, court,
or administrative body with legal authority to act in place of, on behalf of, at the direction
of, or upon the request of the institutionalized person or the institutionalized person's spouse.

(c) This section applies to payments for care or personal services provided by a relative,
unless the compensation was stipulated in a notarized, written agreement deleted text beginwhichdeleted text endnew text begin thatnew text end was
in existence when the service was performed, the care or services directly benefited the
person, and the payments made represented reasonable compensation for the care or services
provided. A notarized written agreement is not required if payment for the services was
made within 60 days after the service was provided.

deleted text begin (d) This section applies to the portion of any asset or interest that an institutionalized
person, an institutionalized person's spouse, or any person, court, or administrative body
with legal authority to act in place of, on behalf of, at the direction of, or upon the request
of the institutionalized person or the institutionalized person's spouse, transfers to any
annuity that exceeds the value of the benefit likely to be returned to the institutionalized
person or institutionalized person's spouse while alive, based on estimated life expectancy
as determined according to the current actuarial tables published by the Office of the Chief
Actuary of the Social Security Administration. The commissioner may adopt rules reducing
life expectancies based on the need for long-term care. This section applies to an annuity
purchased on or after March 1, 2002, that:
deleted text end

deleted text begin (1) is not purchased from an insurance company or financial institution that is subject
to licensing or regulation by the Minnesota Department of Commerce or a similar regulatory
agency of another state;
deleted text end

deleted text begin (2) does not pay out principal and interest in equal monthly installments; or
deleted text end

deleted text begin (3) does not begin payment at the earliest possible date after annuitization.
deleted text end

deleted text begin (e)deleted text endnew text begin (d)new text end Effective for transactions, including the purchase of an annuity, occurring on or
after February 8, 2006, by or on behalf of an institutionalized person who has applied for
or is receiving long-term care services or the institutionalized person's spouse shall be treated
as the disposal of an asset for less than fair market value unless the department is named a
preferred remainder beneficiary as described in section 256B.056, subdivision 11. Any
subsequent change to the designation of the department as a preferred remainder beneficiary
shall result in the annuity being treated as a disposal of assets for less than fair market value.
The amount of such transfer shall be the maximum amount the institutionalized person or
the institutionalized person's spouse could receive from the annuity or similar financial
instrument. Any change in the amount of the income or principal being withdrawn from the
annuity or other similar financial instrument at the time of the most recent disclosure shall
be deemed to be a transfer of assets for less than fair market value unless the institutionalized
person or the institutionalized person's spouse demonstrates that the transaction was for fair
market value. In the event a distribution of income or principal has been improperly
distributed or disbursed from an annuity or other retirement planning instrument of an
institutionalized person or the institutionalized person's spouse, a cause of action exists
against the individual receiving the improper distribution for the cost of medical assistance
services provided or the amount of the improper distribution, whichever is less.

deleted text begin (f)deleted text endnew text begin (e)new text end Effective for transactions, including the purchase of an annuity, occurring on or
after February 8, 2006, by or on behalf of an institutionalized person applying for or receiving
long-term care services shall be treated as a disposal of assets for less than fair market value
unless it is:

(1) an annuity described in subsection (b) or (q) of section 408 of the Internal Revenue
Code of 1986; or

(2) purchased with proceeds from:

(i) an account or trust described in subsection (a), (c), or (p) of section 408 of the Internal
Revenue Code;

(ii) a simplified employee pension within the meaning of section 408(k) of the Internal
Revenue Code; or

(iii) a Roth IRA described in section 408A of the Internal Revenue Code; or

(3) an annuity that is irrevocable and nonassignable; is actuarially sound as determined
in accordance with actuarial publications of the Office of the Chief Actuary of the Social
Security Administration; and provides for payments in equal amounts during the term of
the annuity, with no deferral and no balloon payments made.

deleted text begin (g)deleted text endnew text begin (f)new text end For purposes of this section, long-term care services include services in a nursing
facility, services that are eligible for payment according to section 256B.0625, subdivision
2
, because they are provided in a swing bed, intermediate care facility for persons with
developmental disabilities, and home and community-based services provided pursuant to
chapter 256S and sections 256B.092 and 256B.49. For purposes of this subdivision and
subdivisions 2, 3, and 4, "institutionalized person" includes a person who is an inpatient in
a nursing facility or in a swing bed, or intermediate care facility for persons with
developmental disabilities or who is receiving home and community-based services under
chapter 256S and sections 256B.092 and 256B.49.

deleted text begin (h)deleted text endnew text begin (g)new text end This section applies to funds used to purchase a promissory note, loan, or mortgage
unless the note, loan, or mortgage:

(1) has a repayment term that is actuarially sound;

(2) provides for payments to be made in equal amounts during the term of the loan, with
no deferral and no balloon payments made; and

(3) prohibits the cancellation of the balance upon the death of the lender.

new text begin (h) new text endIn the case of a promissory note, loan, or mortgage that does not meet an exception
innew text begin paragraph (g),new text end clauses (1) to (3), the value of such note, loan, or mortgage shall be the
outstanding balance due as of the date of the institutionalized person's request for medical
assistance payment of long-term care services.

(i) This section applies to the purchase of a life estate interest in another person's home
unless the purchaser resides in the home for a period of at least one year after the date of
purchase.

(j) This section applies to transfers into a pooled trust that qualifies under United States
Code, title 42, section 1396p(d)(4)(C), by:

(1) a person age 65 or older or the person's spouse; or

(2) any person, court, or administrative body with legal authority to act in place of, on
behalf of, at the direction of, or upon the request of a person age 65 or older or the person's
spouse.

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 2020, section 256B.0625, subdivision 64, is amended to read:


Subd. 64.

Investigational drugs, biological products, devices, and clinical
trials.

Medical assistance and the early periodic screening, diagnosis, and treatment (EPSDT)
program do not cover deleted text beginthe costs of any services that are incidental to, associated with, or
resulting from the use of
deleted text end investigational drugs, biological products, or devices as defined
in section 151.375 or any other treatment that is part of an approved clinical trial as defined
in section 62Q.526. Participation of an enrollee in an approved clinical trial does not preclude
coverage of medically necessary services covered under this chapter that are not related to
the approved clinical trial.new text begin Any items or services that are provided solely to satisfy data
collection and analysis for a clinical trial, and not for direct clinical management of the
enrollee, are not covered.
new text end

Sec. 10.

Minnesota Statutes 2021 Supplement, section 256B.0638, subdivision 5, is
amended to read:


Subd. 5.

Program implementation.

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

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

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

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

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

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

(1) monitor prescribing practices more frequently than annually;

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

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

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

new text begin (e) No physician, advanced practice registered nurse, or physician assistant, acting in
good faith based on the needs of the patient, may be disenrolled by the commissioner of
human services solely for prescribing a dosage that equates to an upward deviation from
morphine milligram equivalent dosage recommendations specified in state or federal opioid
prescribing guidelines or policies, or quality improvement thresholds established under this
section.
new text end

Sec. 11.

Minnesota Statutes 2021 Supplement, section 256B.69, subdivision 9f, is amended
to read:


Subd. 9f.

Annual report on provider reimbursement rates.

(a) The commissioner,
by December 15 of each year, deleted text beginbeginning December 15, 2021,deleted text end shall submit to the chairs and
ranking minority members of the legislative committees with jurisdiction over health care
policy and finance a report on managed care and county-based purchasing plan provider
reimbursement rates.

(b) The report must include, for each managed care and county-based purchasing plan,
the mean and median provider reimbursement rates by county for the calendar year preceding
the reporting year, for the five most common billing codes statewide across all plans, in
each of the following provider service categories if within the county there are more than
three medical assistance enrolled providers providing the specific service within the specific
category:

(1) physician prenatal services;

(2) physician preventive services;

(3) physician services other than prenatal or preventive;

(4) dental services;

(5) inpatient hospital services;

(6) outpatient hospital services; deleted text beginand
deleted text end

(7) mental health servicesnew text begin; and
new text end

new text begin (8) substance use disorder servicesnew text end.

(c) The commissioner shall also include in the report:

(1) the mean and median reimbursement rates across all plans by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b); and

(2) the mean and median fee-for-service reimbursement rates by county for the calendar
year preceding the reporting year for the billing codes and provider service categories
described in paragraph (b).

Sec. 12.

new text begin [256B.6903] OMBUDSPERSON FOR MANAGED CARE.
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 them.
new text end

new text begin (b) "Adverse benefit determination" has the meaning provided in Code of Federal
Regulations, title 42, section 438.400, subpart (b).
new text end

new text begin (c) "Appeal" means an oral or written request from an enrollee to the managed care
organization for review of an adverse benefit determination.
new text end

new text begin (d) "Commissioner" means the commissioner of human services.
new text end

new text begin (e) "Complaint" means an enrollee's informal expression of dissatisfaction about any
matter relating to the enrollee's prepaid health plan other than an adverse benefit
determination.
new text end

new text begin (f) "Data analyst" means the person employed by the ombudsperson that uses research
methodologies to conduct research on data collected from prepaid health plans, including
but not limited to scientific theory; hypothesis testing; survey research techniques; data
collection; data manipulation; and statistical analysis interpretation, including multiple
regression techniques.
new text end

new text begin (g) "Enrollee" means a person enrolled in a prepaid health plan under section 256B.69.
When applicable, an enrollee includes an enrollee's authorized representative.
new text end

new text begin (h) "External review" means the process described under Code of Federal Regulations,
title 42, section 438.408, subpart (f); and section 62Q.73, subdivision 2.
new text end

new text begin (i) "Grievance" means an enrollee's expression of dissatisfaction about any matter relating
to the enrollee's prepaid health plan other than an adverse benefit determination that follows
the procedures outlined in Code of Federal Regulations, title 42, part 438, subpart (f). A
grievance may include but is not limited to concerns relating to quality of care, services
provided, or failure to respect an enrollee's rights under a prepaid health plan.
new text end

new text begin (j) "Managed care advocate" means a county or Tribal employee who works with
managed care enrollees when the enrollee has service, billing, or access problems with the
enrollee's prepaid health plan.
new text end

new text begin (k) "Prepaid health plan" means a plan under contract with the commissioner according
to section 256B.69.
new text end

new text begin (l) "State fair hearing" means the appeals process mandated under section 256.045,
subdivision 3a.
new text end

new text begin Subd. 2. new text end

new text begin Ombudsperson. new text end

new text begin The commissioner must designate an ombudsperson to advocate
for enrollees. At the time of enrollment in a prepaid health plan, the local agency must
inform enrollees about the ombudsperson.
new text end

new text begin Subd. 3. new text end

new text begin Duties and cost. new text end

new text begin (a) The ombudsperson must work to ensure enrollees receive
covered services as described in the enrollee's prepaid health plan by:
new text end

new text begin (1) providing assistance and education to enrollees, when requested, regarding covered
health care benefits or services; billing and access; or the grievance, appeal, or state fair
hearing processes;
new text end

new text begin (2) with the enrollee's permission and within the ombudsperson's discretion, using an
informal review process to assist an enrollee with a resolution involving the enrollee's
prepaid health plan's benefits;
new text end

new text begin (3) assisting enrollees, when requested, with prepaid health plan grievances, appeals, or
the state fair hearing process;
new text end

new text begin (4) overseeing, reviewing, and approving documents used by enrollees relating to prepaid
health plans' grievances, appeals, and state fair hearings;
new text end

new text begin (5) reviewing all state fair hearings and requests by enrollees for external review;
overseeing entities under contract to provide external reviews, processes, and payments for
services; and utilizing aggregated results of external reviews to recommend health care
benefits policy changes; and
new text end

new text begin (6) providing trainings to managed care advocates.
new text end

new text begin (b) The ombudsperson must not charge an enrollee for the ombudsperson's services.
new text end

new text begin Subd. 4. new text end

new text begin Powers. new text end

new text begin In exercising the ombudsperson's authority under this section, the
ombudsperson may:
new text end

new text begin (1) gather information and evaluate any practice, policy, procedure, or action by a prepaid
health plan, state human services agency, county, or Tribe; and
new text end

new text begin (2) prescribe the methods by which complaints are to be made, received, and acted upon.
The ombudsperson's authority under this clause includes but is not limited to:
new text end

new text begin (i) determining the scope and manner of a complaint;
new text end

new text begin (ii) holding a prepaid health plan accountable to address a complaint in a timely manner
as outlined in state and federal laws;
new text end

new text begin (iii) requiring a prepaid health plan to respond in a timely manner to a request for data,
case details, and other information as needed to help resolve a complaint or to improve a
prepaid health plan's policy; and
new text end

new text begin (iv) making recommendations for policy, administrative, or legislative changes regarding
prepaid health plans to the proper partners.
new text end

new text begin Subd. 5. new text end

new text begin Data. new text end

new text begin (a) The data analyst must review and analyze prepaid health plan data
on denial, termination, and reduction notices (DTRs), grievances, appeals, and state fair
hearings by:
new text end

new text begin (1) analyzing, reviewing, and reporting on DTRs, grievances, appeals, and state fair
hearings data collected from each prepaid health plan;
new text end

new text begin (2) collaborating with the commissioner's partners and the Department of Health for the
Triennial Compliance Assessment under Code of Federal Regulations, title 42, section
438.358, subpart (b);
new text end

new text begin (3) reviewing state fair hearing decisions for policy or coverage issues that may affect
enrollees; and
new text end

new text begin (4) providing data required under Code of Federal Regulations, title 42, section 438.66
(2016), to the Centers for Medicare and Medicaid Services.
new text end

new text begin (b) The data analyst must share the data analyst's data observations and trends under
this subdivision with the ombudsperson, prepaid health plans, and commissioner's partners.
new text end

new text begin Subd. 6. new text end

new text begin Collaboration and independence. new text end

new text begin (a) The ombudsperson must work in
collaboration with the commissioner and the commissioner's partners when the
ombudsperson's collaboration does not otherwise interfere with the ombudsperson's duties
under this section.
new text end

new text begin (b) The ombudsperson may act independently of the commissioner when:
new text end

new text begin (1) providing information or testimony to the legislature; and
new text end

new text begin (2) contacting and making reports to federal and state officials.
new text end

new text begin Subd. 7. new text end

new text begin Civil actions. new text end

new text begin The ombudsperson is not civilly liable for actions taken under
this section if the action was taken in good faith, was within the scope of the ombudsperson's
authority, and did not constitute willful or reckless misconduct.
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 2020, section 256B.77, subdivision 13, is amended to read:


Subd. 13.

Ombudsman.

Enrollees shall have access to ombudsman services established
in section deleted text begin256B.69, subdivision 20deleted text endnew text begin 256B.6903new text end, and advocacy services provided by the
ombudsman for mental health and developmental disabilities established in sections 245.91
to 245.97. The managed care ombudsman and the ombudsman for mental health and
developmental disabilities shall coordinate services provided to avoid duplication of services.
For purposes of the demonstration project, the powers and responsibilities of the Office of
Ombudsman for Mental Health and Developmental Disabilities, as provided in sections
245.91 to 245.97 are expanded to include all eligible individuals, health plan companies,
agencies, and providers participating in the demonstration project.

new text begin EFFECTIVE DATE. new text end

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

Sec. 14. new text beginDIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
ENTERAL NUTRITION AND SUPPLIES.
new text end

new text begin Notwithstanding Minnesota Statutes, section 256B.766, paragraph (i), but subject to
Minnesota Statutes, section 256B.766, paragraph (l), effective for dates of service on or
after the effective date of this section through June 30, 2023, the commissioner of human
services shall not adjust rates paid for enteral nutrition and supplies.
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. 15. new text beginTEMPORARY TELEPHONE-ONLY TELEHEALTH AUTHORIZATION.
new text end

new text begin Beginning July 1, 2021, and until the COVID-19 federal public health emergency ends
or July 1, 2023, whichever is earlier, telehealth visits, as described in Minnesota Statutes,
section 256B.0625, subdivision 3b, provided through telephone may satisfy the face-to-face
requirements 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.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective retroactively from July 1, 2021, and
expires when the COVID-19 federal public health emergency ends or July 1, 2023, whichever
is earlier. The commissioner of human services shall notify the revisor of statutes when this
section expires.
new text end

Sec. 16. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, section 256B.057, subdivision 7, new text end new text begin is repealed on July 1,
2022.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2020, sections 256B.69, subdivision 20; 501C.0408, subdivision
4; and 501C.1206,
new text end new text begin are repealed the day following final enactment.
new text end

ARTICLE 3

HEALTH-RELATED LICENSING BOARDS

Section 1.

Minnesota Statutes 2020, section 148B.33, is amended by adding a subdivision
to read:


new text begin Subd. 1a. new text end

new text begin Supervision requirement; postgraduate experience. new text end

new text begin The board must allow
an applicant to satisfy the requirement for supervised postgraduate experience in marriage
and family therapy with all required hours of supervision provided through real-time,
two-way interactive audio and visual communication.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
applies to supervision requirements in effect on or after that date.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 148B.5301, subdivision 2, is amended
to read:


Subd. 2.

Supervision.

(a) To qualify as a LPCC, an applicant must have completed
4,000 hours of post-master's degree supervised professional practice in the delivery of
clinical services in the diagnosis and treatment of mental illnesses and disorders in both
children and adults. The supervised practice shall be conducted according to the requirements
in paragraphs (b) to (e).

(b) The supervision must have been received under a contract that defines clinical practice
and supervision from a mental health professional who is qualified according to section
245I.04, subdivision 2, or by a board-approved supervisor, who has at least two years of
postlicensure experience in the delivery of clinical services in the diagnosis and treatment
of mental illnesses and disorders. All supervisors must meet the supervisor requirements in
Minnesota Rules, part 2150.5010.

(c) The supervision must be obtained at the rate of two hours of supervision per 40 hours
of professional practice. The supervision must be evenly distributed over the course of the
supervised professional practice. At least 75 percent of the required supervision hours must
be received in personnew text begin or through real-time, two-way interactive audio and visual
communication, and the board must allow an applicant to satisfy this supervision requirement
with all required hours of supervision received through real-time, two-way interactive audio
and visual communication
new text end. The remaining 25 percent of the required hours may be received
by telephone or by audio or audiovisual electronic device. At least 50 percent of the required
hours of supervision must be received on an individual basis. The remaining 50 percent
may be received in a group setting.

(d) The supervised practice must include at least 1,800 hours of clinical client contact.

(e) The supervised practice must be clinical practice. Supervision includes the observation
by the supervisor of the successful application of professional counseling knowledge, skills,
and values in the differential diagnosis and treatment of psychosocial function, disability,
or impairment, including addictions and emotional, mental, and behavioral disorders.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
applies to supervision requirements in effect on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2020, section 148E.100, subdivision 3, is amended to read:


Subd. 3.

Types of supervision.

Of the 100 hours of supervision required under
subdivision 1:

(1) 50 hours must be provided through one-on-one supervisiondeleted text begin, including: (i) a minimum
of 25 hours of in-person supervision, and (ii) no more than 25 hours of supervision
deleted text endnew text begin. The
supervision must be provided either in person or
new text end via eye-to-eye electronic media, while
maintaining visual contactnew text begin. The board must allow a licensed social worker to satisfy the
supervision requirement of this clause with all required hours of supervision provided via
eye-to-eye electronic media, while maintaining visual contact
new text end; and

(2) 50 hours must be provided through: (i) one-on-one supervision, or (ii) group
supervision. The supervision may be in person, by telephone, or via eye-to-eye electronic
media, while maintaining visual contact. The supervision must not be provided by e-mail.
Group supervision is limited to six supervisees.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
applies to supervision requirements in effect on or after that date.
new text end

Sec. 4.

Minnesota Statutes 2020, section 148E.105, subdivision 3, as amended by Laws
2022, chapter 55, article 1, section 42, is amended to read:


Subd. 3.

Types of supervision.

Of the 100 hours of supervision required under
subdivision 1:

(1) 50 hours must be provided through one-on-one supervisiondeleted text begin, including: (i) a minimum
of 25 hours of in-person supervision, and (ii) no more than 25 hours of supervision
deleted text endnew text begin. The
supervision must be provided either in person or
new text end via eye-to-eye electronic media, while
maintaining visual contactnew text begin. The board must allow a licensed graduate social worker to satisfy
the supervision requirement of this clause with all required hours of supervision provided
via eye-to-eye electronic media, while maintaining visual contact
new text end; and

(2) 50 hours must be provided through: (i) one-on-one supervision, or (ii) group
supervision. The supervision may be in person, by telephone, or via eye-to-eye electronic
media, while maintaining visual contact. The supervision must not be provided by e-mail.
Group supervision is limited to six supervisees.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
applies to supervision requirements in effect on or after that date.
new text end

Sec. 5.

Minnesota Statutes 2020, section 148E.106, subdivision 3, is amended to read:


Subd. 3.

Types of supervision.

Of the 200 hours of supervision required under
subdivision 1:

(1) 100 hours must be provided through one-on-one supervisiondeleted text begin, including: (i) a minimum
of 50 hours of in-person supervision, and (ii) no more than 50 hours of supervision
deleted text endnew text begin. The
supervision must be provided either in person or
new text end via eye-to-eye electronic media, while
maintaining visual contactnew text begin. The board must allow a licensed graduate social worker to satisfy
the supervision requirement of this clause with all required hours of supervision provided
via eye-to-eye electronic media, while maintaining visual contact
new text end; and

(2) 100 hours must be provided through: (i) one-on-one supervision, or (ii) group
supervision. The supervision may be in person, by telephone, or via eye-to-eye electronic
media, while maintaining visual contact. The supervision must not be provided by e-mail.
Group supervision is limited to six supervisees.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
applies to supervision requirements in effect on or after that date.
new text end

Sec. 6.

Minnesota Statutes 2020, section 148E.110, subdivision 7, is amended to read:


Subd. 7.

Supervision; clinical social work practice after licensure as licensed
independent social worker.

Of the 200 hours of supervision required under subdivision
5:

(1) 100 hours must be provided through one-on-one supervisiondeleted text begin, including:deleted text endnew text begin. The
supervision must be provided either in person or via eye-to-eye electronic media, while
maintaining visual contact. The board must allow a licensed independent social worker to
satisfy the supervision requirement of this clause with all required hours of supervision
provided via eye-to-eye electronic media, while maintaining visual contact; and
new text end

deleted text begin (i) a minimum of 50 hours of in-person supervision; and
deleted text end

deleted text begin (ii) no more than 50 hours of supervision via eye-to-eye electronic media, while
maintaining visual contact; and
deleted text end

(2) 100 hours must be provided through:

(i) one-on-one supervision; or

(ii) group supervision.

The supervision may be in person, by telephone, or via eye-to-eye electronic media, while
maintaining visual contact. The supervision must not be provided by e-mail. Group
supervision is limited to six supervisees.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective the day following final enactment and
applies to supervision requirements in effect on or after that date.
new text end

Sec. 7.

Minnesota Statutes 2020, section 150A.06, subdivision 1c, is amended to read:


Subd. 1c.

Specialty dentists.

(a) The board may grant one or more specialty licenses in
the specialty areas of dentistry that are recognized by the Commission on Dental
Accreditation.

(b) An applicant for a specialty license shall:

(1) have successfully completed a postdoctoral specialty program accredited by the
Commission on Dental Accreditation, or have announced a limitation of practice before
1967;

(2) have been certified by a specialty board approved by the Minnesota Board of
Dentistry, or provide evidence of having passed a clinical examination for licensure required
for practice in any state or Canadian province, or in the case of oral and maxillofacial
surgeons only, have a Minnesota medical license in good standing;

(3) have been in active practice or a postdoctoral specialty education program or United
States government service at least 2,000 hours in the 36 months prior to applying for a
specialty license;

(4) if requested by the board, be interviewed by a committee of the board, which may
include the assistance of specialists in the evaluation process, and satisfactorily respond to
questions designed to determine the applicant's knowledge of dental subjects and ability to
practice;

(5) if requested by the board, present complete records on a sample of patients treated
by the applicant. The sample must be drawn from patients treated by the applicant during
the 36 months preceding the date of application. The number of records shall be established
by the board. The records shall be reasonably representative of the treatment typically
provided by the applicant for each specialty area;

(6) at board discretion, pass a board-approved English proficiency test if English is not
the applicant's primary language;

(7) pass all components of the National Board Dental Examinations;

(8) pass the Minnesota Board of Dentistry jurisprudence examination;

(9) abide by professional ethical conduct requirements; and

(10) meet all other requirements prescribed by the Board of Dentistry.

(c) The application must include:

(1) a completed application furnished by the board;

deleted text begin (2) at least two character references from two different dentists for each specialty area,
one of whom must be a dentist practicing in the same specialty area, and the other from the
director of each specialty program attended;
deleted text end

deleted text begin (3) a licensed physician's statement attesting to the applicant's physical and mental
condition;
deleted text end

deleted text begin (4) a statement from a licensed ophthalmologist or optometrist attesting to the applicant's
visual acuity;
deleted text end

deleted text begin (5)deleted text endnew text begin (2)new text end a nonrefundable fee; and

deleted text begin (6)deleted text endnew text begin (3)new text end a deleted text beginnotarized, unmounted passport-type photograph, three inches by three inches,
taken not more than six months before the date of application
deleted text endnew text begin copy of the applicant's
government issued photo identification card
new text end.

(d) A specialty dentist holding one or more specialty licenses is limited to practicing in
the dentist's designated specialty area or areas. The scope of practice must be defined by
each national specialty board recognized by the Commission on Dental Accreditation.

(e) A specialty dentist holding a general dental license is limited to practicing in the
dentist's designated specialty area or areas if the dentist has announced a limitation of
practice. The scope of practice must be defined by each national specialty board recognized
by the Commission on Dental Accreditation.

(f) All specialty dentists who have fulfilled the specialty dentist requirements and who
intend to limit their practice to a particular specialty area or areas may apply for one or more
specialty licenses.

Sec. 8.

Minnesota Statutes 2020, section 150A.06, subdivision 2c, is amended to read:


Subd. 2c.

Guest license.

(a) The board shall grant a guest license to practice as a dentist,
dental hygienist, or licensed dental assistant if the following conditions are met:

(1) the dentist, dental hygienist, or dental assistant is currently licensed in good standing
in another United States jurisdiction;

(2) the dentist, dental hygienist, or dental assistant is currently engaged in the practice
of that person's respective profession in another United States jurisdiction;

(3) the dentist, dental hygienist, or dental assistant will limit that person's practice to a
public health setting in Minnesota that (i) is approved by the board; (ii) was established by
a nonprofit organization that is tax exempt under chapter 501(c)(3) of the Internal Revenue
Code of 1986; and (iii) provides dental care to patients who have difficulty accessing dental
care;

(4) the dentist, dental hygienist, or dental assistant agrees to treat indigent patients who
meet the eligibility criteria established by the clinic; and

(5) the dentist, dental hygienist, or dental assistant has applied to the board for a guest
license and has paid a nonrefundable license fee to the board deleted text beginnot to exceed $75deleted text end.

(b) A guest license must be renewed annually with the board and an annual renewal fee
deleted text begin not to exceed $75deleted text end must be paid to the board. Guest licenses expire on December 31 of each
year.

(c) A dentist, dental hygienist, or dental assistant practicing under a guest license under
this subdivision shall have the same obligations as a dentist, dental hygienist, or dental
assistant who is licensed in Minnesota and shall be subject to the laws and rules of Minnesota
and the regulatory authority of the board. If the board suspends or revokes the guest license
of, or otherwise disciplines, a dentist, dental hygienist, or dental assistant practicing under
this subdivision, the board shall promptly report such disciplinary action to the dentist's,
dental hygienist's, or dental assistant's regulatory board in the jurisdictions in which they
are licensed.

(d) The board may grant a guest license to a dentist, dental hygienist, or dental assistant
licensed in another United States jurisdiction to provide dental care to patients on a voluntary
basis without compensation for a limited period of time. The board shall not assess a fee
for the guest license for volunteer services issued under this paragraph.

new text begin (e) new text endThe board shall issue a guest license for volunteer services if:

(1) the board determines that the applicant's services will provide dental care to patients
who have difficulty accessing dental care;

(2) the care will be provided without compensation; and

(3) the applicant provides adequate proof of the status of all licenses to practice in other
jurisdictions. The board may require such proof on an application form developed by the
board.

new text begin (f) new text endThe guest license for volunteer services shall limit the licensee to providing dental
care services for a period of time not to exceed ten days in a calendar year. Guest licenses
expire on December 31 of each year.

new text begin (g) new text endThe holder of a guest license for volunteer services shall be subject to state laws and
rules regarding dentistry and the regulatory authority of the board. The board may revoke
the license of a dentist, dental hygienist, or dental assistant practicing under this subdivision
or take other regulatory action against the dentist, dental hygienist, or dental assistant. If an
action is taken, the board shall report the action to the regulatory board of those jurisdictions
where an active license is held by the dentist, dental hygienist, or dental assistant.

Sec. 9.

Minnesota Statutes 2020, section 150A.06, subdivision 6, is amended to read:


Subd. 6.

Display of name and certificates.

(a) The renewal certificate of deleted text beginevery dentist,
dental therapist, dental hygienist, or dental assistant
deleted text endnew text begin every licensee or registrantnew text end must be
conspicuously displayed in plain sight of patients in every office in which that person
practices. Duplicate renewal certificates may be obtained from the board.

(b) Near or on the entrance door to every office where dentistry is practiced, the name
of each dentist practicing there, as inscribed on the current license certificate, must be
displayed in plain sight.

(c) The board must allow the display of a mini-license for guest license holders
performing volunteer dental services. There is no fee for the mini-license for guest volunteers.

Sec. 10.

Minnesota Statutes 2020, section 150A.06, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin Licensure by credentials for dental therapy. new text end

new text begin (a) Any dental therapist may,
upon application and payment of a fee established by the board, apply for licensure based
on an evaluation of the applicant's education, experience, and performance record. The
applicant may be interviewed by the board to determine if the applicant:
new text end

new text begin (1) graduated with a baccalaureate or master's degree from a dental therapy program
accredited by the Commission on Dental Accreditation;
new text end

new text begin (2) provided evidence of successfully completing the board's jurisprudence examination;
new text end

new text begin (3) actively practiced at least 2,000 hours within 36 months of the application date or
passed a board-approved reentry program within 36 months of the application date;
new text end

new text begin (4) either:
new text end

new text begin (i) is currently licensed in another state or Canadian province and not subject to any
pending or final disciplinary action; or
new text end

new text begin (ii) was previously licensed in another state or Canadian province in good standing and
not subject to any final or pending disciplinary action at the time of surrender;
new text end

new text begin (5) passed a board-approved English proficiency test if English is not the applicant's
primary language required at the board's discretion; and
new text end

new text begin (6) met all curriculum equivalency requirements regarding dental therapy scope of
practice in Minnesota.
new text end

new text begin (b) The 2,000 practice hours required by clause (3) may count toward the 2,000 practice
hours required for consideration for advanced dental therapy certification, provided that all
other requirements of section 150A.106, subdivision 1, are met.
new text end

new text begin (c) The board, at its discretion, may waive specific licensure requirements in paragraph
(a).
new text end

new text begin (d) The board must license an applicant who fulfills the conditions of this subdivision
and demonstrates the minimum knowledge in dental subjects required for licensure under
subdivision 1d to practice the applicant's profession.
new text end

new text begin (e) The board must deny the application if the applicant does not demonstrate the
minimum knowledge in dental subjects required for licensure under subdivision 1d. If
licensure is denied, the board may notify the applicant of any specific remedy the applicant
could take to qualify for licensure. A denial does not prohibit the applicant from applying
for licensure under subdivision 1d.
new text end

new text begin (f) A candidate may appeal a denied application to the board according to subdivision
4a.
new text end

Sec. 11.

Minnesota Statutes 2020, section 150A.09, is amended to read:


150A.09 deleted text beginREGISTRATION OFdeleted text end LICENSES deleted text beginANDdeleted text endnew text begin ORnew text end REGISTRATION
CERTIFICATES.

Subdivision 1.

Registration information and procedure.

On or before the license
certificate expiration date every deleted text beginlicensed dentist, dental therapist, dental hygienist, and
dental assistant
deleted text endnew text begin licensee or registrantnew text end shall deleted text begintransmit to the executive secretary of the board,
pertinent information
deleted text endnew text begin submit the renewalnew text end required by the board, together with thenew text begin applicablenew text end
fee deleted text beginestablished by the boarddeleted text endnew text begin under section 150A.091new text end. At least 30 days before a license
certificate expiration date, the board shall send a written notice stating the amount and due
date of the fee deleted text beginand the information to be provided to every licensed dentist, dental therapist,
dental hygienist, and dental assistant
deleted text end.

Subd. 3.

Current address, change of address.

Every deleted text begindentist, dental therapist, dental
hygienist, and dental assistant
deleted text endnew text begin licensee or registrantnew text end shall maintain with the board a correct
and current mailing address and electronic mail address. For dentists engaged in the practice
of dentistry, the postal address shall be that of the location of the primary dental practice.
Within 30 days after changing postal or electronic mail addresses, every deleted text begindentist, dental
therapist, dental hygienist, and dental assistant
deleted text endnew text begin licensee or registrantnew text end shall provide the board
deleted text begin writtendeleted text end notice deleted text beginof the new address either personally or by first class maildeleted text end.

Subd. 4.

Duplicate certificates.

Duplicate licenses or duplicate certificates of deleted text beginlicensedeleted text end
renewal may be issued by the board upon satisfactory proof of the need for the duplicates
and upon payment of the fee established by the board.

Subd. 5.

Late fee.

A late fee established by the board shall be paid if the deleted text begininformation
and
deleted text end fee required by subdivision 1 is not received by deleted text beginthe executive secretary ofdeleted text end the board on
or before the registration or deleted text beginlicensedeleted text end renewal date.

Sec. 12.

Minnesota Statutes 2020, section 150A.091, subdivision 2, is amended to read:


Subd. 2.

Applicationnew text begin and initial license or registrationnew text end fees.

Each applicant shall
submit with a license, advanced dental therapist certificate, or permit application a
nonrefundable fee in the following amounts in order to administratively process an
application:

(1) dentist, deleted text begin$140deleted text endnew text begin $308new text end;

(2) full faculty dentist, deleted text begin$140deleted text endnew text begin $308new text end;

(3) limited faculty dentist, $140;

(4) resident dentist or dental provider, $55;

(5) advanced dental therapist, $100;

(6) dental therapist, deleted text begin$100deleted text endnew text begin $220new text end;

(7) dental hygienist, deleted text begin$55deleted text endnew text begin $115new text end;

(8) licensed dental assistant, deleted text begin$55; anddeleted text endnew text begin $115;
new text end

(9) dental assistant with deleted text begina permitdeleted text endnew text begin registrationnew text end as described in Minnesota Rules, part
3100.8500, subpart 3, deleted text begin$15.deleted text endnew text begin $27; and
new text end

new text begin (10) guest license, $50.
new text end

Sec. 13.

Minnesota Statutes 2020, section 150A.091, subdivision 5, is amended to read:


Subd. 5.

Biennial license or deleted text beginpermitdeleted text endnew text begin registration renewalnew text end fees.

Each of the following
applicants shall submit with a biennial license or permit renewal application a fee as
established by the board, not to exceed the following amounts:

(1) dentist or full faculty dentist, $475;

(2) dental therapist, $300;

(3) dental hygienist, $200;

(4) licensed dental assistant, $150; and

(5) dental assistant with a deleted text beginpermitdeleted text endnew text begin registrationnew text end as described in Minnesota Rules, part
3100.8500, subpart 3, $24.

Sec. 14.

Minnesota Statutes 2020, section 150A.091, subdivision 8, is amended to read:


Subd. 8.

Duplicate license or certificate fee.

Each applicant shall submit, with a request
for issuance of a duplicate of the original license, or of an annual or biennial renewal
certificate for a license or permit, a fee in the following amounts:

(1) original dentist, full faculty dentist, dental therapist, dental hygiene, or dental assistant
license, $35;new text begin and
new text end

(2) annual or biennial renewal certificates, $10deleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (3) wallet-sized license and renewal certificate, $15.
deleted text end

Sec. 15.

Minnesota Statutes 2020, section 150A.091, subdivision 9, is amended to read:


Subd. 9.

Licensure by credentials.

Each applicant for licensure as a dentist, dental
hygienist, or dental assistant by credentials pursuant to section 150A.06, subdivisions 4 and
8, and Minnesota Rules, part 3100.1400, shall submit with the license application a fee in
the following amounts:

(1) dentist, deleted text begin$725deleted text endnew text begin $893new text end;

(2) dental hygienist, deleted text begin$175; anddeleted text endnew text begin $235;
new text end

(3) dental assistant, deleted text begin$35.deleted text endnew text begin $71; and
new text end

new text begin (4) dental therapist, $340.
new text end

Sec. 16.

Minnesota Statutes 2020, section 150A.091, is amended by adding a subdivision
to read:


new text begin Subd. 21. new text end

new text begin Failure to practice with a current license. new text end

new text begin (a) If a licensee practices without
a current license and pursues reinstatement, the board may take the following administrative
actions based on the length of time practicing without a current license:
new text end

new text begin (1) for under one month, the board may not assess a penalty fee;
new text end

new text begin (2) for one month to six months, the board may assess a penalty of $250;
new text end

new text begin (3) for over six months, the board may assess a penalty of $500; and
new text end

new text begin (4) for over 12 months, the board may assess a penalty of $1,000.
new text end

new text begin (b) In addition to the penalty fee, the board shall initiate the complaint process against
the licensee for failure to practice with a current license for over 12 months.
new text end

Sec. 17.

Minnesota Statutes 2020, section 150A.091, is amended by adding a subdivision
to read:


new text begin Subd. 22. new text end

new text begin Delegating regulated procedures to an individual with a terminated
license.
new text end

new text begin (a) If a dentist or dental therapist delegates regulated procedures to another dental
professional who had their license terminated, the board may take the following
administrative actions against the delegating dentist or dental therapist based on the length
of time they delegated regulated procedures:
new text end

new text begin (1) for under one month, the board may not assess a penalty fee;
new text end

new text begin (2) for one month to six months, the board may assess a penalty of $100;
new text end

new text begin (3) for over six months, the board may assess a penalty of $250; and
new text end

new text begin (4) for over 12 months, the board may assess a penalty of $500.
new text end

new text begin (b) In addition to the penalty fee, the board shall initiate the complaint process against
a dentist or dental therapist who delegated regulated procedures to a dental professional
with a terminated license for over 12 months.
new text end

Sec. 18.

Minnesota Statutes 2020, section 150A.10, subdivision 1a, is amended to read:


Subd. 1a.

Collaborative practice authorization for dental hygienists in community
settings.

(a) Notwithstanding subdivision 1, a dental hygienist licensed under this chapter
may be employed or retained by a health care facility, program, deleted text beginordeleted text end nonprofit organizationnew text begin,
or licensed dentist
new text end to perform the dental hygiene services listed in Minnesota Rules, part
3100.8700, subpart 1, without the patient first being examined by a licensed dentist if the
dental hygienist:

(1) has entered into a collaborative agreement with a licensed dentist that designates
authorization for the services provided by the dental hygienist; and

(2) has documented completion of a course on medical emergencies within each
continuing education cycle.

(b) A collaborating dentist must be licensed under this chapter and may enter into a
collaborative agreement with no more than four dental hygienists unless otherwise authorized
by the board. The board shall develop parameters and a process for obtaining authorization
to collaborate with more than four dental hygienists. The collaborative agreement must
include:

(1) consideration for medically compromised patients and medical conditions for which
a dental evaluation and treatment plan must occur prior to the provision of dental hygiene
services;

(2) age- and procedure-specific standard collaborative practice protocols, including
recommended intervals for the performance of dental hygiene services and a period of time
in which an examination by a dentist should occur;

(3) copies of consent to treatment form provided to the patient by the dental hygienist;

(4) specific protocols for the placement of pit and fissure sealants and requirements for
follow-up care to deleted text beginassure thedeleted text endnew text begin ensurenew text end efficacy deleted text beginof the sealants after applicationdeleted text end; and

(5) the procedure for creating and maintaining dental records for patients who are treated
by the dental hygienist under Minnesota Rules, part 3100.9600, including specifying where
records will be located.

deleted text begin The collaborative agreement must be signed and maintained by the dentist, the dental
hygienist, and the facility, program, or organization; must be reviewed annually by the
collaborating dentist and dental hygienist and must be made available to the board upon
request.
deleted text end

new text begin (c) The collaborative agreement must be:
new text end

new text begin (1) signed and maintained by the dentist; the dental hygienist; and the facility, program,
or organization;
new text end

new text begin (2) reviewed annually by the collaborating dentist and the dental hygienist; and
new text end

new text begin (3) made available to the board upon request.
new text end

deleted text begin (c)deleted text endnew text begin (d)new text end Before performing any services authorized under this subdivision, a dental
hygienist must provide the patient with a consent to treatment form which must include a
statement advising the patient that the dental hygiene services provided are not a substitute
for a dental examination by a licensed dentist. When the patient requires a referral for
additional dental services, the dental hygienist shall complete a referral form and provide
a copy to the patient, the facility, if applicable, the dentist to whom the patient is being
referred, and the collaborating dentist, if specified in the collaborative agreement. A copy
of the referral form shall be maintained in the patient's health care record. The patient does
not become a new patient of record of the dentist to whom the patient was referred until the
dentist accepts the patient for follow-up services after referral from the dental hygienist.

deleted text begin (d)deleted text endnew text begin (e)new text end For the purposes of this subdivision, a "health care facility, program, or nonprofit
organization" includes a hospital; nursing home; home health agency; group home serving
the elderly, disabled, or juveniles; state-operated facility licensed by the commissioner of
human services or the commissioner of corrections; new text begina state agency administered public
health program or event;
new text endand federal, state, or local public health facility, community clinic,
tribal clinic, school authority, Head Start program, or nonprofit organization that serves
individuals who are uninsured or who are Minnesota health care public program recipients.

deleted text begin (e)deleted text endnew text begin (f)new text end For purposes of this subdivision, a "collaborative agreement" means a written
agreement with a licensed dentist who authorizes and accepts responsibility for the services
performed by the dental hygienist.

new text begin (g) A collaborative practice dental hygienist must be reimbursed for all services performed
through a health care facility, program, nonprofit organization, or licensed dentist.
new text end

Sec. 19.

Minnesota Statutes 2020, section 150A.105, subdivision 8, is amended to read:


Subd. 8.

Definitions.

(a) For the purposes of this section, the following definitions apply.

(b) "Practice settings that serve the low-income and underserved" mean:

(1) critical access dental provider settings as designated by the commissioner of human
services under section 256B.76, subdivision 4;

(2) dental hygiene collaborative practice settings identified in section 150A.10,
subdivision 1a, paragraph deleted text begin(d)deleted text endnew text begin (e)new text end, and including medical facilities, assisted living facilities,
federally qualified health centers, and organizations eligible to receive a community clinic
grant under section 145.9268, subdivision 1;

(3) military and veterans administration hospitals, clinics, and care settings;

(4) a patient's residence or home when the patient is home-bound or receiving or eligible
to receive home care services or home and community-based waivered services, regardless
of the patient's income;

(5) oral health educational institutions; or

(6) any other clinic or practice setting, including mobile dental units, in which at least
50 percent of the total patient base of the dental therapist or advanced dental therapist
consists of patients who:

(i) are enrolled in a Minnesota health care program;

(ii) have a medical disability or chronic condition that creates a significant barrier to
receiving dental care;

(iii) do not have dental health coverage, either through a public health care program or
private insurance, and have an annual gross family income equal to or less than 200 percent
of the federal poverty guidelines; or

(iv) do not have dental health coverage, either through a state public health care program
or private insurance, and whose family gross income is equal to or less than 200 percent of
the federal poverty guidelines.

(c) "Dental health professional shortage area" means an area that meets the criteria
established by the secretary of the United States Department of Health and Human Services
and is designated as such under United States Code, title 42, section 254e.

Sec. 20.

Minnesota Statutes 2020, section 151.01, subdivision 27, is amended to read:


Subd. 27.

Practice of pharmacy.

"Practice of pharmacy" means:

(1) interpretation and evaluation of prescription drug orders;

(2) compounding, labeling, and dispensing drugs and devices (except labeling by a
manufacturer or packager of nonprescription drugs or commercially packaged legend drugs
and devices);

(3) participation in clinical interpretations and monitoring of drug therapy for assurance
of safe and effective use of drugs, including the performance of laboratory tests that are
waived under the federal Clinical Laboratory Improvement Act of 1988, United States Code,
title 42, section 263a et seq., provided that a pharmacist may interpret the results of laboratory
tests but may modify drug therapy only pursuant to a protocol or collaborative practice
agreement;

(4) participation in drug and therapeutic device selection; drug administration for first
dosage and medical emergencies; intramuscular and subcutaneous new text begindrug new text endadministration deleted text beginused
for the treatment of alcohol or opioid dependence
deleted text endnew text begin under a prescription drug ordernew text end; drug
regimen reviews; and drug or drug-related research;

(5) drug administration, through intramuscular and subcutaneous administration used
to treat mental illnesses as permitted under the following conditions:

(i) upon the order of a prescriber and the prescriber is notified after administration is
complete; or

(ii) pursuant to a protocol or collaborative practice agreement as defined by section
151.01, subdivisions 27b and 27c, and participation in the initiation, management,
modification, administration, and discontinuation of drug therapy is according to the protocol
or collaborative practice agreement between the pharmacist and a dentist, optometrist,
physician, podiatrist, or veterinarian, or an advanced practice registered nurse authorized
to prescribe, dispense, and administer under section 148.235. Any changes in drug therapy
or medication administration made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(6) participation in administration of influenza vaccines and vaccines approved by the
United States Food and Drug Administration related to COVID-19 or SARS-CoV-2 to all
eligible individuals six years of age and older and all other vaccines to patients 13 years of
age and older by written protocol with a physician licensed under chapter 147, a physician
assistant authorized to prescribe drugs under chapter 147A, or an advanced practice registered
nurse authorized to prescribe drugs under section 148.235, provided that:

(i) the protocol includes, at a minimum:

(A) the name, dose, and route of each vaccine that may be given;

(B) the patient population for whom the vaccine may be given;

(C) contraindications and precautions to the vaccine;

(D) the procedure for handling an adverse reaction;

(E) the name, signature, and address of the physician, physician assistant, or advanced
practice registered nurse;

(F) a telephone number at which the physician, physician assistant, or advanced practice
registered nurse can be contacted; and

(G) the date and time period for which the protocol is valid;

(ii) the pharmacist has successfully completed a program approved by the Accreditation
Council for Pharmacy Education specifically for the administration of immunizations or a
program approved by the board;

(iii) the pharmacist utilizes the Minnesota Immunization Information Connection to
assess the immunization status of individuals prior to the administration of vaccines, except
when administering influenza vaccines to individuals age nine and older;

(iv) the pharmacist reports the administration of the immunization to the Minnesota
Immunization Information Connection; and

(v) the pharmacist complies with guidelines for vaccines and immunizations established
by the federal Advisory Committee on Immunization Practices, except that a pharmacist
does not need to comply with those portions of the guidelines that establish immunization
schedules when administering a vaccine pursuant to a valid, patient-specific order issued
by a physician licensed under chapter 147, a physician assistant authorized to prescribe
drugs under chapter 147A, or an advanced practice registered nurse authorized to prescribe
drugs under section 148.235, provided that the order is consistent with the United States
Food and Drug Administration approved labeling of the vaccine;

(7) participation in the initiation, management, modification, and discontinuation of
drug therapy according to a written protocol or collaborative practice agreement between:
(i) one or more pharmacists and one or more dentists, optometrists, physicians, podiatrists,
or veterinarians; or (ii) one or more pharmacists and one or more physician assistants
authorized to prescribe, dispense, and administer under chapter 147A, or advanced practice
registered nurses authorized to prescribe, dispense, and administer under section 148.235.
Any changes in drug therapy made pursuant to a protocol or collaborative practice agreement
must be documented by the pharmacist in the patient's medical record or reported by the
pharmacist to a practitioner responsible for the patient's care;

(8) participation in the storage of drugs and the maintenance of records;

(9) patient counseling on therapeutic values, content, hazards, and uses of drugs and
devices;

(10) offering or performing those acts, services, operations, or transactions necessary
in the conduct, operation, management, and control of a pharmacy;

(11) participation in the initiation, management, modification, and discontinuation of
therapy with opiate antagonists, as defined in section 604A.04, subdivision 1, pursuant to:

(i) a written protocol as allowed under clause (7); or

(ii) a written protocol with a community health board medical consultant or a practitioner
designated by the commissioner of health, as allowed under section 151.37, subdivision 13;
deleted text begin and
deleted text end

(12) prescribing self-administered hormonal contraceptives; nicotine replacement
medications; and opiate antagonists for the treatment of an acute opiate overdose pursuant
to section 151.37, subdivision 14, 15, or 16deleted text begin.deleted text endnew text begin; and
new text end

new text begin (13) participation in the placement of drug monitoring devices according to a prescription,
protocol, or collaborative practice agreement.
new text end

Sec. 21.

Minnesota Statutes 2020, section 153.16, subdivision 1, is amended to read:


Subdivision 1.

License requirements.

The board shall issue a license to practice podiatric
medicine to a person who meets the following requirements:

(a) The applicant for a license shall file a written notarized application on forms provided
by the board, showing to the board's satisfaction that the applicant is of good moral character
and satisfies the requirements of this section.

(b) The applicant shall present evidence satisfactory to the board of being a graduate of
a podiatric medical school approved by the board based upon its faculty, curriculum, facilities,
accreditation by a recognized national accrediting organization approved by the board, and
other relevant factors.

(c) The applicant must have received a passing score on each part of the national board
examinations, parts one and two, prepared and graded by the National Board of Podiatric
Medical Examiners. The passing score for each part of the national board examinations,
parts one and two, is as defined by the National Board of Podiatric Medical Examiners.

(d) Applicants graduating after deleted text begin1986deleted text endnew text begin 1990new text end from a podiatric medical school shall present
evidence of successful completion of a residency program approved by a national accrediting
podiatric medicine organization.

(e) The applicant shall appear in person before the board or its designated representative
to show that the applicant satisfies the requirements of this section, including knowledge
of laws, rules, and ethics pertaining to the practice of podiatric medicine. The board may
establish as internal operating procedures the procedures or requirements for the applicant's
personal presentation. Upon completion of all other application requirements, a doctor of
podiatric medicine applying for a temporary military license has six months in which to
comply with this subdivision.

(f) The applicant shall pay a fee established by the board by rule. The fee shall not be
refunded.

(g) The applicant must not have engaged in conduct warranting disciplinary action
against a licensee. If the applicant does not satisfy the requirements of this paragraph, the
board may refuse to issue a license unless it determines that the public will be protected
through issuance of a license with conditions and limitations the board considers appropriate.

(h) Upon payment of a fee as the board may require, an applicant who fails to pass an
examination and is refused a license is entitled to reexamination within one year of the
board's refusal to issue the license. No more than two reexaminations are allowed without
a new application for 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. 22.

Laws 2021, First Special Session chapter 7, article 16, section 5, is amended to
read:


Sec. 5. EMERGENCY MEDICAL SERVICES
REGULATORY BOARD

$
4,780,000
$
4,576,000

(a) Cooper/Sams Volunteer Ambulance
Program.
$950,000 in fiscal year 2022 and
$950,000 in fiscal year 2023 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.

(1) Of this amount, $861,000 in fiscal year
2022 and $861,000 in fiscal year 2023 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.

(2) Of this amount, $89,000 in fiscal year 2022
and $89,000 in fiscal year 2023 are for the
operations of the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.

(b) EMSRB Operations. $1,880,000 in fiscal
year 2022 and $1,880,000 in fiscal year 2023
are for board operations.

deleted text begin (c) Regional Grants for Continuing
Education.
$585,000 in fiscal year 2022 and
$585,000 in fiscal year 2023 are for regional
emergency medical services programs, to be
distributed equally to the eight emergency
medical service regions under Minnesota
Statutes, section 144E.52.
deleted text end

deleted text begin (d) deleted text beginRegional Grants for Local and Regional
Emergency Medical Services
deleted text end.
deleted text endnew text begin (c)
Emergency Medical Services Fund.
new text end
deleted text begin $800,000deleted text endnew text begin $1,385,000new text end in fiscal year 2022 and
deleted text begin $800,000deleted text endnew text begin $1,385,000new text end in fiscal year 2023 are
for distribution tonew text begin regionalnew text end emergency medical
services deleted text beginregionsdeleted text endnew text begin systemsnew text end for deleted text beginregional
emergency medical services programs
deleted text endnew text begin the
purposes
new text end specified in Minnesota Statutes,
section 144E.50. Notwithstanding Minnesota
Statutes, section 144E.50, subdivision 5, in
each year the board shall distribute the
appropriation equally among the eight
emergency medical services deleted text beginregionsdeleted text endnew text begin systems
designated by the board
new text end. deleted text beginThis is a onetime
appropriation
deleted text endnew text begin The general fund base for this
appropriation is $585,000 in fiscal year 2024
and $585,000 in fiscal year 2025
new text end.

deleted text begin (e)deleted text endnew text begin (d)new text end Ambulance Training Grants.
$565,000 in fiscal year 2022 and $361,000 in
fiscal year 2023 are for training grants under
Minnesota Statutes, section 144E.35.

deleted text begin (f)deleted text endnew text begin (e)new text end Base Level Adjustment. The general
fund base is $3,776,000 in fiscal year 2024
and $3,776,000 in fiscal year 2025.

new text begin EFFECTIVE DATE. new text end

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

Sec. 23. new text beginTEMPORARY REQUIREMENTS GOVERNING AMBULANCE SERVICE
OPERATIONS AND THE PROVISION OF EMERGENCY MEDICAL SERVICES.
new text end

new text begin Subdivision 1. new text end

new text begin Application. new text end

new text begin Notwithstanding any law to the contrary in Minnesota
Statutes, chapter 144E, an ambulance service may operate according to this section, and
emergency medical technicians, advanced emergency medical technicians, and paramedics
may provide emergency medical services according to this section.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

new text begin (a) The terms defined in this subdivision apply to this section.
new text end

new text begin (b) "Advanced emergency medical technician" has the meaning given in Minnesota
Statutes, section 144E.001, subdivision 5d.
new text end

new text begin (c) "Advanced life support" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 1b.
new text end

new text begin (d) "Ambulance" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 2.
new text end

new text begin (e) "Ambulance service personnel" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 3a.
new text end

new text begin (f) "Basic life support" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 4b.
new text end

new text begin (g) "Board" means the Emergency Medical Services Regulatory Board.
new text end

new text begin (h) "Emergency medical technician" has the meaning given in Minnesota Statutes, section
144E.001, subdivision 5c.
new text end

new text begin (i) "Paramedic" has the meaning given in Minnesota Statutes, section 144E.001,
subdivision 5e.
new text end

new text begin (j) "Primary service area" means the area designated by the board according to Minnesota
Statutes, section 144E.06, to be served by an ambulance service.
new text end

new text begin Subd. 3. new text end

new text begin Staffing. new text end

new text begin (a) For emergency ambulance calls and interfacility transfers in an
ambulance service's primary service area, an ambulance service must staff an ambulance
that provides basic life support with at least:
new text end

new text begin (1) one emergency medical technician, who must be in the patient compartment when
a patient is being transported; and
new text end

new text begin (2) one individual to drive the ambulance. The driver must hold a valid driver's license
from any state, must have attended an emergency vehicle driving course approved by the
ambulance service, and must have completed a course on cardiopulmonary resuscitation
approved by the ambulance service.
new text end

new text begin (b) For emergency ambulance calls and interfacility transfers in an ambulance service's
primary service area, an ambulance service must staff an ambulance that provides advanced
life support with at least:
new text end

new text begin (1) one paramedic; one registered nurse who meets the requirements in Minnesota
Statutes, section 144E.001, subdivision 3a, clause (2); or one physician assistant who meets
the requirements in Minnesota Statutes, section 144E.001, subdivision 3a, clause (3), and
who must be in the patient compartment when a patient is being transported; and
new text end

new text begin (2) one individual to drive the ambulance. The driver must hold a valid driver's license
from any state, must have attended an emergency vehicle driving course approved by the
ambulance service, and must have completed a course on cardiopulmonary resuscitation
approved by the ambulance service.
new text end

new text begin (c) The ambulance service director and medical director must approve the staffing of
an ambulance according to this subdivision.
new text end

new text begin (d) An ambulance service staffing an ambulance according to this subdivision must
immediately notify the board in writing and in a manner prescribed by the board. The notice
must specify how the ambulance service is staffing its basic life support or advanced life
support ambulances and the time period the ambulance service plans to staff the ambulances
according to this subdivision. If an ambulance service continues to staff an ambulance
according to this subdivision after the date provided to the board in its initial notice, the
ambulance service must provide a new notice to the board in a manner that complies with
this paragraph.
new text end

new text begin (e) If an individual serving as a driver under this subdivision commits an act listed in
Minnesota Statutes, section 144E.27, subdivision 5, paragraph (a), the board may temporarily
suspend or prohibit the individual from driving an ambulance or place conditions on the
individual's ability to drive an ambulance using the procedures and authority in Minnesota
Statutes, section 144E.27, subdivisions 5 and 6.
new text end

new text begin Subd. 4. new text end

new text begin Use of expired emergency medications and medical supplies. new text end

new text begin (a) If an
ambulance service experiences a shortage of an emergency medication or medical supply,
ambulance service personnel may use an emergency medication or medical supply for up
to six months after the emergency medication's or medical supply's specified expiration
date, provided:
new text end

new text begin (1) the ambulance service director and medical director approve the use of the expired
emergency medication or medical supply;
new text end

new text begin (2) ambulance service personnel use an expired emergency medication or medical supply
only after depleting the ambulance service's supply of that emergency medication or medical
supply that is unexpired;
new text end

new text begin (3) the ambulance service has stored and maintained the expired emergency medication
or medical supply according to the manufacturer's instructions;
new text end

new text begin (4) if possible, ambulance service personnel obtain consent from the patient to use the
expired emergency medication or medical supply prior to its use; and
new text end

new text begin (5) when the ambulance service obtains a supply of that emergency medication or medical
supply that is unexpired, ambulance service personnel cease use of the expired emergency
medication or medical supply and instead use the unexpired emergency medication or
medical supply.
new text end

new text begin (b) Before approving the use of an expired emergency medication, an ambulance service
director and medical director must consult with the Board of Pharmacy regarding the safety
and efficacy of using the expired emergency medication.
new text end

new text begin (c) An ambulance service must keep a record of all expired emergency medications and
all expired medical supplies used and must submit that record in writing to the board in a
time and manner specified by the board. The record must list the specific expired emergency
medications and medical supplies used and the time period during which ambulance service
personnel used the expired emergency medication or medical supply.
new text end

new text begin Subd. 5. new text end

new text begin Provision of emergency medical services after certification expires. new text end

new text begin (a) At
the request of an emergency medical technician, advanced emergency medical technician,
or paramedic, and with the approval of the ambulance service director, an ambulance service
medical director may authorize the emergency medical technician, advanced emergency
medical technician, or paramedic to provide emergency medical services for the ambulance
service for up to three months after the certification of the emergency medical technician,
advanced emergency medical technician, or paramedic expires.
new text end

new text begin (b) An ambulance service must immediately notify the board each time its medical
director issues an authorization under paragraph (a). The notice must be provided in writing
and in a manner prescribed by the board and must include information on the time period
each emergency medical technician, advanced emergency medical technician, or paramedic
will provide emergency medical services according to an authorization under this subdivision;
information on why the emergency medical technician, advanced emergency medical
technician, or paramedic needs the authorization; and an attestation from the medical director
that the authorization is necessary to help the ambulance service adequately staff its
ambulances.
new text end

new text begin Subd. 6. new text end

new text begin Reports. new text end

new text begin The board must provide quarterly reports to the chairs and ranking
minority members of the legislative committees with jurisdiction over the board regarding
actions taken by ambulance services according to subdivisions 3, 4, and 5. The board must
submit reports by June 30, September 30, and December 31 of 2022; and by March 31, June
30, September 30, and December 31 of 2023. Each report must include the following
information:
new text end

new text begin (1) for each ambulance service staffing basic life support or advanced life support
ambulances according to subdivision 3, the primary service area served by the ambulance
service, the number of ambulances staffed according to subdivision 3, and the time period
the ambulance service has staffed and plans to staff the ambulances according to subdivision
3;
new text end

new text begin (2) for each ambulance service that authorized the use of an expired emergency
medication or medical supply according to subdivision 4, the expired emergency medications
and medical supplies authorized for use and the time period the ambulance service used
each expired emergency medication or medical supply; and
new text end

new text begin (3) for each ambulance service that authorized the provision of emergency medical
services according to subdivision 5, the number of emergency medical technicians, advanced
emergency medical technicians, and paramedics providing emergency medical services
under an expired certification and the time period each emergency medical technician,
advanced emergency medical technician, or paramedic provided and will provide emergency
medical services under an expired certification.
new text end

new text begin Subd. 7. new text end

new text begin Expiration. new text end

new text begin This section expires January 1, 2024.
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. 24. new text beginEXPEDITED REREGISTRATION FOR LAPSED NURSING LICENSES.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 148.231, a nurse who desires to resume
the practice of professional or practical nursing at a licensed nursing facility or licensed
assisted living facility but whose license to practice nursing has lapsed effective on or after
January 1, 2019, may submit an application to the Board of Nursing for reregistration. The
application must be submitted and received by the board between March 31, 2022, and
March 31, 2023, and must be accompanied with the reregistration fee specified in Minnesota
Statutes, section 148.243, subdivision 5. The applicant must include with the application
the name and location of the facility where the nurse is or will be employed.
new text end

new text begin (b) The board shall issue a current registration if upon a licensure history review, the
board determines that at the time the nurse's license lapsed:
new text end

new text begin (1) the nurse's license was in good standing; and
new text end

new text begin (2) the nurse was not the subject of any pending investigations or disciplinary actions
or was not disqualified to practice in any way.
new text end

new text begin The board shall waive any other requirements for reregistration including any continuing
education requirements.
new text end

new text begin (c) The registration issued under this section shall remain valid until the nurse's next
registration period. If the nurse desires to continue to practice after that date, the nurse must
meet the reregistration requirements under Minnesota Statutes, section 148.231, including
any penalty fees required.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 25. new text beginAPPROPRIATION; BOARD OF DENTISTRY.
new text end

new text begin $3,000 in fiscal year 2023 is appropriated from the state government special revenue
fund to the Board of Dentistry to process new credential applications and to administer
administrative fines. This is a onetime appropriation.
new text end

Sec. 26. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 150A.091, subdivisions 3, 15, and 17, new text end new text begin are repealed.
new text end

ARTICLE 4

COMMUNITY SUPPORTS AND BEHAVIORAL HEALTH POLICY

Section 1.

Minnesota Statutes 2021 Supplement, 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 deleted text beginas
defined
deleted text end under section deleted text begin245.462, subdivision 18, or 245.4871, subdivision 27deleted text endnew text begin 245I.04,
subdivision 2
new text end; a mental health practitioner deleted text beginas defineddeleted text end under section deleted text begin245.462, subdivision
17
, or 245.4871, subdivision 26
deleted text endnew text begin 245I.04, subdivision 4; a clinical trainee under section
245I.04, subdivision 6
new text end; 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, 2023, telehealth also includes audio-only communication between a health
care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth does
not include communication between health care providers that consists solely of a telephone
conversation, e-mail, or facsimile transmission. Telehealth does not include communication
between a health care provider and a patient that consists solely of an e-mail 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, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, 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 deleted text beginindividuals defined in section 256B.0623, subdivision 5, clauses
(1) to (6),
deleted text endnew text begin staff personsnew text end 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, or 256B.0623.

(b) Nothing in this chapter prohibits technicians and resident managers in programs
licensed by the Department of Human Services from discharging their duties as provided
in Minnesota Rules, chapter 9530.

(c) Any person who is exempt from licensure under this section must not use a title
incorporating the words "alcohol and drug counselor" or "licensed alcohol and drug
counselor" or otherwise hold himself or herself out to the public by any title or description
stating or implying that he or she is engaged in the practice of alcohol and drug counseling,
or that he or she is licensed to engage in the practice of alcohol and drug counseling, unless
that person is also licensed as an alcohol and drug counselor. Persons engaged in the practice
of alcohol and drug counseling are not exempt from the board's jurisdiction solely by the
use of one of the titles in paragraph (a).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 3.

Minnesota Statutes 2020, 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) new text beginbe a mental health practitioner as defined in section 245I.04, subdivision 4, or new text endhave
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 deleted text beginordeleted text endnew text begin.
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
new text end 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; 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 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. 4.

Minnesota Statutes 2021 Supplement, section 245.467, subdivision 2, is amended
to read:


Subd. 2.

Diagnostic assessment.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by this
section must complete a diagnostic assessment new text beginof a client new text endaccording to the standards of
section 245I.10deleted text begin, subdivisions 4 to 6deleted text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 5.

Minnesota Statutes 2021 Supplement, section 245.467, subdivision 3, is amended
to read:


Subd. 3.

Individual treatment plans.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by
this section must complete an individual treatment plan new text beginfor a client new text endaccording to the standards
of section 245I.10, subdivisions 7 and 8.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 6.

Minnesota Statutes 2021 Supplement, section 245.4871, subdivision 21, is amended
to read:


Subd. 21.

Individual treatment plan.

new text begin(a) new text end"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.

new text begin (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:
new text end

new text begin (1) include a written plan of intervention, treatment, and services for a child with an
emotional disturbance that the service provider develops under the clinical supervision of
a mental health professional on the basis of a diagnostic assessment;
new text end

new text begin (2) be developed in conjunction with the family unless clinically inappropriate; and
new text end

new text begin (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 an emotional disturbance.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 7.

Minnesota Statutes 2021 Supplement, section 245.4876, subdivision 2, is amended
to read:


Subd. 2.

Diagnostic assessment.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by this
section deleted text beginshalldeleted text endnew text begin mustnew text end complete a diagnostic assessment new text beginof a client new text endaccording to the standards
of section 245I.10deleted text begin, subdivisions 4 to 6deleted text end.new text begin Notwithstanding the required timelines for completing
a diagnostic assessment in section 245I.10, a children's residential facility licensed under
Minnesota Rules, chapter 2960, that provides mental health services to children must, within
ten days of the client's admission: (1) complete the client's diagnostic assessment; or (2)
review and update the client's diagnostic assessment with a summary of the child's current
mental health status and service needs if a diagnostic assessment is available that was
completed within 180 days preceding admission and the client's mental health status has
not changed markedly since the diagnostic assessment.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 8.

Minnesota Statutes 2021 Supplement, section 245.4876, subdivision 3, is amended
to read:


Subd. 3.

Individual treatment plans.

deleted text beginProvidersdeleted text endnew text begin A providernew text end of services governed by
this section deleted text beginshalldeleted text endnew text begin mustnew text end complete an individual treatment plan new text beginfor a client new text endaccording to the
standards of section 245I.10, subdivisions 7 and 8.new text begin A children's residential facility licensed
according to Minnesota Rules, chapter 2960, is exempt from the requirements in section
245I.10, subdivisions 7 and 8. Instead, the facility must involve the child and the child's
family in all phases of developing and implementing the individual treatment plan to the
extent appropriate and must review the individual treatment plan every 90 days after intake.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 9.

Minnesota Statutes 2021 Supplement, section 245.735, subdivision 3, is amended
to read:


Subd. 3.

Certified community behavioral health clinics.

(a) The commissioner shall
establish a state certification process for certified community behavioral health clinics
(CCBHCs) that satisfy all federal requirements necessary for CCBHCs certified under this
section to be eligible for reimbursement under medical assistance, without service area
limits based on geographic area or region. The commissioner shall consult with CCBHC
stakeholders before establishing and implementing changes in the certification process and
requirements. Entities that choose to be CCBHCs must:

(1) comply with state licensing requirements and other requirements issued by the
commissioner;

(2) employ or contract for clinic staff who have backgrounds in diverse disciplines,
including licensed mental health professionals and licensed alcohol and drug counselors,
and staff who are culturally and linguistically trained to meet the needs of the population
the clinic serves;

(3) ensure that clinic services are available and accessible to individuals and families of
all ages and genders and that crisis management services are available 24 hours per day;

(4) establish fees for clinic services for individuals who are not enrolled in medical
assistance using a sliding fee scale that ensures that services to patients are not denied or
limited due to an individual's inability to pay for services;

(5) comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data;

(6) provide crisis mental health and substance use services, withdrawal management
services, emergency crisis intervention services, and stabilization services through existing
mobile crisis services; screening, assessment, and diagnosis services, including risk
assessments and level of care determinations; person- and family-centered treatment planning;
outpatient mental health and substance use services; targeted case management; psychiatric
rehabilitation services; peer support and counselor services and family support services;
and intensive community-based mental health services, including mental health services
for members of the armed forces and veterans. CCBHCs must directly provide the majority
of these services to enrollees, but may coordinate some services with another entity through
a collaboration or agreement, pursuant to paragraph (b);

(7) provide coordination of care across settings and providers to ensure seamless
transitions for individuals being served across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with:

(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified
health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or
community-based mental health providers; and

(ii) other community services, supports, and providers, including schools, child welfare
agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally
licensed health care and mental health facilities, urban Indian health clinics, Department of
Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals,
and hospital outpatient clinics;

(8) be certified as new text begina new text endmental health deleted text beginclinicsdeleted text endnew text begin clinicnew text end under section deleted text begin245.69, subdivision 2deleted text endnew text begin
245I.20
new text end;

(9) comply with standards established by the commissioner relating to CCBHC
screenings, assessments, and evaluations;

(10) be licensed to provide substance use disorder treatment under chapter 245G;

(11) be certified to provide children's therapeutic services and supports under section
256B.0943;

(12) be certified to provide adult rehabilitative mental health services under section
256B.0623;

(13) be enrolled to provide mental health crisis response services under deleted text beginsectionsdeleted text endnew text begin sectionnew text end
256B.0624 deleted text beginand 256B.0944deleted text end;

(14) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;

(15) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926;

(16) provide services that comply with the evidence-based practices described in
paragraph (e); and

(17) comply with standards relating to peer services under sections 256B.0615,
256B.0616, and 245G.07, deleted text beginsubdivision 1, paragraph (a), clause (5)deleted text endnew text begin subdivision 2, clause (8)new text end,
as applicable when peer services are provided.

(b) If a certified CCBHC is unable to provide one or more of the services listed in
paragraph (a), clauses (6) to (17), the CCBHC may contract with another entity that has the
required authority to provide that service and that meets the following criteria as a designated
collaborating organization:

(1) the entity has a formal agreement with the CCBHC to furnish one or more of the
services under paragraph (a), clause (6);

(2) the entity provides assurances that it will provide services according to CCBHC
service standards and provider requirements;

(3) the entity agrees that the CCBHC is responsible for coordinating care and has clinical
and financial responsibility for the services that the entity provides under the agreement;
and

(4) the entity meets any additional requirements issued by the commissioner.

(c) Notwithstanding any other law that requires a county contract or other form of county
approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise meets
CCBHC requirements may receive the prospective payment under section 256B.0625,
subdivision 5m
, for those services without a county contract or county approval. As part of
the certification process in paragraph (a), the commissioner shall require a letter of support
from the CCBHC's host county confirming that the CCBHC and the county or counties it
serves have an ongoing relationship to facilitate access and continuity of care, especially
for individuals who are uninsured or who may go on and off medical assistance.

(d) When the standards listed in paragraph (a) or other applicable standards conflict or
address similar issues in duplicative or incompatible ways, the commissioner may grant
variances to state requirements if the variances do not conflict with federal requirements
for services reimbursed under medical assistance. If standards overlap, the commissioner
may substitute all or a part of a licensure or certification that is substantially the same as
another licensure or certification. The commissioner shall consult with stakeholders, as
described in subdivision 4, before granting variances under this provision. For the CCBHC
that is certified but not approved for prospective payment under section 256B.0625,
subdivision 5m
, the commissioner may grant a variance under this paragraph if the variance
does not increase the state share of costs.

(e) The commissioner shall issue a list of required evidence-based practices to be
delivered by CCBHCs, and may also provide a list of recommended evidence-based practices.
The commissioner may update the list to reflect advances in outcomes research and medical
services for persons living with mental illnesses or substance use disorders. The commissioner
shall take into consideration the adequacy of evidence to support the efficacy of the practice,
the quality of workforce available, and the current availability of the practice in the state.
At least 30 days before issuing the initial list and any revisions, the commissioner shall
provide stakeholders with an opportunity to comment.

(f) The commissioner shall recertify CCBHCs at least every three years. The
commissioner shall establish a process for decertification and shall require corrective action,
medical assistance repayment, or decertification of a CCBHC that no longer meets the
requirements in this section or that fails to meet the standards provided by the commissioner
in the application and certification process.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 10.

Minnesota Statutes 2021 Supplement, section 245A.03, subdivision 7, is amended
to read:


Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a family child foster care home or family adult foster care home
license is issued during this moratorium, and the license holder changes the license holder's
primary residence away from the physical location of the foster care license, the
commissioner shall revoke the license according to section 245A.07. The commissioner
shall not issue an initial license for a community residential setting licensed under chapter
245D. When approving an exception under this paragraph, the commissioner shall consider
the resource need determination process in paragraph (h), the availability of foster care
licensed beds in the geographic area in which the licensee seeks to operate, the results of a
person's choices during their annual assessment and service plan review, and the
recommendation of the local county board. The determination by the commissioner is final
and not subject to appeal. Exceptions to the moratorium include:

(1) foster care settings where at least 80 percent of the residents are 55 years of age or
older;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital level care;new text begin
or
new text end

deleted text begin (5) new foster care licenses or community residential setting licenses for people receiving
services under chapter
deleted text end deleted text begin 245D deleted text end deleted text begin and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter
deleted text end deleted text begin 14 deleted text end deleted text begin . The exception is available
until June 30, 2018. This exception is available when:
deleted text end

deleted text begin (i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and
deleted text end

deleted text begin (ii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the unlicensed
setting as determined by the lead agency; or
deleted text end

deleted text begin (6)deleted text endnew text begin (5)new text end new foster care licenses or community residential setting licenses for people
receiving customized living or 24-hour customized living services under the brain injury
or community access for disability inclusion waiver plans under section 256B.49 and residing
in the customized living setting before July 1, 2022, for which a license is required. A
customized living service provider subject to this exception may rebut the presumption that
a license is required by seeking a reconsideration of the commissioner's determination. The
commissioner's disposition of a request for reconsideration is final and not subject to appeal
under chapter 14. The exception is available until June 30, 2023. This exception is available
when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people under the brain injury or community access for disability
inclusion waiver plans under section 256B.49 in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

(ii) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and

(iii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the customized
living setting as determined by the lead agency.

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
reports required by section 144A.351, and other data and information shall be used to
determine where the reduced capacity determined under section 256B.493 will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet the
informed decisions of those people who want to move out of corporate foster care or
community residential settings, long-term service needs within budgetary limits, including
seeking proposals from service providers or lead agencies to change service type, capacity,
or location to improve services, increase the independence of residents, and better meet
needs identified by the long-term services and supports reports and statewide data and
information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493. Annually, by August 1, the commissioner shall provide
information and data on capacity of licensed long-term services and supports, actions taken
under the subdivision to manage statewide long-term services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over the
health and human services budget.

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2020, section 245A.11, subdivision 2, is amended to read:


Subd. 2.

Permitted single-family residential use.

new text begin(a) new text endResidential programs with a
licensed capacity of six or fewer persons shall be considered a permitted single-family
residential use of property for the purposes of zoning and other land use regulations, except
that a residential program whose primary purpose is to treat juveniles who have violated
criminal statutes relating to sex offenses or have been adjudicated delinquent on the basis
of conduct in violation of criminal statutes relating to sex offenses shall not be considered
a permitted use. This exception shall not apply to residential programs licensed before July
1, 1995. Programs otherwise allowed under this subdivision shall not be prohibited by
operation of restrictive covenants or similar restrictions, regardless of when entered into,
which cannot be met because of the nature of the licensed program, including provisions
which require the home's occupants be related, and that the home must be occupied by the
owner, or similar provisions.

new text begin (b) Unless otherwise provided in any town, municipal, or county zoning regulation,
licensed residential services provided to more than four persons with developmental
disabilities in a supervised living facility, including intermediate care facilities for persons
with developmental disabilities, with a licensed capacity of seven to eight persons shall be
considered a permitted single-family residential use of property for the purposes of zoning
and other land use regulations. A town, municipal, or county zoning authority may require
a conditional use or special use permit to assure proper maintenance and operation of the
residential program. Conditions imposed on the residential program must not be more
restrictive than those imposed on other conditional uses or special uses of residential property
in the same zones, unless the additional conditions are necessary to protect the health and
safety of the persons being served by the program. This paragraph expires July 1, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 12.

Minnesota Statutes 2020, section 245A.11, subdivision 2a, is amended to read:


Subd. 2a.

Adult foster care and community residential setting license capacity.

(a)
The commissioner shall issue adult foster care and community residential setting licenses
with a maximum licensed capacity of four beds, including nonstaff roomers and boarders,
except that the commissioner may issue a license with a capacity of five beds, including
roomers and boarders, according to paragraphs (b) to (g).

(b) The license holder may have a maximum license capacity of five if all persons in
care are age 55 or over and do not have a serious and persistent mental illness or a
developmental disability.

(c) The commissioner may grant variances to paragraph (b) to allow a facility with a
licensed capacity of up to five persons to admit an individual under the age of 55 if the
variance complies with section 245A.04, subdivision 9, and approval of the variance is
recommended by the county in which the licensed facility is located.

(d) The commissioner may grant variances to paragraph (a) to allow the use of an
additional bed, up to deleted text beginfivedeleted text endnew text begin sixnew text end, for emergency crisis services for a person with serious and
persistent mental illness or a developmental disability, regardless of age, if the variance
complies with section 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located.

(e) The commissioner may grant a variance to paragraph (b) to allow for the use of an
additional bed, up to deleted text beginfivedeleted text endnew text begin sixnew text end, for respite services, as defined in section 245A.02, for persons
with disabilities, regardless of age, if the variance complies with sections 245A.03,
subdivision 7
, and 245A.04, subdivision 9, and approval of the variance is recommended
by the county in which the licensed facility is located. Respite care may be provided under
the following conditions:

(1) staffing ratios cannot be reduced below the approved level for the individuals being
served in the home on a permanent basis;

(2) no more than two different individuals can be accepted for respite services in any
calendar month and the total respite days may not exceed 120 days per program in any
calendar year;

(3) the person receiving respite services must have his or her own bedroom, which could
be used for alternative purposes when not used as a respite bedroom, and cannot be the
room of another person who lives in the facility; and

(4) individuals living in the facility must be notified when the variance is approved. The
provider must give 60 days' notice in writing to the residents and their legal representatives
prior to accepting the first respite placement. Notice must be given to residents at least two
days prior to service initiation, or as soon as the license holder is able if they receive notice
of the need for respite less than two days prior to initiation, each time a respite client will
be served, unless the requirement for this notice is waived by the resident or legal guardian.

(f) The commissioner may issue an adult foster care or community residential setting
license with a capacity of five adults if the fifth bed does not increase the overall statewide
capacity of licensed adult foster care or community residential setting beds in homes that
are not the primary residence of the license holder, as identified in a plan submitted to the
commissioner by the county, when the capacity is recommended by the county licensing
agency of the county in which the facility is located and if the recommendation verifies
that:

(1) the facility meets the physical environment requirements in the adult foster care
licensing rule;

(2) the five-bed living arrangement is specified for each resident in the resident's:

(i) individualized plan of care;

(ii) individual service plan under section 256B.092, subdivision 1b, if required; or

(iii) individual resident placement agreement under Minnesota Rules, part 9555.5105,
subpart 19, if required;

(3) the license holder obtains written and signed informed consent from each resident
or resident's legal representative documenting the resident's informed choice to remain
living in the home and that the resident's refusal to consent would not have resulted in
service termination; and

(4) the facility was licensed for adult foster care before March 1, 2016.

(g) The commissioner shall not issue a new adult foster care license under paragraph (f)
after December 31, 2020. The commissioner shall allow a facility with an adult foster care
license issued under paragraph (f) before December 31, 2020, to continue with a capacity
of five adults if the license holder continues to comply with the requirements in paragraph
(f).

new text begin (h) Notwithstanding Minnesota Rules, part 9520.0500, adult foster care and community
residential setting licenses with a capacity of up to six adults as allowed under this subdivision
are not required to be licensed as an adult mental health residential program according to
Minnesota Rules, parts 9520.0500 to 9520.0670.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective upon federal approval. The amendments
to paragraphs (d) and (e) expire 365 calendar days after federal approval is obtained and
the language of Minnesota Statutes 2020, section 245A.11, subdivision 2a, paragraphs (d)
and (e), is revived and reenacted as of that date. The commissioner of human services shall
notify the revisor of statutes when federal approval is obtained.
new text end

Sec. 13.

Minnesota Statutes 2020, section 245A.11, is amended by adding a subdivision
to read:


new text begin Subd. 2c. new text end

new text begin Residential programs in intermediate care facilities; license
capacity.
new text end

new text begin Notwithstanding subdivision 4 and section 252.28, subdivision 3, for licensed
residential services provided to more than four persons with developmental disabilities in
a supervised living facility, including intermediate care facilities for persons with
developmental disabilities, located in a single-family home and in a town, municipal, or
county zoning authority that will permit a licensed capacity of seven or eight persons in a
single-family home, the commissioner may increase the licensed capacity of the program
to seven or eight if the seventh or eighth bed does not increase the overall statewide capacity
in intermediate care facilities for persons with developmental disabilities. If the licensed
capacity of these facilities is increased under this subdivision, the capacity of the license
may remain at the increased number of persons. This subdivision expires July 1, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 14.

Minnesota Statutes 2020, section 245D.12, is amended to read:


245D.12 INTEGRATED COMMUNITY SUPPORTS; SETTING CAPACITY
REPORT.

(a) The license holder providing integrated community support, as defined in section
245D.03, subdivision 1, paragraph (c), clause (8), must submit a setting capacity report to
the commissioner to ensure the identified location of service delivery meets the criteria of
the home and community-based service requirements as specified in section 256B.492.

(b) The license holder shall provide the setting capacity report on the forms and in the
manner prescribed by the commissioner. The report must include:

(1) the address of the multifamily housing building where the license holder delivers
integrated community supports and owns, leases, or has a direct or indirect financial
relationship with the property owner;

(2) the total number of living units in the multifamily housing building described in
clause (1) where integrated community supports are delivered;

(3) the total number of living units in the multifamily housing building described in
clause (1), including the living units identified in clause (2); deleted text beginand
deleted text end

new text begin (4) the total number of people who could reside in the living units in the multifamily
housing building described in clause (2) and receive integrated community supports; and
new text end

deleted text begin (4)deleted text endnew text begin (5)new text end the percentage of living units that are controlled by the license holder in the
multifamily housing building by dividing clause (2) by clause (3).

(c) Only one license holder may deliver integrated community supports at the address
of the multifamily housing building.

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2020, section 245G.01, is amended by adding a subdivision
to read:


new text begin Subd. 13b. new text end

new text begin Guest speaker. new text end

new text begin "Guest speaker" means an individual who is not an alcohol
and drug counselor qualified according to section 245G.11, subdivision 5; is not qualified
according to the commissioner's list of professionals under section 245G.07, subdivision
3; and who works under the direct observation of an alcohol and drug counselor to present
to clients on topics in which the guest speaker has expertise and that the license holder has
determined to be beneficial to a client's recovery. Tribally licensed programs have autonomy
to identify the qualifications of their guest speakers.
new text end

Sec. 16.

Minnesota Statutes 2020, section 245G.07, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Use of guest speakers. new text end

new text begin (a) The license holder may allow a guest speaker to
present information to clients as part of a treatment service provided by an alcohol and drug
counselor, according to the requirements of this subdivision.
new text end

new text begin (b) An alcohol and drug counselor must visually observe and listen to the presentation
of information by a guest speaker the entire time the guest speaker presents information to
the clients. The alcohol and drug counselor is responsible for all information the guest
speaker presents to the clients.
new text end

new text begin (c) The presentation of information by a guest speaker constitutes a direct contact service,
as defined in section 245C.02, subdivision 11.
new text end

new text begin (d) The license holder must provide the guest speaker with all training required for staff
members. If the guest speaker provides direct contact services one day a month or less, the
license holder must only provide the guest speaker with orientation training on the following
subjects before the guest speaker provides direct contact services:
new text end

new text begin (1) mandatory reporting of maltreatment, as specified in sections 245A.65, 626.557, and
626.5572 and chapter 260E;
new text end

new text begin (2) applicable client confidentiality rules and regulations;
new text end

new text begin (3) ethical standards for client interactions; and
new text end

new text begin (4) emergency procedures.
new text end

Sec. 17.

Minnesota Statutes 2020, section 245G.12, is amended to read:


245G.12 PROVIDER POLICIES AND PROCEDURES.

A license holder must develop a written policies and procedures manual, indexed
according to section 245A.04, subdivision 14, paragraph (c), that provides staff members
immediate access to all policies and procedures and provides a client and other authorized
parties access to all policies and procedures. The manual must contain the following
materials:

(1) assessment and treatment planning policies, including screening for mental health
concerns and treatment objectives related to the client's identified mental health concerns
in the client's treatment plan;

(2) policies and procedures regarding HIV according to section 245A.19;

(3) the license holder's methods and resources to provide information on tuberculosis
and tuberculosis screening to each client and to report a known tuberculosis infection
according to section 144.4804;

(4) personnel policies according to section 245G.13;

(5) policies and procedures that protect a client's rights according to section 245G.15;

(6) a medical services plan according to section 245G.08;

(7) emergency procedures according to section 245G.16;

(8) policies and procedures for maintaining client records according to section 245G.09;

(9) procedures for reporting the maltreatment of minors according to chapter 260E, and
vulnerable adults according to sections 245A.65, 626.557, and 626.5572;

(10) a description of treatment services that: (i) includes the amount and type of services
provided; (ii) identifies which services meet the definition of group counseling under section
245G.01, subdivision 13a; deleted text beginanddeleted text end (iii) new text beginidentifies which groups and topics on which a guest
speaker could provide services under the direct observation of an alcohol and drug counselor;
and (iv)
new text enddefines the program's treatment week;

(11) the methods used to achieve desired client outcomes;

(12) the hours of operation; and

(13) the target population served.

Sec. 18.

Minnesota Statutes 2021 Supplement, section 245I.02, subdivision 19, is amended
to read:


Subd. 19.

Level of care assessment.

"Level of care assessment" means the level of care
decision support tool appropriate to the client's age. For a client five years of age or younger,
a level of care assessment is the Early Childhood Service Intensity Instrument (ESCII). For
a client six to 17 years of age, a level of care assessment is the Child and Adolescent Service
Intensity Instrument (CASII). For a client 18 years of age or older, a level of care assessment
is the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS)new text begin
or another tool authorized by the commissioner
new text end.

Sec. 19.

Minnesota Statutes 2021 Supplement, section 245I.02, subdivision 36, is amended
to read:


Subd. 36.

Staff person.

"Staff person" means an individual who works under a license
holder's direction or under a contract with a license holder. Staff person includes an intern,
consultant, contractor, individual who works part-time, and an individual who does not
provide direct contact services to clientsnew text begin but does have physical access to clientsnew text end. Staff
person includes a volunteer who provides treatment services to a client or a volunteer whom
the license holder regards as a staff person for the purpose of meeting staffing or service
delivery requirements. A staff person must be 18 years of age or older.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 20.

Minnesota Statutes 2021 Supplement, section 245I.03, subdivision 5, is amended
to read:


Subd. 5.

Health services and medications.

If a license holder is licensed as a residential
program, stores or administers client medications, or observes clients self-administer
medications, the license holder must ensure that a staff person who is a registered nurse or
licensed prescriber reviews and approves of the license holder's policies and procedures to
comply with the health services and medications requirements in section 245I.11, the training
requirements in section 245I.05, subdivision deleted text begin6deleted text endnew text begin 5new text end, and the documentation requirements in
section 245I.08, subdivision 5.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 21.

Minnesota Statutes 2021 Supplement, section 245I.03, subdivision 9, is amended
to read:


Subd. 9.

Volunteers.

deleted text beginAdeleted text endnew text begin If a license holder uses volunteers, thenew text end license holder must have
policies and procedures for using volunteers, including when deleted text beginadeleted text endnew text begin thenew text end license holder must
submit a background study for a volunteer, and the specific tasks that a volunteer may
perform.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 22.

Minnesota Statutes 2021 Supplement, section 245I.04, subdivision 4, is amended
to read:


Subd. 4.

Mental health practitioner qualifications.

(a) An individual who is qualified
in at least one of the ways described in paragraph (b) to (d) may serve as a mental health
practitioner.

(b) An individual is qualified as a mental health practitioner through relevant coursework
if the individual completes at least 30 semester hours or 45 quarter hours in behavioral
sciences or related fields and:

(1) has at least 2,000 hours of experience providing services to individuals with:

(i) a mental illness or a substance use disorder; or

(ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to a client;

(2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the individual's clients belong, and completes the additional training described in section
245I.05, subdivision 3, paragraph (c), before providing direct contact services to a client;

(3) is working in a day treatment program under section 256B.0671, subdivision 3, or
256B.0943; deleted text beginor
deleted text end

(4) has completed a practicum or internship that (i) required direct interaction with adult
clients or child clients, and (ii) was focused on behavioral sciences or related fieldsdeleted text begin.deleted text endnew text begin; or
new text end

new text begin (5) is in the process of completing a practicum or internship as part of a formal
undergraduate or graduate training program in social work, psychology, or counseling.
new text end

(c) An individual is qualified as a mental health practitioner through work experience
if the individual:

(1) has at least 4,000 hours of experience in the delivery of services to individuals with:

(i) a mental illness or a substance use disorder; or

(ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients; or

(2) receives treatment supervision at least once per week until meeting the requirement
in clause (1) of 4,000 hours of experience and has at least 2,000 hours of experience providing
services to individuals with:

(i) a mental illness or a substance use disorder; or

(ii) a traumatic brain injury or a developmental disability, and completes the additional
training described in section 245I.05, subdivision 3, paragraph (c), before providing direct
contact services to clients.

(d) An individual is qualified as a mental health practitioner if the individual has a
master's or other graduate degree in behavioral sciences or related fields.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 23.

Minnesota Statutes 2021 Supplement, 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 deleted text beginqualified underdeleted text end new text beginrequired
to receive the training according to
new text end 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 effects.

(d) Within 90 days of first providing direct contact services to an adult client, a clinical
trainee, mental health practitioner, mental health certified peer specialist, or mental health
rehabilitation worker must receive training about:

(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, a clinical
trainee, mental health practitioner, mental health certified family peer specialist, mental
health certified peer specialist, or mental health behavioral aide must receive training about
the topics in clauses (1) to (5). This training must address the developmental characteristics
of each child served by the license holder and address the needs of each child in the context
of the child's family, support system, and culture. Training topics must include:

(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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 24.

Minnesota Statutes 2021 Supplement, section 245I.08, subdivision 4, is amended
to read:


Subd. 4.

Progress notes.

A license holder must use a progress note to document each
occurrence of a mental health service that a staff person provides to a client. A progress
note must include the following:

(1) the type of service;

(2) the date of service;

(3) the start and stop time of the service unless the license holder is licensed as a
residential program;

(4) the location of the service;

(5) the scope of the service, including: (i) the targeted goal and objective; (ii) the
intervention that the staff person provided to the client and the methods that the staff person
used; (iii) the client's response to the intervention; (iv) the staff person's plan to take future
actions, including changes in treatment that the staff person will implement if the intervention
was ineffective; and (v) the service modality;

(6) the signaturedeleted text begin, printed name,deleted text end and credentials of the staff person who provided the
service to the client;

(7) the mental health provider travel documentation required by section 256B.0625, if
applicable; and

(8) significant observations by the staff person, if applicable, including: (i) the client's
current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with
or referrals to other professionals, family, or significant others; and (iv) changes in the
client's mental or physical symptoms.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 25.

Minnesota Statutes 2021 Supplement, section 245I.09, subdivision 2, is amended
to read:


Subd. 2.

Record retention.

A license holder must retain client records of a discharged
client for a minimum of five years from the date of the client's discharge. A license holder
who deleted text beginceases to provide treatment services to a clientdeleted text endnew text begin closes a programnew text end must retain deleted text beginthedeleted text endnew text begin anew text end
client's records for a minimum of five years from the date that the license holder stopped
providing services to the client and must notify the commissioner of the location of the
client records and the name of the individual responsible for storing and maintaining the
client records.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 26.

Minnesota Statutes 2021 Supplement, section 245I.10, subdivision 2, is amended
to read:


Subd. 2.

Generally.

(a) A license holder must use a client's diagnostic assessment or
crisis assessment to determine a client's eligibility for mental health services, except as
provided in this section.

(b) Prior to completing a client's initial diagnostic assessment, a license holder may
provide a client with the following services:

(1) an explanation of findings;

(2) neuropsychological testing, neuropsychological assessment, and psychological
testing;

(3) any combination of psychotherapy sessions, family psychotherapy sessions, and
family psychoeducation sessions not to exceed three sessions;

(4) crisis assessment services according to section 256B.0624; and

(5) ten days of intensive residential treatment services according to the assessment and
treatment planning standards in section deleted text begin245.23deleted text endnew text begin 245I.23new text end, subdivision 7.

(c) Based on the client's needs that a crisis assessment identifies under section 256B.0624,
a license holder may provide a client with the following services:

(1) crisis intervention and stabilization services under section 245I.23 or 256B.0624;
and

(2) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization.

(d) Based on the client's needs in the client's brief diagnostic assessment, a license holder
may provide a client with any combination of psychotherapy sessions, group psychotherapy
sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed
ten sessions within a 12-month period without prior authorization for any new client or for
an existing client who the license holder projects will need fewer than ten sessions during
the next 12 months.

(e) Based on the client's needs that a hospital's medical history and presentation
examination identifies, a license holder may provide a client with:

(1) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization for any new client or for an existing
client who the license holder projects will need fewer than ten sessions during the next 12
months; and

(2) up to five days of day treatment services or partial hospitalization.

(f) A license holder must complete a new standard diagnostic assessment of a client:

(1) when the client requires services of a greater number or intensity than the services
that paragraphs (b) to (e) describe;

(2) at least annually following the client's initial diagnostic assessment if the client needs
additional mental health services and the client does not meet the criteria for a brief
assessment;

(3) when the client's mental health condition has changed markedly since the client's
most recent diagnostic assessment; or

(4) when the client's current mental health condition does not meet the criteria of the
client's current diagnosis.

(g) For an existing client, the license holder must ensure that a new standard diagnostic
assessment includes a written update containing all significant new or changed information
about the client, and an update regarding what information has not significantly changed,
including a discussion with the client about changes in the client's life situation, functioning,
presenting problems, and progress with achieving treatment goals since the client's last
diagnostic assessment was completed.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 27.

Minnesota Statutes 2021 Supplement, section 245I.10, subdivision 6, is amended
to read:


Subd. 6.

Standard diagnostic assessment; required elements.

(a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context.

(b) When completing a standard diagnostic assessment of a client, the assessor must
gather and document information about the client's current life situation, including the
following information:

(1) the client's age;

(2) the client's current living situation, including the client's housing status and household
members;

(3) the status of the client's basic needs;

(4) the client's education level and employment status;

(5) the client's current medications;

(6) any immediate risks to the client's health and safety;

(7) the client's perceptions of the client's condition;

(8) the client's description of the client's symptoms, including the reason for the client's
referral;

(9) the client's history of mental health treatment; and

(10) cultural influences on the client.

(c) If the assessor cannot obtain the information that this deleted text beginsubdivisiondeleted text endnew text begin paragraphnew text end requires
without retraumatizing the client or harming the client's willingness to engage in treatment,
the assessor must identify which topics will require further assessment during the course
of the client's treatment. The assessor must gather and document information related to the
following topics:

(1) the client's relationship with the client's family and other significant personal
relationships, including the client's evaluation of the quality of each relationship;

(2) the client's strengths and resources, including the extent and quality of the client's
social networks;

(3) important developmental incidents in the client's life;

(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;

(5) the client's history of or exposure to alcohol and drug usage and treatment; and

(6) the client's health history and the client's family health history, including the client's
physical, chemical, and mental health history.

(d) When completing a standard diagnostic assessment of a client, an assessor must use
a recognized diagnostic framework.

(1) When completing a standard diagnostic assessment of a client who is five years of
age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
Classification of Mental Health and Development Disorders of Infancy and Early Childhood
published by Zero to Three.

(2) When completing a standard diagnostic assessment of a client who is six years of
age or older, the assessor must use the current edition of the Diagnostic and Statistical
Manual of Mental Disorders published by the American Psychiatric Association.

(3) When completing a standard diagnostic assessment of a client who is five years of
age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
(ECSII) to the client and include the results in the client's assessment.

(4) When completing a standard diagnostic assessment of a client who is six to 17 years
of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
(CASII) to the client and include the results in the client's assessment.

(5) When completing a standard diagnostic assessment of a client who is 18 years of
age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association to screen and assess the client for a
substance use disorder.

(e) When completing a standard diagnostic assessment of a client, the assessor must
include and document the following components of the assessment:

(1) the client's mental status examination;

(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
vulnerabilities; safety needs, including client information that supports the assessor's findings
after applying a recognized diagnostic framework from paragraph (d); and any differential
diagnosis of the client;

(3) an explanation of: (i) how the assessor diagnosed the client using the information
from the client's interview, assessment, psychological testing, and collateral information
about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
and (v) the client's responsivity factors.

(f) When completing a standard diagnostic assessment of a client, the assessor must
consult the client and the client's family about which services that the client and the family
prefer to treat the client. The assessor must make referrals for the client as to services required
by law.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 28.

Minnesota Statutes 2021 Supplement, section 245I.20, subdivision 5, is amended
to read:


Subd. 5.

Treatment supervision specified.

(a) A mental health professional must remain
responsible for each client's case. The certification holder must document the name of the
mental health professional responsible for each case and the dates that the mental health
professional is responsible for the client's case from beginning date to end date. The
certification holder must assign each client's case for assessment, diagnosis, and treatment
services to a treatment team member who is competent in the assigned clinical service, the
recommended treatment strategy, and in treating the client's characteristics.

(b) Treatment supervision of mental health practitioners and clinical trainees required
by section 245I.06 must include case reviews as described in this paragraph. Every two
months, a mental health professional must completenew text begin and documentnew text end a case review of each
client assigned to the mental health professional when the client is receiving clinical services
from a mental health practitioner or clinical trainee. The case review must include a
consultation process that thoroughly examines the client's condition and treatment, including:
(1) a review of the client's reason for seeking treatment, diagnoses and assessments, and
the individual treatment plan; (2) a review of the appropriateness, duration, and outcome
of treatment provided to the client; and (3) treatment recommendations.

Sec. 29.

Minnesota Statutes 2021 Supplement, section 245I.23, subdivision 22, is amended
to read:


Subd. 22.

Additional policy and procedure requirements.

(a) In addition to the policies
and procedures in section 245I.03, the license holder must establish, enforce, and maintain
the policies and procedures in this subdivision.

(b) The license holder must have policies and procedures for receiving referrals and
making admissions determinations about referred persons under subdivisions deleted text begin14 to 16deleted text endnew text begin 15
to 17
new text end.

(c) The license holder must have policies and procedures for discharging clients under
subdivision deleted text begin17deleted text endnew text begin 18new text end. In the policies and procedures, the license holder must identify the staff
persons who are authorized to discharge clients from the program.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 30.

Minnesota Statutes 2021 Supplement, section 254B.05, subdivision 5, is amended
to read:


Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

(1) outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) care coordination services provided according to section 245G.07, subdivision 1,
paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) on July 1, 2019, or upon federal approval, whichever is later, withdrawal management
services provided according to chapter 245F;

(6) medication-assisted therapy services that are licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;

(7) medication-assisted therapy plus enhanced treatment services that meet the
requirements of clause (6) and provide nine hours of clinical services each week;

(8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;

(9) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

(10) adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;

(11) high-intensity residential treatment services that are licensed according to sections
245G.01 to 245G.17 and 245G.21 or applicable tribal license, which provide 30 hours of
clinical services each week provided by a state-operated vendor or to clients who have been
civilly committed to the commissioner, present the most complex and difficult care needs,
and are a potential threat to the community; and

(12) room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific or culturally responsive programs as defined in section 254B.01,
subdivision 4a
;

(3) disability responsive programs as defined in section 254B.01, subdivision 4b;

(4) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; or

(5) programs that offer services to individuals with co-occurring mental health and
chemical dependency problems if:

(i) the program meets the co-occurring requirements in section 245G.20;

(ii) 25 percent of the counseling staff are licensed mental health professionalsdeleted text begin, as defined
in section 245.462, subdivision 18, clauses (1) to (6)
deleted text endnew text begin under section 245I.04, subdivision 2new text end,
or are students or licensing candidates under the supervision of a licensed alcohol and drug
counselor supervisor and deleted text beginlicenseddeleted text end mental health professionalnew text begin under section 245I.04,
subdivision 2
new text end, except that no more than 50 percent of the mental health staff may be students
or licensing candidates with time documented to be directly related to provisions of
co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance abuse disorders
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the chemical dependency facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, substance use disorder services that are otherwise covered
as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,
subdivision 3b. The use of telehealth to deliver services must be medically appropriate to
the condition and needs of the person being served. Reimbursement shall be at the same
rates and under the same conditions that would otherwise apply to direct face-to-face services.

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

(h) Payment for outpatient substance use disorder services that are licensed according
to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
prior authorization of a greater number of hours is obtained from the commissioner.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 31.

Minnesota Statutes 2021 Supplement, section 256B.0622, subdivision 2, is
amended to read:


Subd. 2.

Definitions.

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

(b) "ACT team" means the group of interdisciplinary mental health staff who work as
a team to provide assertive community treatment.

(c) "Assertive community treatment" means intensive nonresidential treatment and
rehabilitative mental health services provided according to the assertive community treatment
model. Assertive community treatment provides a single, fixed point of responsibility for
treatment, rehabilitation, and support needs for clients. Services are offered 24 hours per
day, seven days per week, in a community-based setting.

(d) "Individual treatment plan" means a plan described by section 245I.10, subdivisions
7
and 8.

(e) "Crisis assessment and intervention" means deleted text beginmental healthdeleted text endnew text begin mobilenew text end crisis response
services deleted text beginas defined indeleted text endnew text begin undernew text end section 256B.0624deleted text begin, subdivision 2deleted text end.

(f) "Individual treatment team" means a minimum of three members of the ACT team
who are responsible for consistently carrying out most of a client's assertive community
treatment services.

(g) "Primary team member" means the person who leads and coordinates the activities
of the individual treatment team and is the individual treatment team member who has
primary responsibility for establishing and maintaining a therapeutic relationship with the
client on a continuing basis.

(h) "Certified rehabilitation specialist" means a staff person who is qualified according
to section 245I.04, subdivision 8.

(i) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6.

(j) "Mental health certified peer specialist" means a staff person who is qualified
according to section 245I.04, subdivision 10.

(k) "Mental health practitioner" means a staff person who is qualified according to section
245I.04, subdivision 4.

(l) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

(m) "Mental health rehabilitation worker" means a staff person who is qualified according
to section 245I.04, subdivision 14.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 32.

Minnesota Statutes 2021 Supplement, 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 visitsdeleted text begin, as described in this subdivisiondeleted text end provided through audio and visual
communicationdeleted text begin,deleted text endnew text begin or accessible video-based platformsnew text end 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.

deleted text begin (e) For mental health services or assessments delivered through telehealth that are based
on an individual treatment plan, the provider may document the client's verbal approval or
electronic written approval of the treatment plan or change in the treatment plan in lieu of
the client's signature in accordance with Minnesota Rules, part 9505.0371.
deleted text end

deleted text begin (f)deleted text endnew text begin (e)new text end For purposes of this subdivision, unless otherwise covered under this chapter:

(1) "telehealth" means the delivery of health care services or consultations deleted text beginthrough the
use of
deleted text endnew text begin usingnew text end real-time two-way interactive audio and visual communicationnew text begin or accessible
telehealth video-based platforms
new text end 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 includesnew text begin:new text end the application of secure video conferencingdeleted text begin,deleted text endnew text begin
consisting of a real-time, full-motion synchronized video;
new text end store-and-forward technologydeleted text begin,deleted text endnew text begin;new text end
and synchronous interactionsnew text begin,new text end 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, e-mail, or facsimile transmission or as specified by law;

(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 deleted text begin256B.0615, subdivision 5deleted text endnew text begin 245I.04, subdivision 10new text end, a
mental health certified family peer specialist under section deleted text begin256B.0616, subdivision 5deleted text endnew text begin 245I.04,
subdivision 12
new text end, a mental health rehabilitation worker under section deleted text begin256B.0623, subdivision
5, paragraph (a), clause (4), and paragraph (b)
deleted text endnew text begin 245I.04, subdivision 14new text end, a mental health
behavioral aide under section deleted text begin256B.0943, subdivision 7, paragraph (b), clause (3)deleted text endnew text begin 245I.04,
subdivision 16
new text end, a treatment coordinator under section 245G.11, subdivision 7, an alcohol
and drug counselor under section 245G.11, subdivision 5,new text begin ornew text end 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, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 33.

Minnesota Statutes 2020, section 256B.0659, subdivision 19, is amended to read:


Subd. 19.

Personal care assistance choice option; qualifications; duties.

(a) Under
personal care assistance choice, the recipient or responsible party shall:

(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);

(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;

(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;

(4) deleted text begineffective January 1, 2010,deleted text end supervise and evaluate the personal care assistant with the
qualified professional, who is required to visit the recipient at least every 180 days;

(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;

(6) engage in an annual deleted text beginface-to-facedeleted text end reassessmentnew text begin as required in subdivision 3anew text end to
determine continuing eligibility and service authorization; and

(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being used.

(b) The personal care assistance choice provider agency shall:

(1) meet all personal care assistance provider agency standards;

(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;

(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and

(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.

(c) The duties of the personal care assistance choice provider agency are to:

(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations includingdeleted text begin,deleted text end but not limited todeleted text begin,deleted text end purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation includingdeleted text begin,deleted text end but not
limited todeleted text begin,deleted text end workers' compensation, unemployment insurance, and labor market data required
under section 256B.4912, subdivision 1a;

(2) bill the medical assistance program for personal care assistance services and qualified
professional services;

(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;

(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(5) withhold and pay all applicable federal and state taxes;

(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;

(8) enroll in the medical assistance program as a personal care assistance choice agency;
and

(9) enter into a written agreement as specified in subdivision 20 before services are
provided.

Sec. 34.

Minnesota Statutes 2021 Supplement, section 256B.0671, subdivision 6, is
amended to read:


Subd. 6.

Dialectical behavior therapy.

(a) Subject to federal approval, medical assistance
covers intensive mental health outpatient treatment for dialectical behavior therapy deleted text beginfor
adults
deleted text end. A dialectical behavior therapy provider must make reasonable and good faith efforts
to report individual client outcomes to the commissioner using instruments and protocols
that are approved by the commissioner.

(b) "Dialectical behavior therapy" means an evidence-based treatment approach that a
mental health professional or clinical trainee provides to a client or a group of clients in an
intensive outpatient treatment program using a combination of individualized rehabilitative
and psychotherapeutic interventions. A dialectical behavior therapy program involves:
individual dialectical behavior therapy, group skills training, telephone coaching, and team
consultation meetings.

(c) To be eligible for dialectical behavior therapy, a client must:

deleted text begin (1) be 18 years of age or older;
deleted text end

deleted text begin (2)deleted text endnew text begin (1)new text end have mental health needs that available community-based services cannot meet
or that the client must receive concurrently with other community-based services;

deleted text begin (3)deleted text endnew text begin (2)new text end have either:

(i) a diagnosis of borderline personality disorder; or

(ii) multiple mental health diagnoses, exhibit behaviors characterized by impulsivity or
intentional self-harm, and be at significant risk of death, morbidity, disability, or severe
dysfunction in multiple areas of the client's life;

deleted text begin (4)deleted text endnew text begin (3)new text end be cognitively capable of participating in dialectical behavior therapy as an
intensive therapy program and be able and willing to follow program policies and rules to
ensure the safety of the client and others; and

deleted text begin (5)deleted text endnew text begin (4)new text end be at significant risk of one or more of the following if the client does not receive
dialectical behavior therapy:

(i) having a mental health crisis;

(ii) requiring a more restrictive setting such as hospitalization;

(iii) decompensating; or

(iv) engaging in intentional self-harm behavior.

(d) Individual dialectical behavior therapy combines individualized rehabilitative and
psychotherapeutic interventions to treat a client's suicidal and other dysfunctional behaviors
and to reinforce a client's use of adaptive skillful behaviors. A mental health professional
or clinical trainee must provide individual dialectical behavior therapy to a client. A mental
health professional or clinical trainee providing dialectical behavior therapy to a client must:

(1) identify, prioritize, and sequence the client's behavioral targets;

(2) treat the client's behavioral targets;

(3) assist the client in applying dialectical behavior therapy skills to the client's natural
environment through telephone coaching outside of treatment sessions;

(4) measure the client's progress toward dialectical behavior therapy targets;

(5) help the client manage mental health crises and life-threatening behaviors; and

(6) help the client learn and apply effective behaviors when working with other treatment
providers.

(e) Group skills training combines individualized psychotherapeutic and psychiatric
rehabilitative interventions conducted in a group setting to reduce the client's suicidal and
other dysfunctional coping behaviors and restore function. Group skills training must teach
the client adaptive skills in the following areas: (1) mindfulness; (2) interpersonal
effectiveness; (3) emotional regulation; and (4) distress tolerance.

(f) Group skills training must be provided by two mental health professionals or by a
mental health professional co-facilitating with a clinical trainee or a mental health practitioner.
Individual skills training must be provided by a mental health professional, a clinical trainee,
or a mental health practitioner.

(g) Before a program provides dialectical behavior therapy to a client, the commissioner
must certify the program as a dialectical behavior therapy provider. To qualify for
certification as a dialectical behavior therapy provider, a provider must:

(1) allow the commissioner to inspect the provider's program;

(2) provide evidence to the commissioner that the program's policies, procedures, and
practices meet the requirements of this subdivision and chapter 245I;

(3) be enrolled as a MHCP provider; and

(4) have a manual that outlines the program's policies, procedures, and practices that
meet the requirements of this subdivision.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 35.

Minnesota Statutes 2021 Supplement, section 256B.0911, subdivision 3a, is
amended to read:


Subd. 3a.

Assessment and support planning.

(a) Persons requesting assessment, services
planning, or other assistance intended to support community-based living, including persons
who need assessment deleted text beginin orderdeleted text end to determine waiver or alternative care program eligibility,
must be visited by a long-term care consultation team within 20 calendar days after the date
on which an assessment was requested or recommended. Upon statewide implementation
of subdivisions 2b, 2c, and 5, this requirement also applies to an assessment of a person
requesting personal care assistance services. The commissioner shall provide at least a
90-day notice to lead agencies prior to the effective date of this requirement. Assessments
must be conducted according to paragraphs (b) to (r).

(b) Upon implementation of subdivisions 2b, 2c, and 5, lead agencies shall use certified
assessors to conduct the assessment. For a person with complex health care needs, a public
health or registered nurse from the team must be consulted.

(c) The MnCHOICES assessment provided by the commissioner to lead agencies must
be used to complete a comprehensive, conversation-based, person-centered assessment.
The assessment must include the health, psychological, functional, environmental, and
social needs of the individual necessary to develop a person-centered community support
plan that meets the individual's needs and preferences.

(d) Except as provided in paragraph (r), the assessment must be conducted by a certified
assessor in a face-to-face conversational interview with the person being assessed. The
person's legal representative must provide input during the assessment process and may do
so remotely if requested. At the request of the person, other individuals may participate in
the assessment to provide information on the needs, strengths, and preferences of the person
necessary to develop a community support plan that ensures the person's health and safety.
Except for legal representatives or family members invited by the person, persons
participating in the assessment may not be a provider of service or have any financial interest
in the provision of services. For persons who are to be assessed for elderly waiver customized
living or adult day services under chapter 256S, with the permission of the person being
assessed or the person's designated or legal representative, the client's current or proposed
provider of services may submit a copy of the provider's nursing assessment or written
report outlining its recommendations regarding the client's care needs. The person conducting
the assessment must notify the provider of the date by which this information is to be
submitted. This information shall be provided to the person conducting the assessment prior
to the assessment. For a person who is to be assessed for waiver services under section
256B.092 or 256B.49, with the permission of the person being assessed or the person's
designated legal representative, the person's current provider of services may submit a
written report outlining recommendations regarding the person's care needs the person
completed in consultation with someone who is known to the person and has interaction
with the person on a regular basis. The provider must submit the report at least 60 days
before the end of the person's current service agreement. The certified assessor must consider
the content of the submitted report prior to finalizing the person's assessment or reassessment.

(e) The certified assessor and the individual responsible for developing the coordinated
service and support plan must complete the community support plan and the coordinated
service and support plan no more than 60 calendar days from the assessment visit. The
person or the person's legal representative must be provided with a written community
support plan within the timelines established by the commissioner, regardless of whether
the person is eligible for Minnesota health care programs.

(f) For a person being assessed for elderly waiver services under chapter 256S, a provider
who submitted information under paragraph (d) shall receive the final written community
support plan when available and the Residential Services Workbook.

(g) The written community support plan must include:

(1) a summary of assessed needs as defined in paragraphs (c) and (d);

(2) the individual's options and choices to meet identified needs, including:

(i) all available options for case management services and providers;

(ii) all available options for employment services, settings, and providers;

(iii) all available options for living arrangements;

(iv) all available options for self-directed services and supports, including self-directed
budget options; and

(v) service provided in a non-disability-specific setting;

(3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;

(4) referral information; and

(5) informal caregiver supports, if applicable.

For a person determined eligible for state plan home care under subdivision 1a, paragraph
(b), clause (1), the person or person's representative must also receive a copy of the home
care service plan developed by the certified assessor.

(h) A person may request assistance in identifying community supports without
participating in a complete assessment. Upon a request for assistance identifying community
support, the person must be transferred or referred to long-term care options counseling
services available under sections 256.975, subdivision 7, and 256.01, subdivision 24, for
telephone assistance and follow up.

(i) The person has the right to make the final decision:

(1) between institutional placement and community placement after the recommendations
have been provided, except as provided in section 256.975, subdivision 7a, paragraph (d);

(2) between community placement in a setting controlled by a provider and living
independently in a setting not controlled by a provider;

(3) between day services and employment services; and

(4) regarding available options for self-directed services and supports, including
self-directed funding options.

(j) The lead agency must give the person receiving long-term care consultation services
or the person's legal representative, materials, and forms supplied by the commissioner
containing the following information:

(1) written recommendations for community-based services and consumer-directed
options;

(2) documentation that the most cost-effective alternatives available were offered to the
individual. For purposes of this clause, "cost-effective" means community services and
living arrangements that cost the same as or less than institutional care. For an individual
found to meet eligibility criteria for home and community-based service programs under
chapter 256S or section 256B.49, "cost-effectiveness" has the meaning found in the federally
approved waiver plan for each program;

(3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the individual selects nursing facility placement, the lead
agency shall forward information needed to complete the level of care determinations and
screening for developmental disability and mental illness collected during the assessment
to the long-term care options counselor using forms provided by the commissioner;

(4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs, and state plan home care, case
management, and other services as defined in subdivision 1a, paragraphs (a), clause (6),
and (b);

(5) information about Minnesota health care programs;

(6) the person's freedom to accept or reject the recommendations of the team;

(7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;

(8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 4e and the certified assessor's
decision regarding eligibility for all services and programs as defined in subdivision 1a,
paragraphs (a), clause (6), and (b);

(9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 1a, paragraphs (a), clauses (6), (7), and
(8), and (b), and incorporating the decision regarding the need for institutional level of care
or the lead agency's final decisions regarding public programs eligibility according to section
256.045, subdivision 3. The certified assessor must verbally communicate this appeal right
to the person and must visually point out where in the document the right to appeal is stated;
and

(10) documentation that available options for employment services, independent living,
and self-directed services and supports were described to the individual.

(k) An assessment that is completed as part of an eligibility determination for multiple
programs for the alternative care, elderly waiver, developmental disabilities, community
access for disability inclusion, community alternative care, and brain injury waiver programs
under chapter 256S and sections 256B.0913, 256B.092, and 256B.49 is valid to establish
service eligibility for no more than 60 calendar days after the date of the assessment.

(l) The effective eligibility start date for programs in paragraph (k) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (k)
cannot be prior to the date the most recent updated assessment is completed.

(m) If an eligibility update is completed within 90 days of the previous assessment and
documented in the department's Medicaid Management Information System (MMIS), the
effective date of eligibility for programs included in paragraph (k) is the date of the previous
face-to-face assessment when all other eligibility requirements are met.

(n) If a person who receives home and community-based waiver services under section
256B.0913, 256B.092, or 256B.49 or chapter 256S temporarily enters for 121 days or fewer
a hospital, institution of mental disease, nursing facility, intensive residential treatment
services program, transitional care unit, or inpatient substance use disorder treatment setting,
the person may return to the community with home and community-based waiver services
under the same waiver, without requiring an assessment or reassessment under this section,
unless the person's annual reassessment is otherwise due. Nothing in this paragraph shall
change annual long-term care consultation reassessment requirements, payment for
institutional or treatment services, medical assistance financial eligibility, or any other law.

(o) At the time of reassessment, the certified assessor shall assess each person receiving
waiver residential supports and services currently residing in a community residential setting,
licensed adult foster care home that is either not the primary residence of the license holder
or in which the license holder is not the primary caregiver, family adult foster care residence,
customized living setting, or supervised living facility to determine if that person would
prefer to be served in a community-living setting as defined in section 256B.49, subdivision
23
, in a setting not controlled by a provider, or to receive integrated community supports
as described in section 245D.03, subdivision 1, paragraph (c), clause (8). The certified
assessor shall offer the person, through a person-centered planning process, the option to
receive alternative housing and service options.

(p) At the time of reassessment, the certified assessor shall assess each person receiving
waiver day services to determine if that person would prefer to receive employment services
as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified
assessor shall describe to the person through a person-centered planning process the option
to receive employment services.

(q) At the time of reassessment, the certified assessor shall assess each person receiving
non-self-directed waiver services to determine if that person would prefer an available
service and setting option that would permit self-directed services and supports. The certified
assessor shall describe to the person through a person-centered planning process the option
to receive self-directed services and supports.

(r) All assessments performed according to this subdivision must be face-to-face unless
the assessment is a reassessment meeting the requirements of this paragraph. Remote
reassessments conducted by interactive video or telephone may substitute for face-to-face
reassessments. For services provided by the developmental disabilities waiver under section
256B.092, and the community access for disability inclusion, community alternative care,
and brain injury waiver programs under section 256B.49, remote reassessments may be
substituted for two consecutive reassessments if followed by a face-to-face reassessment.
For services provided by alternative care under section 256B.0913, essential community
supports under section 256B.0922, and the elderly waiver under chapter 256S, remote
reassessments may be substituted for one reassessment if followed by a face-to-face
reassessment. A remote reassessment is permitted only if the new text beginlead agency provides informed
choice and the
new text endperson being reassesseddeleted text begin, or the person's legal representative, and the lead
agency case manager both agree that there is no change in the person's condition, there is
no need for a change in service, and that a remote reassessment is appropriate
deleted text endnew text begin or the person's
legal representative provides informed consent for a remote assessment
new text end. new text beginLead agencies must
document that informed choice was offered.
new text endThe person being reassessed, or the person's
legal representative, has the right to refuse a remote reassessment at any time. During a
remote reassessment, if the certified assessor determines a face-to-face reassessment is
necessary deleted text beginin orderdeleted text end to complete the assessment, the lead agency shall schedule a face-to-face
reassessment. All other requirements of a face-to-face reassessment shall apply to a remote
reassessment, including updates to a person's support plan.

Sec. 36.

Minnesota Statutes 2020, section 256B.092, subdivision 1a, is amended to read:


Subd. 1a.

Case management services.

(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described in
the federally approved waiver application.

(b) Case management service activities provided to or arranged for a person include:

(1) development of the person-centered coordinated service and support plan under
subdivision 1b;

(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options, including all service options available under the
waiver plan;

(3) consulting with relevant medical experts or service providers;

(4) assisting the person in the identification of potential providers of chosen services,
including:

(i) providers of services provided in a non-disability-specific setting;

(ii) employment service providers;

(iii) providers of services provided in settings that are not controlled by a provider; and

(iv) providers of financial management services;

(5) assisting the person to access services and assisting in appeals under section 256.045;

(6) coordination of services, if coordination is not provided by another service provider;

(7) evaluation and monitoring of the services identified in the coordinated service and
support plan, which must incorporate at least one annual face-to-face visit by the case
manager with each person; and

(8) reviewing coordinated service and support plans and providing the lead agency with
recommendations for service authorization based upon the individual's needs identified in
the coordinated service and support plan.

(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.new text begin
If a county agency contracts for case management services, the county agency must provide
each recipient of home and community-based services who is receiving contracted case
management services with the contact information the recipient may use to file a grievance
with the county agency about the quality of the contracted services the recipient is receiving
from a county-contracted case manager.
new text end Case management services must be provided by a
public or private agency that is enrolled as a medical assistance provider determined by the
commissioner to meet all of the requirements in the approved federal waiver plans. Case
management services must not be provided to a recipient by a private agency that has a
financial interest in the provision of any other services included in the recipient's coordinated
service and support plan. For purposes of this section, "private agency" means any agency
that is not identified as a lead agency under section 256B.0911, subdivision 1a, paragraph
(e).

(d) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
person-centered coordinated service and support plan and habilitation plan.

(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than ten hours of case management
education and disability-related training each year. The education and training must include
person-centered planning. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision 1a, paragraph
(f).

Sec. 37.

Minnesota Statutes 2021 Supplement, section 256B.0946, subdivision 1, is
amended to read:


Subdivision 1.

Required covered service components.

(a) Subject to federal approval,
medical assistance covers medically necessary intensive treatment services when the services
are provided by a provider entity certified under and meeting the standards in this section.
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.

(b) Intensive treatment services to children with mental illness residing in foster family
settings that comprise specific required service components provided in clauses (1) to (6)
are reimbursed by medical assistance when they meet the following standards:

(1) psychotherapy provided by a mental health professional or a clinical trainee;

(2) crisis planning;

(3) individual, family, and group psychoeducation services provided by a mental health
professional or a clinical trainee;

(4) clinical care consultation provided by a mental health professional or a clinical
trainee;

(5) individual treatment plan development as defined in deleted text beginMinnesota Rules, part 9505.0371,
subpart 7
deleted text endnew text begin section 245I.10, subdivisions 7 and 8new text end; and

(6) service delivery payment requirements as provided under subdivision 4.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 38.

Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 2, is
amended to read:


Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

(a) "Intensive nonresidential rehabilitative mental health services" means child
rehabilitative mental health services as defined in section 256B.0943, except that these
services are provided by a multidisciplinary staff using a total team approach consistent
with assertive community treatment, as adapted for youth, and are directed to recipients
who are eight years of age or older and under 26 years of age who require intensive services
to prevent admission to an inpatient psychiatric hospital or placement in a residential
treatment facility or who require intensive services to step down from inpatient or residential
care to community-based care.

(b) "Co-occurring mental illness and substance use disorder" means a dual diagnosis of
at least one form of mental illness and at least one substance use disorder. Substance use
disorders include alcohol or drug abuse or dependence, excluding nicotine use.

(c) "Standard diagnostic assessment" means the assessment described in section 245I.10,
subdivision 6
.

(d) "Medication education services" means services provided individually or in groups,
which focus on:

(1) educating the client and client's family or significant nonfamilial supporters about
mental illness and symptoms;

(2) the role and effects of medications in treating symptoms of mental illness; and

(3) the side effects of medications.

Medication education is coordinated with medication management services and does not
duplicate it. Medication education services are provided by physicians, pharmacists, or
registered nurses with certification in psychiatric and mental health care.

(e) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

(f) "Provider agency" means a for-profit or nonprofit organization established to
administer an assertive community treatment for youth team.

(g) "Substance use disorders" means one or more of the disorders defined in the diagnostic
and statistical manual of mental disorders, current edition.

(h) "Transition services" means:

(1) activities, materials, consultation, and coordination that ensures continuity of the
client's care in advance of and in preparation for the client's move from one stage of care
or life to another by maintaining contact with the client and assisting the client to establish
provider relationships;

(2) providing the client with knowledge and skills needed posttransition;

(3) establishing communication between sending and receiving entities;

(4) supporting a client's request for service authorization and enrollment; and

(5) establishing and enforcing procedures and schedules.

deleted text begin A youth's transition from the children's mental health system and services to the adult
mental health system and services and return to the client's home and entry or re-entry into
community-based mental health services following discharge from an out-of-home placement
or inpatient hospital stay.
deleted text end

(i) "Treatment team" means all staff who provide services to recipients under this section.

(j) "Family peer specialist" means a staff person who is qualified under section
256B.0616.

Sec. 39.

Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 6, is
amended to read:


Subd. 6.

Service standards.

The standards in this subdivision apply to intensive
nonresidential rehabilitative mental health services.

(a) The treatment team must use team treatment, not an individual treatment model.

(b) Services must be available at times that meet client needs.

(c) Services must be age-appropriate and meet the specific needs of the client.

(d) The level of care assessment as defined in section 245I.02, subdivision 19, and
functional assessment as defined in section 245I.02, subdivision 17, must be updated at
least every deleted text begin90 daysdeleted text endnew text begin six monthsnew text end or prior to discharge from the service, whichever comes
first.

(e) The treatment team must complete an individual treatment plan for each client,
according to section 245I.10, subdivisions 7 and 8, and the individual treatment plan must:

(1) be completed in consultation with the client's current therapist and key providers and
provide for ongoing consultation with the client's current therapist to ensure therapeutic
continuity and to facilitate the client's return to the community. For clients under the age of
18, the treatment team must consult with parents and guardians in developing the treatment
plan;

(2) if a need for substance use disorder treatment is indicated by validated assessment:

(i) identify goals, objectives, and strategies of substance use disorder treatment;

(ii) develop a schedule for accomplishing substance use disorder treatment goals and
objectives; and

(iii) identify the individuals responsible for providing substance use disorder treatment
services and supports;new text begin and
new text end

(3) provide for the client's transition out of intensive nonresidential rehabilitative mental
health services by defining the team's actions to assist the client and subsequent providers
in the transition to less intensive or "stepped down" servicesdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (4) notwithstanding section 245I.10, subdivision 8, be reviewed at least every 90 days
and revised to document treatment progress or, if progress is not documented, to document
changes in treatment.
deleted text end

(f) The treatment team shall actively and assertively engage the client's family members
and significant others by establishing communication and collaboration with the family and
significant others and educating the family and significant others about the client's mental
illness, symptom management, and the family's role in treatment, unless the team knows or
has reason to suspect that the client has suffered or faces a threat of suffering any physical
or mental injury, abuse, or neglect from a family member or significant other.

(g) For a client age 18 or older, the treatment team may disclose to a family member,
other relative, or a close personal friend of the client, or other person identified by the client,
the protected health information directly relevant to such person's involvement with the
client's care, as provided in Code of Federal Regulations, title 45, part 164.502(b). If the
client is present, the treatment team shall obtain the client's agreement, provide the client
with an opportunity to object, or reasonably infer from the circumstances, based on the
exercise of professional judgment, that the client does not object. If the client is not present
or is unable, by incapacity or emergency circumstances, to agree or object, the treatment
team may, in the exercise of professional judgment, determine whether the disclosure is in
the best interests of the client and, if so, disclose only the protected health information that
is directly relevant to the family member's, relative's, friend's, or client-identified person's
involvement with the client's health care. The client may orally agree or object to the
disclosure and may prohibit or restrict disclosure to specific individuals.

(h) The treatment team shall provide interventions to promote positive interpersonal
relationships.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 40.

Minnesota Statutes 2021 Supplement, section 256B.0949, subdivision 2, is
amended to read:


Subd. 2.

Definitions.

(a) The terms used in this section have the meanings given in this
subdivision.

new text begin (b) "Advanced certification" means a person who has completed advanced certification
in an approved modality under subdivision 13, paragraph (b).
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end "Agency" means the legal entity that is enrolled with Minnesota health care
programs as a medical assistance provider according to Minnesota Rules, part 9505.0195,
to provide EIDBI services and that has the legal responsibility to ensure that its employees
or contractors carry out the responsibilities defined in this section. Agency includes a licensed
individual professional who practices independently and acts as an agency.

deleted text begin (c)deleted text endnew text begin (d)new text end "Autism spectrum disorder or a related condition" or "ASD or a related condition"
means either autism spectrum disorder (ASD) as defined in the current version of the
Diagnostic and Statistical Manual of Mental Disorders (DSM) or a condition that is found
to be closely related to ASD, as identified under the current version of the DSM, and meets
all of the following criteria:

(1) is severe and chronic;

(2) results in impairment of adaptive behavior and function similar to that of a person
with ASD;

(3) requires treatment or services similar to those required for a person with ASD; and

(4) results in substantial functional limitations in three core developmental deficits of
ASD: social or interpersonal interaction; functional communication, including nonverbal
or social communication; and restrictive or repetitive behaviors or hyperreactivity or
hyporeactivity to sensory input; and may include deficits or a high level of support in one
or more of the following domains:

(i) behavioral challenges and self-regulation;

(ii) cognition;

(iii) learning and play;

(iv) self-care; or

(v) safety.

deleted text begin (d)deleted text endnew text begin (e)new text end "Person" means a person under 21 years of age.

deleted text begin (e)deleted text endnew text begin (f)new text end "Clinical supervision" means the overall responsibility for the control and direction
of EIDBI service delivery, including individual treatment planning, staff supervision,
individual treatment plan progress monitoring, and treatment review for each person. Clinical
supervision is provided by a qualified supervising professional (QSP) who takes full
professional responsibility for the service provided by each supervisee.

deleted text begin (f)deleted text endnew text begin (g)new text end "Commissioner" means the commissioner of human services, unless otherwise
specified.

deleted text begin (g)deleted text endnew text begin (h)new text end "Comprehensive multidisciplinary evaluation" or "CMDE" means a comprehensive
evaluation of a person to determine medical necessity for EIDBI services based on the
requirements in subdivision 5.

deleted text begin (h)deleted text endnew text begin (i)new text end "Department" means the Department of Human Services, unless otherwise
specified.

deleted text begin (i)deleted text endnew text begin (j)new text end "Early intensive developmental and behavioral intervention benefit" or "EIDBI
benefit" means a variety of individualized, intensive treatment modalities approved and
published by the commissioner that are based in behavioral and developmental science
consistent with best practices on effectiveness.

deleted text begin (j)deleted text endnew text begin (k)new text end "Generalizable goals" means results or gains that are observed during a variety
of activities over time with different people, such as providers, family members, other adults,
and people, and in different environments including, but not limited to, clinics, homes,
schools, and the community.

deleted text begin (k)deleted text endnew text begin (l)new text end "Incident" means when any of the following occur:

(1) an illness, accident, or injury that requires first aid treatment;

(2) a bump or blow to the head; or

(3) an unusual or unexpected event that jeopardizes the safety of a person or staff,
including a person leaving the agency unattended.

deleted text begin (l)deleted text endnew text begin (m)new text end "Individual treatment plan" or "ITP" means the person-centered, individualized
written plan of care that integrates and coordinates person and family information from the
CMDE for a person who meets medical necessity for the EIDBI benefit. An individual
treatment plan must meet the standards in subdivision 6.

deleted text begin (m)deleted text endnew text begin (n)new text end "Legal representative" means the parent of a child who is under 18 years of age,
a court-appointed guardian, or other representative with legal authority to make decisions
about service for a person. For the purpose of this subdivision, "other representative with
legal authority to make decisions" includes a health care agent or an attorney-in-fact
authorized through a health care directive or power of attorney.

deleted text begin (n)deleted text endnew text begin (o)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 endnew text begin (p)new text end "Person-centered" means a service that both responds to the identified needs,
interests, values, preferences, and desired outcomes of the person or the person's legal
representative and respects the person's history, dignity, and cultural background and allows
inclusion and participation in the person's community.

deleted text begin (p)deleted text endnew text begin (q)new text end "Qualified EIDBI provider" means a person who is a QSP or a level I, level II,
or level III treatment provider.

Sec. 41.

Minnesota Statutes 2020, section 256B.0949, subdivision 8, is amended to read:


Subd. 8.

Refining the benefit with stakeholders.

new text beginBefore making revisions to the EIDBI
benefit or proposing statutory changes to this section,
new text endthe commissioner must deleted text beginrefine the
details of the benefit in consultation
deleted text endnew text begin consultnew text end with stakeholders and consider recommendations
from the Department of Human Services Early Intensive Developmental and Behavioral
Intervention Advisory Council, the early intensive developmental and behavioral intervention
learning collaborative, and the Departments of Health, Education, Employment and Economic
Development, and Human Services. deleted text beginThe details mustdeleted text endnew text begin Revisions and proposed statutory
changes subject to this subdivision
new text end include, but are not limited to, the following components:

(1) a definition of the qualifications, standards, and roles of the treatment team, including
recommendations after stakeholder consultation on whether board-certified behavior analysts
and other professionals certified in other treatment approaches recognized by the department
or trained in ASD or a related condition and child development should be added as
professionals qualified to provide EIDBI clinical supervision or other functions under
medical assistance;

(2) refinement of uniform parameters for CMDE and ongoing ITP progress monitoring
standards;

(3) the design of an effective and consistent process for assessing the person's and the
person's legal representative's and the person's caregiver's preferences and options to
participate in the person's early intervention treatment and efficacy of methods to involve
and educate the person's legal representative and caregiver in the treatment of the person;

(4) formulation of a collaborative process in which professionals have opportunities to
collectively inform provider standards and qualifications; standards for CMDE; medical
necessity determination; efficacy of treatment apparatus, including modality, intensity,
frequency, and duration; and ITP progress monitoring processes to support quality
improvement of EIDBI services;

(5) coordination of this benefit and its interaction with other services provided by the
Departments of Human Services, Health, Employment and Economic Development, and
Education;

(6) evaluation, on an ongoing basis, of EIDBI services outcomes and efficacy of treatment
modalities provided to people under this benefit; and

(7) as provided under subdivision 17, determination of the availability of qualified EIDBI
providers with necessary expertise and training in ASD or a related condition throughout
the state to assess whether there are sufficient professionals to provide timely access and
prevent delay in the CMDE and treatment of a person with ASD or a related condition.

Sec. 42.

Minnesota Statutes 2021 Supplement, section 256B.0949, subdivision 13, is
amended to read:


Subd. 13.

Covered services.

(a) The services described in paragraphs (b) to (l) are
eligible for reimbursement by medical assistance under this section. Services must be
provided by a qualified EIDBI provider and supervised by a QSP. An EIDBI service must
address the person's medically necessary treatment goals and must be targeted to develop,
enhance, or maintain the individual developmental skills of a person with ASD or a related
condition to improve functional communication, including nonverbal or social
communication, social or interpersonal interaction, restrictive or repetitive behaviors,
hyperreactivity or hyporeactivity to sensory input, behavioral challenges and self-regulation,
cognition, learning and play, self-care, and safety.

(b) EIDBI treatment must be delivered consistent with the standards of an approved
modality, as published by the commissioner. EIDBI modalities include:

(1) applied behavior analysis (ABA);

(2) developmental individual-difference relationship-based model (DIR/Floortime);

(3) early start Denver model (ESDM);

(4) PLAY project;

(5) relationship development intervention (RDI); or

(6) additional modalities not listed in clauses (1) to (5) upon approval by the
commissioner.

(c) An EIDBI provider may use one or more of the EIDBI modalities in paragraph (b),
clauses (1) to (5), as the primary modality for treatment as a covered service, or several
EIDBI modalities in combination as the primary modality of treatment, as approved by the
commissioner. An EIDBI provider that identifies and provides assurance of qualifications
for a single specific treatment modalitynew text begin, including an EIDBI provider with advanced
certification overseeing implementation,
new text end must document the required qualifications to meet
fidelity to the specific modelnew text begin in a manner determined by the commissionernew text end.

(d) Each qualified EIDBI provider must identify and provide assurance of qualifications
for professional licensure certification, or training in evidence-based treatment methods,
and must document the required qualifications outlined in subdivision 15 in a manner
determined by the commissioner.

(e) CMDE is a comprehensive evaluation of the person's developmental status to
determine medical necessity for EIDBI services and meets the requirements of subdivision
5. The services must be provided by a qualified CMDE provider.

(f) EIDBI intervention observation and direction is the clinical direction and oversight
of EIDBI services by the QSP, level I treatment provider, or level II treatment provider,
including developmental and behavioral techniques, progress measurement, data collection,
function of behaviors, and generalization of acquired skills for the direct benefit of a person.
EIDBI intervention observation and direction informs any modification of the current
treatment protocol to support the outcomes outlined in the ITP.

(g) Intervention is medically necessary direct treatment provided to a person with ASD
or a related condition as outlined in their ITP. All intervention services must be provided
under the direction of a QSP. Intervention may take place across multiple settings. The
frequency and intensity of intervention services are provided based on the number of
treatment goals, person and family or caregiver preferences, and other factors. Intervention
services may be provided individually or in a group. Intervention with a higher provider
ratio may occur when deemed medically necessary through the person's ITP.

(1) Individual intervention is treatment by protocol administered by a single qualified
EIDBI provider delivered to one person.

(2) Group intervention is treatment by protocol provided by one or more qualified EIDBI
providers, delivered to at least two people who receive EIDBI services.

new text begin (3) Higher provider ratio intervention is treatment with protocol modification provided
by two or more qualified EIDBI providers delivered to one person in an environment that
meets the person's needs and under the direction of the QSP or level I provider.
new text end

(h) ITP development and ITP progress monitoring is development of the initial, annual,
and progress monitoring of an ITP. ITP development and ITP progress monitoring documents
provide oversight and ongoing evaluation of a person's treatment and progress on targeted
goals and objectives and integrate and coordinate the person's and the person's legal
representative's information from the CMDE and ITP progress monitoring. This service
must be reviewed and completed by the QSP, and may include input from a level I provider
or a level II provider.

(i) Family caregiver training and counseling is specialized training and education for a
family or primary caregiver to understand the person's developmental status and help with
the person's needs and development. This service must be provided by the QSP, level I
provider, or level II provider.

(j) A coordinated care conference is a voluntary meeting with the person and the person's
family to review the CMDE or ITP progress monitoring and to integrate and coordinate
services across providers and service-delivery systems to develop the ITP. This service
deleted text begin must be provided by the QSP anddeleted text end may include the CMDE provider deleted text beginordeleted text endnew text begin, QSP,new text end a level I
providernew text begin,new text end or a level II provider.

(k) Travel time is allowable billing for traveling to and from the person's home, school,
a community setting, or place of service outside of an EIDBI center, clinic, or office from
a specified location to provide in-person EIDBI intervention, observation and direction, or
family caregiver training and counseling. The person's ITP must specify the reasons the
provider must travel to the person.

(l) Medical assistance covers medically necessary EIDBI services and consultations
delivered deleted text beginby a licensed health care providerdeleted text end via telehealth, as defined under section
256B.0625, subdivision 3b, in the same manner as if the service or consultation was delivered
in person.

Sec. 43.

Minnesota Statutes 2020, section 256G.02, subdivision 6, is amended to read:


Subd. 6.

Excluded time.

"Excluded time" means:

(1) any period an applicant spends in a hospital, sanitarium, nursing home, shelter other
than an emergency shelter, halfway house, foster home, community residential setting
licensed under chapter 245D, semi-independent living domicile or services program,
residential facility offering care, board and lodging facility or other institution for the
hospitalization or care of human beings, as defined in section 144.50, 144A.01, or 245A.02,
subdivision 14
; maternity home, battered women's shelter, or correctional facility; or any
facility based on an emergency hold under section 253B.05, subdivisions 1 and 2;

(2) any period an applicant spends on a placement basis in a training and habilitation
program, including: a rehabilitation facility or work or employment program as defined in
section 268A.01; semi-independent living services provided under section 252.275, and
chapter 245D; or day training and habilitation programs deleted text beginanddeleted text endnew text begin;
new text end

new text begin (3) any period an applicant is receiving new text endassisted living servicesnew text begin, integrated community
supports, or day support services
new text end; and

deleted text begin (3)deleted text endnew text begin (4)new text end any placement for a person with an indeterminate commitment, including
independent living.

Sec. 44.

Minnesota Statutes 2020, section 256K.26, subdivision 2, is amended to read:


Subd. 2.

Implementation.

The commissioner, in consultation with the commissioners
of the Department of Corrections and the Minnesota Housing Finance Agency, counties,
new text begin Tribes, new text endprovidersnew text begin,new text end and funders of supportive housing and services, shall develop application
requirements and make funds available according to this section, with the goal of providing
maximum flexibility in program design.

Sec. 45.

Minnesota Statutes 2020, section 256K.26, subdivision 6, is amended to read:


Subd. 6.

Outcomes.

Projects will be selected to further the following outcomes:

(1) reduce the number of Minnesota individuals and families that experience long-term
homelessness;

(2) increase the number of housing opportunities with supportive services;

(3) develop integrated, cost-effective service models that address the multiple barriers
to obtaining housing stability faced by people experiencing long-term homelessness,
including abuse, neglect, chemical dependency, disability, chronic health problems, or other
factors including ethnicity and race that may result in poor outcomes or service disparities;

(4) encourage partnerships among counties, new text beginTribes, new text endcommunity agencies, schools, and
other providers so that the service delivery system is seamless for people experiencing
long-term homelessness;

(5) increase employability, self-sufficiency, and other social outcomes for individuals
and families experiencing long-term homelessness; and

(6) reduce inappropriate use of emergency health care, shelter, deleted text beginchemical dependencydeleted text endnew text begin
substance use disorder treatment
new text end, foster care, child protection, corrections, and similar
services used by people experiencing long-term homelessness.

Sec. 46.

Minnesota Statutes 2020, section 256K.26, subdivision 7, is amended to read:


Subd. 7.

Eligible services.

Services eligible for funding under this section are all services
needed to maintain households in permanent supportive housing, as determined by the
deleted text begin county ordeleted text end countiesnew text begin or Tribesnew text end administering the project or projects.

Sec. 47.

Minnesota Statutes 2021 Supplement, section 256P.01, subdivision 6a, is amended
to read:


Subd. 6a.

Qualified professional.

(a) For illness, injury, or incapacity, a "qualified
professional" means a licensed physician, physician assistant, advanced practice registered
nurse, physical therapist, occupational therapist, or licensed chiropractor, according to their
scope of practice.

(b) For developmental disability, learning disability, and intelligence testing, a "qualified
professional" means a licensed physician, physician assistant, advanced practice registered
nurse, licensed independent clinical social worker, licensed psychologist, certified school
psychologist, or certified psychometrist working under the supervision of a licensed
psychologist.

(c) For mental health, a "qualified professional" means a licensed physician, advanced
practice registered nurse, or qualified mental health professional under section 245I.04,
subdivision 2
.

(d) For substance use disorder, a "qualified professional" means a licensed physician, a
qualified mental health professional under section deleted text begin245.462, subdivision 18, clauses (1) to
(6)
deleted text endnew text begin 245I.04, subdivision 2new text end, or an individual as defined in section 245G.11, subdivision 3,
4, or 5.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 48.

Minnesota Statutes 2020, section 256Q.06, is amended by adding a subdivision
to read:


new text begin Subd. 6. new text end

new text begin Account creation. new text end

new text begin If an eligible individual is unable to establish the eligible
individual's own ABLE account, an ABLE account may be established on behalf of the
eligible individual by the eligible individual's agent under a power of attorney or, if none,
by the eligible individual's conservator or legal guardian, spouse, parent, sibling, or
grandparent or a representative payee appointed for the eligible individual by the Social
Security Administration, in that order.
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. 49.

Laws 2020, First Special Session chapter 7, section 1, subdivision 1, as amended
by Laws 2021, First Special Session chapter 7, article 2, section 71, is amended to read:


Subdivision 1.

Waivers and modifications; federal funding extension.

When the
peacetime emergency declared by the governor in response to the COVID-19 outbreak
expires, is terminated, or is rescinded by the proper authority, the following waivers and
modifications to human services programs issued by the commissioner of human services
pursuant to Executive Orders 20-11 and 20-12 deleted text beginthat are required to comply with federal lawdeleted text end
may remain in effect for the time period set out in applicable federal law or for the time
period set out in any applicable federally approved waiver or state plan amendment,
whichever is later:

(1) CV15: allowing telephone or video visits for waiver programs;

(2) CV17: preserving health care coverage for Medical Assistance and MinnesotaCare;

(3) CV18: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

(4) CV20: eliminating cost-sharing for COVID-19 diagnosis and treatment;

(5) CV24: allowing telephone or video use for targeted case management visits;

(6) CV30: expanding telemedicine in health care, mental health, and substance use
disorder settings;

(7) CV37: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

(8) CV39: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

(9) CV42: implementation of federal changes to the Supplemental Nutrition Assistance
Program;

(10) CV43: expanding remote home and community-based waiver services;

(11) CV44: allowing remote delivery of adult day services;

(12) CV59: modifying eligibility period for the federally funded Refugee Cash Assistance
Program;

(13) CV60: modifying eligibility period for the federally funded Refugee Social Services
Program; and

(14) CV109: providing 15 percent increase for Minnesota Food Assistance Program and
Minnesota Family Investment Program maximum food benefits.

Sec. 50.

Laws 2021, First Special Session chapter 7, article 11, section 38, is amended to
read:


Sec. 38. DIRECTION TO THE COMMISSIONER; SUBSTANCE USE DISORDER
TREATMENT PAPERWORK REDUCTION.

(a) The commissioner of human services, in consultation with counties, tribes, managed
care organizations, substance use disorder treatment professional associations, and other
relevant stakeholders, shall develop, assess, and recommend systems improvements to
minimize regulatory paperwork and improve systems for substance use disorder programs
licensed under Minnesota Statutes, chapter 245A, and regulated under Minnesota Statutes,
chapters 245F and 245G, and Minnesota Rules, chapters 2960 and 9530. The commissioner
of human services shall make available any resources needed from other divisions within
the department to implement systems improvements.

(b) The commissioner of health shall make available needed information and resources
from the Division of Health Policy.

(c) The Office of MN.IT Services shall provide advance consultation and implementation
of the changes needed in data systems.

(d) The commissioner of human services shall contract with a vendor that has experience
with developing statewide system changes for multiple states at the payer and provider
levels. If the commissioner, after exercising reasonable diligence, is unable to secure a
vendor with the requisite qualifications, the commissioner may select the best qualified
vendor available. When developing recommendations, the commissioner shall consider
input from all stakeholders. The commissioner's recommendations shall maximize benefits
for clients and utility for providers, regulatory agencies, and payers.

(e) The commissioner of human services and the contracted vendor shall follow the
recommendations from the report issued in response to Laws 2019, First Special Session
chapter 9, article 6, section 76.

(f) deleted text beginBy December 15, 2022deleted text endnew text begin Within two years of contracting with a qualified vendor
according to paragraph (d)
new text end, the commissioner of human services shall take steps to implement
paperwork reductions and systems improvements within the commissioner's authority and
submit to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services a report that includes recommendations for
changes in statutes that would further enhance systems improvements to reduce paperwork.
The report shall include a summary of the approaches developed and assessed by the
commissioner of human services and stakeholders and the results of any assessments
conducted.

Sec. 51. new text beginREVISOR INSTRUCTION.
new text end

new text begin In Minnesota Statutes and Minnesota Rules, the revisor of statutes shall change the term
"chemical dependency" or similar terms to "substance use disorder." The revisor may make
grammatical changes related to the term change.
new text end

Sec. 52. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 254A.04; and 254B.14, subdivisions 1, 2, 3, 4,
and 6,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2021 Supplement, section 254B.14, subdivision 5, new text end new text begin is repealed.
new text end

ARTICLE 5

COMMUNITY SUPPORTS

Section 1.

Minnesota Statutes 2020, section 245D.10, subdivision 3a, is amended to read:


Subd. 3a.

Service termination.

(a) The license holder must establish policies and
procedures for service termination that promote continuity of care and service coordination
with the person and the case manager and with other licensed caregivers, if any, who also
provide support to the person. The policy must include the requirements specified in
paragraphs (b) to (f).

(b) The license holder must permit each person to remain in the programnew text begin or to continue
receiving services
new text end and must not terminate services unless:

(1) the termination is necessary for the person's welfare and the deleted text beginfacilitydeleted text endnew text begin license holdernew text end
cannot meet the person's needs;

(2) the safety of the person deleted text beginordeleted text endnew text begin,new text end others in the programnew text begin, or staffnew text end is endangered and positive
support strategies were attempted and have not achieved and effectively maintained safety
for the person or others;

(3) the health of the person deleted text beginordeleted text endnew text begin,new text end others in the programnew text begin, or staffnew text end would otherwise be
endangered;

(4) the deleted text beginprogramdeleted text endnew text begin license holdernew text end has not been paid for services;

(5) the programnew text begin or license holdernew text end ceases to operate;

(6) the person has been terminated by the lead agency from waiver eligibility; or

(7) for state-operated community-based services, the person no longer demonstrates
complex behavioral needs that cannot be met by private community-based providers
identified in section 252.50, subdivision 5, paragraph (a), clause (1).

(c) Prior to giving notice of service termination, the license holder must document actions
taken to minimize or eliminate the need for termination. Action taken by the license holder
must include, at a minimum:

(1) consultation with the person's support team or expanded support team to identify
and resolve issues leading to issuance of the termination notice;

(2) a request to the case manager for intervention services identified in section 245D.03,
subdivision 1
, paragraph (c), clause (1), or other professional consultation or intervention
services to support the person in the program. This requirement does not apply to notices
of service termination issued under paragraph (b), clauses (4) and (7); and

(3) for state-operated community-based services terminating services under paragraph
(b), clause (7), the state-operated community-based services must engage in consultation
with the person's support team or expanded support team to:

(i) identify that the person no longer demonstrates complex behavioral needs that cannot
be met by private community-based providers identified in section 252.50, subdivision 5,
paragraph (a), clause (1);

(ii) provide notice of intent to issue a termination of services to the lead agency when a
finding has been made that a person no longer demonstrates complex behavioral needs that
cannot be met by private community-based providers identified in section 252.50, subdivision
5, paragraph (a), clause (1);

(iii) assist the lead agency and case manager in developing a person-centered transition
plan to a private community-based provider to ensure continuity of care; and

(iv) coordinate with the lead agency to ensure the private community-based service
provider is able to meet the person's needs and criteria established in a person's
person-centered transition plan.

If, based on the best interests of the person, the circumstances at the time of the notice were
such that the license holder was unable to take the action specified in clauses (1) and (2),
the license holder must document the specific circumstances and the reason for being unable
to do so.

(d) The notice of service termination must meet the following requirements:

(1) the license holder must notify the person or the person's legal representative and the
case manager in writing of the intended service termination. If the service termination is
from residential supports and services as defined in section 245D.03, subdivision 1, paragraph
(c), clause (3), the license holder must also notify the commissioner in writing; and

(2) the notice must include:

(i) the reason for the action;

(ii) except for a service termination under paragraph (b), clause (5), a summary of actions
taken to minimize or eliminate the need for service termination or temporary service
suspension as required under paragraph (c), and why these measures failed to prevent the
termination or suspension;

(iii) the person's right to appeal the termination of services under section 256.045,
subdivision 3, paragraph (a); and

(iv) the person's right to seek a temporary order staying the termination of services
according to the procedures in section 256.045, subdivision 4a or 6, paragraph (c).

(e) Notice of the proposed termination of service, including those situations that began
with a temporary service suspension, must be given at least 90 days prior to termination of
services under paragraph (b), clause (7), 60 days prior to termination when a license holder
is providing intensive supports and services identified in section 245D.03, subdivision 1,
paragraph (c), and 30 days prior to termination for all other services licensed under this
chapter. This notice may be given in conjunction with a notice of temporary service
suspension under subdivision 3.

(f) During the service termination notice period, the license holder must:

(1) work with the support team or expanded support team to develop reasonable
alternatives to protect the person and others and to support continuity of care;

(2) provide information requested by the person or case manager; and

(3) maintain information about the service termination, including the written notice of
intended service termination, in the service recipient record.

(g) For notices issued under paragraph (b), clause (7), the lead agency shall provide
notice to the commissioner and state-operated services at least 30 days before the conclusion
of the 90-day termination period, if an appropriate alternative provider cannot be secured.
Upon receipt of this notice, the commissioner and state-operated services shall reassess
whether a private community-based service can meet the person's needs. If the commissioner
determines that a private provider can meet the person's needs, state-operated services shall,
if necessary, extend notice of service termination until placement can be made. If the
commissioner determines that a private provider cannot meet the person's needs,
state-operated services shall rescind the notice of service termination and re-engage with
the lead agency in service planning for the person.

(h) For state-operated community-based services, the license holder shall prioritize the
capacity created within the existing service site by the termination of services under paragraph
(b), clause (7), to serve persons described in section 252.50, subdivision 5, paragraph (a),
clause (1).

Sec. 2.

Minnesota Statutes 2020, section 256.045, subdivision 3, is amended to read:


Subd. 3.

State agency hearings.

(a) State agency hearings are available for the following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food and Nutrition Act whose application for assistance is denied, not acted upon
with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
claimed to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under chapter 260E is denied or not acted
upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under chapter 260E, after the individual or facility has exercised the
right to administrative reconsideration under chapter 260E;

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food and Nutrition Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;

(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, deleted text beginfromdeleted text endnew text begin by a licensed provider of anynew text end residential supports deleted text beginanddeleted text endnew text begin ornew text end services deleted text beginas defineddeleted text endnew text begin listednew text end
in section 245D.03, subdivision 1, deleted text beginparagraphdeleted text endnew text begin paragraphs (b) andnew text end (c), deleted text beginclause (3),deleted text end that is not
otherwise subject to appeal under subdivision 4a;

(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914; or

(14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4a.

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.

(c) For purposes of this section, bargaining unit grievance procedures are not an
administrative appeal.

(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.

(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a
, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.

(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.

(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.

(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.

(i) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.

Sec. 3.

Minnesota Statutes 2020, section 256I.03, subdivision 6, is amended to read:


Subd. 6.

Medical assistance room and board rate.

"Medical assistance room and board
rate" means an amount equal to deleted text beginthe medical assistance income standarddeleted text endnew text begin 81 percent of the
federal poverty guideline
new text end for a single individual living alone in the community less the
medical assistance personal needs allowance under section 256B.35. For the purposes of
this section, the amount of the room and board rate that exceeds the medical assistance room
and board rate is considered a remedial care cost. A remedial care cost may be used to meet
a spenddown obligation under section 256B.056, subdivision 5. The medical assistance
room and board rate is to be adjusted on the first day of January of each year.

ARTICLE 6

BEHAVIORAL HEALTH

Section 1.

new text begin [4.046] OPIOIDS, SUBSTANCE USE, AND ADDICTION SUBCABINET.
new text end

new text begin Subdivision 1. new text end

new text begin Subcabinet established; purposes. new text end

new text begin The Opioids, Substance Use, and
Addiction Subcabinet is established. The purposes of the subcabinet are to identify:
new text end

new text begin (1) challenges that exist within state government that create silos around addiction,
treatment, prevention, and recovery; that limit access to treatment options or addiction-related
services for all Minnesotans; and that prevent successful treatment outcomes;
new text end

new text begin (2) opportunities that exist within state government that support accessible and effective
substance use disorder treatment options or addiction-related services;
new text end

new text begin (3) barriers and gaps in service for all Minnesotans seeking treatment for opioid or
substance use disorder, particularly those barriers and gaps affecting members of communities
disproportionately impacted by substance use and addiction;
new text end

new text begin (4) potential solutions to barriers and gaps identified in clause (3);
new text end

new text begin (5) how the state can address addiction as a chronic disease, emphasizing that there are
multiple ways to enter sobriety; and
new text end

new text begin (6) policies and strategies that address prevention efforts, including addressing underlying
causes of addiction and public awareness and education around the dangers of issues
including but not limited to opioid abuse, use of fentanyl and other synthetic opioids, other
substance use, excessive alcohol consumption, and addiction.
new text end

new text begin Subd. 2. new text end

new text begin Subcabinet membership. new text end

new text begin The subcabinet consists of the following members:
new text end

new text begin (1) the commissioner of human services;
new text end

new text begin (2) the commissioner of health;
new text end

new text begin (3) the commissioner of education;
new text end

new text begin (4) the commissioner of public safety;
new text end

new text begin (5) the commissioner of corrections;
new text end

new text begin (6) the commissioner of management and budget;
new text end

new text begin (7) the commissioner of higher education;
new text end

new text begin (8) the chair of the Interagency Council on Homelessness; and
new text end

new text begin (9) the governor's director of addiction and recovery, who shall serve as chair of the
subcabinet.
new text end

new text begin Subd. 3. new text end

new text begin Policy and strategy development. new text end

new text begin The subcabinet must engage in the following
duties related to the development of opioid use, substance use, and addiction policy and
strategy:
new text end

new text begin (1) identify challenges and opportunities that exist relating to accessing treatment and
support services and develop recommendations to overcome these barriers for all
Minnesotans;
new text end

new text begin (2) with input from affected communities, develop policies and strategies that will reduce
barriers and gaps in service for all Minnesotans seeking treatment for opioid or substance
use disorder, particularly for those Minnesotans who are members of communities
disproportionately impacted by substance use and addiction;
new text end

new text begin (3) develop policies and strategies that the state may adopt to expand Minnesota's recovery
infrastructure, including detoxification or withdrawal management facilities, treatment
facilities, and sober housing;
new text end

new text begin (4) identify innovative services and strategies for effective treatment and support;
new text end

new text begin (5) develop policies and strategies to expand services and support for people in Minnesota
suffering from opioid or substance use disorder through partnership with the Opioid Epidemic
Response Advisory Council and other relevant partnerships;
new text end

new text begin (6) develop policies and strategies for agencies to manage addiction and the relationship
it has with co-occurring conditions;
new text end

new text begin (7) identify policies and strategies to address opioid or substance use disorder among
Minnesotans experiencing homelessness; and
new text end

new text begin (8) submit recommendations to the legislature addressing opioid use, substance use, and
addiction in Minnesota.
new text end

new text begin Subd. 4. new text end

new text begin Public engagement. new text end

new text begin The subcabinet must develop and implement a framework
to ensure meaningful public engagement is conducted by the subcabinet's agencies and
boards. The purpose of the framework is to:
new text end

new text begin (1) engage with and seek feedback from all affected Minnesotans, including members
of the 11 Tribal Nations within Minnesota;
new text end

new text begin (2) build partnerships and shared understanding with all affected Minnesotans, including
members of Tribal communities in urban areas, communities of color, local communities,
and industries, including but not limited to the health and business sectors;
new text end

new text begin (3) provide a platform for dialogue about the needs and challenges of those in active
addiction or in recovery and to identify effective solutions and how those solutions will
impact the lives of people in Minnesota, including those who are members of communities
disproportionately impacted by addiction, including opioid addiction; and
new text end

new text begin (4) gather and share ideas for how Minnesotans can get involved with and stay informed
about addiction issues that matter to them.
new text end

new text begin Subd. 5. new text end

new text begin Governor's Advisory Council on Opioids, Substance Use, and Addiction. new text end

new text begin (a)
The Governor's Advisory Council on Opioids, Substance Use, and Addiction is established
to advise the subcabinet on the purposes and duties described in this section. The advisory
council consists of up to 18 members appointed by the governor. The governor must seek
representation from community leaders, individuals with direct experience with addiction,
individuals providing treatment services, and other relevant stakeholders in making
appointments to the council. The governor will appoint one member as chair of the advisory
council.
new text end

new text begin (b) The advisory council must:
new text end

new text begin (1) meet up to four times per year to identify opportunities for and barriers to the
development and implementation of policies and strategies to expand access to effective
services for people in Minnesota suffering from addiction;
new text end

new text begin (2) examine what services and supports are needed in communities that are
disproportionately impacted by the opioid epidemic; and
new text end

new text begin (3) provide opportunities for Minnesotans who have directly experienced addiction to
address needs, challenges, and solutions.
new text end

new text begin (c) The terms, compensation, and removal of members of the advisory council are
governed by section 15.059.
new text end

new text begin Subd. 6. new text end

new text begin Addiction and recovery director. new text end

new text begin The governor must appoint an addiction
and recovery director, who shall serve as chair of the subcabinet. The director shall serve
in the unclassified service and shall report to the governor. The director must:
new text end

new text begin (1) make efforts to break down silos and work across agencies to better target the state's
role in addressing addiction, treatment, and recovery;
new text end

new text begin (2) assist in leading the subcabinet and the advisory council toward progress on
measurable goals that track the state's efforts in combatting addiction; and
new text end

new text begin (3) establish and manage external partnerships and build relationships with communities,
community leaders, and those who have direct experience with addiction to ensure that all
voices of recovery are represented in the work of the subcabinet and advisory council.
new text end

new text begin Subd. 7. new text end

new text begin Staff and administrative support. new text end

new text begin The commissioner of human services, in
coordination with other state agencies and boards as applicable, must provide staffing and
administrative support to the addiction and recovery director, the subcabinet, and the advisory
council established in this section.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 2.

Minnesota Statutes 2020, section 13.46, subdivision 7, is amended to read:


Subd. 7.

Mental health data.

(a) Mental health data are private data on individuals and
shall not be disclosed, except:

(1) pursuant to section 13.05, as determined by the responsible authority for the
community mental health center, mental health division, or provider;

(2) pursuant to court order;

(3) pursuant to a statute specifically authorizing access to or disclosure of mental health
data or as otherwise provided by this subdivision;

(4) to personnel of the welfare system working in the same program or providing services
to the same individual or family to the extent necessary to coordinate services, provided
that a health record may be disclosed only as provided under section 144.293;

(5) to a health care provider governed by sections 144.291 to 144.298, to the extent
necessary to coordinate services; or

(6) with the consent of the client or patient.

(b) An agency of the welfare system may not require an individual to consent to the
release of mental health data as a condition for receiving services or for reimbursing a
community mental health center, mental health division of a county, or provider under
contract to deliver mental health services.

(c) Notwithstanding section 245.69, subdivision 2, paragraph (f), or any other law to the
contrary, deleted text beginthe responsible authority fordeleted text end a community mental health center, mental health
division of a county, or a mental health provider must disclose mental health data to a law
enforcement agency if the law enforcement agency provides the name of a client or patient
and communicates that the:

(1) client or patient is currently involved in deleted text beginan emergency interaction withdeleted text endnew text begin a mental
health crisis as defined in section 256B.0624, subdivision 2, paragraph (j), to which
new text end the law
enforcement agencynew text begin has respondednew text end; and

(2) data is necessary to protect the health or safety of the client or patient or of another
person.

The scope of disclosure under this paragraph is limited to the minimum necessary for
law enforcement to new text beginsafely new text endrespond to the deleted text beginemergencydeleted text endnew text begin mental health crisisnew text end. Disclosure under
this paragraph may includedeleted text begin, but is not limited to,deleted text end the name and telephone number of the
psychiatrist, psychologist, therapist, mental health professional, practitioner, or case manager
of the client or patientnew text begin, if known; and strategies to address the mental health crisisnew text end. A law
enforcement agency that obtains mental health data under this paragraph shall maintain a
record of the requestor, the provider of the deleted text begininformationdeleted text endnew text begin datanew text end, and the client or patient name.
Mental health data obtained by a law enforcement agency under this paragraph are private
data on individuals and must not be used by the law enforcement agency for any other
purpose. A law enforcement agency that obtains mental health data under this paragraph
shall inform the subject of the data that mental health data was obtained.

(d) In the event of a request under paragraph (a), clause (6), a community mental health
center, county mental health division, or provider must release mental health data to Criminal
Mental Health Court personnel in advance of receiving a copy of a consent if the Criminal
Mental Health Court personnel communicate that the:

(1) client or patient is a defendant in a criminal case pending in the district court;

(2) data being requested is limited to information that is necessary to assess whether the
defendant is eligible for participation in the Criminal Mental Health Court; and

(3) client or patient has consented to the release of the mental health data and a copy of
the consent will be provided to the community mental health center, county mental health
division, or provider within 72 hours of the release of the data.

For purposes of this paragraph, "Criminal Mental Health Court" refers to a specialty
criminal calendar of the Hennepin County District Court for defendants with mental illness
and brain injury where a primary goal of the calendar is to assess the treatment needs of the
defendants and to incorporate those treatment needs into voluntary case disposition plans.
The data released pursuant to this paragraph may be used for the sole purpose of determining
whether the person is eligible for participation in mental health court. This paragraph does
not in any way limit or otherwise extend the rights of the court to obtain the release of mental
health data pursuant to court order or any other means allowed by law.

Sec. 3.

Minnesota Statutes 2020, section 144.294, subdivision 2, is amended to read:


Subd. 2.

Disclosure to law enforcement agency.

Notwithstanding section 144.293,
subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental
health to a law enforcement agency if the law enforcement agency provides the name of
the patient and communicates that the:

(1) patient is currently involved in deleted text beginan emergency interaction withdeleted text endnew text begin a mental health crisis
as defined in section 256B.0624, subdivision 2, paragraph (j), to which
new text end the law enforcement
agencynew text begin has respondednew text end; and

(2) disclosure of the records is necessary to protect the health or safety of the patient or
of another person.

The scope of disclosure under this subdivision is limited to the minimum necessary for
law enforcement to new text beginsafely new text endrespond to the deleted text beginemergencydeleted text endnew text begin mental health crisisnew text end. new text beginThe disclosure
may include the name and telephone number of the psychiatrist, psychologist, therapist,
mental health professional, practitioner, or case manager of the patient, if known; and
strategies to address the mental health crisis.
new text endA law enforcement agency that obtains health
records under this subdivision shall maintain a record of the requestor, the provider of the
information, and the patient's name. Health records obtained by a law enforcement agency
under this subdivision are private data on individuals as defined in section 13.02, subdivision
12, and must not be used by law enforcement for any other purpose.new text begin A law enforcement
agency that obtains health records under this subdivision shall inform the patient that health
records were obtained.
new text end

Sec. 4.

Minnesota Statutes 2021 Supplement, 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 124D.23 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 out-of-home placementnew text begin or already in out-of-home placement
in family foster settings as defined in chapter 245A and at risk of change in out-of-home
placement or placement in a residential facility or other higher level of care. Allowable
activities and expenses for respite care services are defined under subdivision 4
new text end. A child is
not required to have case management services to receive respite care services;

(4) children's mental health crisis services;

(5) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;

(6) children's mental health screening and follow-up diagnostic assessment and treatment;

(7) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;

(8) school-linked mental health services under section 245.4901;

(9) building evidence-based mental health intervention capacity for children birth to age
five;

(10) suicide prevention and counseling services that use text messaging statewide;

(11) mental health first aid training;

(12) 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;

(13) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;

(14) early childhood mental health consultation;

(15) 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;

(16) psychiatric consultation for primary care practitioners; and

(17) 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 5.

Minnesota Statutes 2020, section 245.4889, is amended by adding a subdivision
to read:


new text begin Subd. 4. new text end

new text begin Respite care services. new text end

new text begin Respite care services under subdivision 1, paragraph
(b), clause (3), include hourly or overnight stays at a licensed foster home or with a qualified
and approved family member or friend and may occur at a child's or provider's home. Respite
care services may also include the following activities and expenses:
new text end

new text begin (1) recreational, sport, and nonsport extracurricular activities and programs for the child
including camps, clubs, lessons, group outings, sports, or other activities and programs;
new text end

new text begin (2) family activities, camps, and retreats that the family does together and provide a
break from the family's circumstance;
new text end

new text begin (3) cultural programs and activities for the child and family designed to address the
unique needs of individuals who share a common language, racial, ethnic, or social
background; and
new text end

new text begin (4) costs of transportation, food, supplies, and equipment directly associated with
approved respite care services and expenses necessary for the child and family to access
and participate in respite care services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 6.

Minnesota Statutes 2020, section 245.713, subdivision 2, is amended to read:


Subd. 2.

Total funds available; allocation.

Funds granted to the state by the federal
government under United States Code, title 42, sections 300X to 300X-9 each federal fiscal
year for mental health services must be allocated as follows:

(a) Any amount set aside by the commissioner of human services for American Indian
organizations within the state, which funds shall not duplicate any direct federal funding of
American Indian organizations and which funds shall be at least 25 percent of the total
federal allocation to the state for mental health servicesdeleted text begin; provided that sufficient applications
for funding are received by the commissioner which meet the specifications contained in
requests for proposals
deleted text end. Money from this source may be used for special committees to advise
the commissioner on mental health programs and services for American Indians and other
minorities or underserved groups. For purposes of this subdivision, "American Indian
organization" means an American Indian tribe or band or an organization providing mental
health services that is legally incorporated as a nonprofit organization registered with the
secretary of state and governed by a board of directors having at least a majority of American
Indian directors.

(b) An amount not to exceed five percent of the federal block grant allocation for mental
health services to be retained by the commissioner for administration.

(c) Any amount permitted under federal law which the commissioner approves for
demonstration or research projects for severely disturbed children and adolescents, the
underserved, special populations or multiply disabled mentally ill persons. The groups to
be served, the extent and nature of services to be provided, the amount and duration of any
grant awards are to be based on criteria set forth in the Alcohol, Drug Abuse and Mental
Health Block Grant Law, United States Code, title 42, sections 300X to 300X-9, and on
state policies and procedures determined necessary by the commissioner. Grant recipients
must comply with applicable state and federal requirements and demonstrate fiscal and
program management capabilities that will result in provision of quality, cost-effective
services.

(d) The amount required under federal law, for federally mandated expenditures.

(e) An amount not to exceed 15 percent of the federal block grant allocation for mental
health services to be retained by the commissioner for planning and evaluation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 7.

Minnesota Statutes 2021 Supplement, section 256B.0625, subdivision 5m, is
amended to read:


Subd. 5m.

Certified community behavioral health clinic services.

(a) Medical
assistance covers new text beginservices provided by a not-for-profit new text endcertified community behavioral health
clinic (CCBHC) deleted text beginservicesdeleted text end that deleted text beginmeetdeleted text endnew text begin meetsnew text end the requirements of section 245.735, subdivision
3
.

(b) The commissioner shall reimburse CCBHCs on a deleted text beginper-visitdeleted text endnew text begin per-daynew text end basis deleted text beginunder the
prospective payment
deleted text endnew text begin for each day that an eligible service is delivered using the CCBHC
daily bundled rate
new text end system for medical assistance payments as described in paragraph (c).
The commissioner shall include a quality incentive payment in the deleted text beginprospective paymentdeleted text end
new text begin CCBHC daily bundled rate new text endsystem as described in paragraph (e). There is no county share
for medical assistance services when reimbursed through the CCBHC deleted text beginprospective paymentdeleted text endnew text begin
daily bundled rate
new text end system.

(c) The commissioner shall ensure that the deleted text beginprospective paymentdeleted text endnew text begin CCBHC daily bundled
rate
new text end system for CCBHC payments under medical assistance meets the following requirements:

(1) the deleted text beginprospective paymentdeleted text endnew text begin CCBHC daily bundlednew text end rate shall be a provider-specific rate
calculated for each CCBHC, based on the daily cost of providing CCBHC services and the
total annual allowable new text beginCCBHC new text endcosts deleted text beginfor CCBHCsdeleted text end divided by the total annual number of
CCBHC visits. For calculating the payment rate, total annual visits include visits covered
by medical assistance and visits not covered by medical assistance. Allowable costs include
but are not limited to the salaries and benefits of medical assistance providers; the cost of
CCBHC services provided under section 245.735, subdivision 3, paragraph (a), clauses (6)
and (7); and other costs such as insurance or supplies needed to provide CCBHC services;

(2) payment shall be limited to one payment per day per medical assistance enrollee deleted text beginfor
each
deleted text endnew text begin when an eligiblenew text end CCBHC deleted text beginvisit eligible for reimbursementdeleted text endnew text begin service is providednew text end. A
CCBHC visit is eligible for reimbursement if at least one of the CCBHC services listed
under section 245.735, subdivision 3, paragraph (a), clause (6), is furnished to a medical
assistance enrollee by a health care practitioner or licensed agency employed by or under
contract with a CCBHC;

(3) deleted text beginnew paymentdeleted text endnew text begin initial CCBHC daily bundlednew text end rates deleted text beginset by the commissionerdeleted text end for newly
certified CCBHCs under section 245.735, subdivision 3, shall be deleted text beginbased on rates for
established CCBHCs with a similar scope of services. If no comparable CCBHC exists, the
commissioner shall establish a clinic-specific rate using audited historical cost report data
adjusted for the estimated cost of delivering CCBHC services, including the estimated cost
of providing the full scope of services and the projected change in visits resulting from the
change in scope
deleted text endnew text begin established by the commissioner using a provider-specific rate based on
the newly certified CCBHC's audited historical cost report data adjusted for the expected
cost of delivering CCBHC services. Estimates are subject to review by the commissioner
and must include the expected cost of providing the full scope of CCBHC services and the
expected number of visits for the rate period
new text end;

(4) the commissioner shall rebase CCBHC rates once every three yearsnew text begin following the
last rebasing
new text end and no less than 12 months following an initial rate or a rate change due to a
change in the scope of services;

(5) the commissioner shall provide for a 60-day appeals process after notice of the results
of the rebasing;

(6) the deleted text beginprospective paymentdeleted text endnew text begin CCBHC daily bundlednew text end rate under this section does not apply
to services rendered by CCBHCs to individuals who are dually eligible for Medicare and
medical assistance when Medicare is the primary payer for the service. An entity that receives
a deleted text beginprospective paymentdeleted text end new text beginCCBHC daily bundled rate new text endsystem deleted text beginratedeleted text end that overlaps with the CCBHC
rate is not eligible for the CCBHC rate;

(7) payments for CCBHC services to individuals enrolled in managed care shall be
coordinated with the state's phase-out of CCBHC wrap payments. The commissioner shall
complete the phase-out of CCBHC wrap payments within 60 days of the implementation
of the deleted text beginprospective paymentdeleted text end new text beginCCBHC daily bundled rate new text endsystem in the Medicaid Management
Information System (MMIS), for CCBHCs reimbursed under this chapter, with a final
settlement of payments due made payable to CCBHCs no later than 18 months thereafter;

(8) the deleted text beginprospective paymentdeleted text endnew text begin CCBHC daily bundlednew text end rate for each CCBHC shall be updated
by trending each provider-specific rate by the Medicare Economic Index for primary care
services. This update shall occur each year in between rebasing periods determined by the
commissioner in accordance with clause (4). CCBHCs must provide data on costs and visits
to the state annually using the CCBHC cost report established by the commissioner; and

(9) a CCBHC may request a rate adjustment for changes in the CCBHC's scope of
services when such changes are expected to result in an adjustment to the CCBHC payment
rate by 2.5 percent or more. The CCBHC must provide the commissioner with information
regarding the changes in the scope of services, including the estimated cost of providing
the new or modified services and any projected increase or decrease in the number of visits
resulting from the change. new text beginEstimated costs are subject to review by the commissioner. new text endRate
adjustments for changes in scope shall occur no more than once per year in between rebasing
periods per CCBHC and are effective on the date of the annual CCBHC rate update.

(d) Managed care plans and county-based purchasing plans shall reimburse CCBHC
providers at the deleted text beginprospective paymentdeleted text endnew text begin CCBHC daily bundlednew text end rate. The commissioner shall
monitor the effect of this requirement on the rate of access to the services delivered by
CCBHC providers. If, for any contract year, federal approval is not received for this
paragraph, the commissioner must adjust the capitation rates paid to managed care plans
and county-based purchasing plans for that contract year to reflect the removal of this
provision. Contracts between managed care plans and county-based purchasing plans and
providers to whom this paragraph applies must allow recovery of payments from those
providers if capitation rates are adjusted in accordance with this paragraph. Payment
recoveries must not exceed the amount equal to any increase in rates that results from this
provision. This paragraph expires if federal approval is not received for this paragraph at
any time.

(e) The commissioner shall implement a quality incentive payment program for CCBHCs
that meets the following requirements:

(1) a CCBHC shall receive a quality incentive payment upon meeting specific numeric
thresholds for performance metrics established by the commissioner, in addition to payments
for which the CCBHC is eligible under the deleted text beginprospective paymentdeleted text endnew text begin CCBHC daily bundled
rate
new text end system described in paragraph (c);

(2) a CCBHC must be certified and enrolled as a CCBHC for the entire measurement
year to be eligible for incentive payments;

(3) each CCBHC shall receive written notice of the criteria that must be met in order to
receive quality incentive payments at least 90 days prior to the measurement year; and

(4) a CCBHC must provide the commissioner with data needed to determine incentive
payment eligibility within six months following the measurement year. The commissioner
shall notify CCBHC providers of their performance on the required measures and the
incentive payment amount within 12 months following the measurement year.

(f) All claims to managed care plans for CCBHC services as provided under this section
shall be submitted directly to, and paid by, the commissioner on the dates specified no later
than January 1 of the following calendar year, if:

(1) one or more managed care plans does not comply with the federal requirement for
payment of clean claims to CCBHCs, as defined in Code of Federal Regulations, title 42,
section 447.45(b), and the managed care plan does not resolve the payment issue within 30
days of noncompliance; and

(2) the total amount of clean claims not paid in accordance with federal requirements
by one or more managed care plans is 50 percent of, or greater than, the total CCBHC claims
eligible for payment by managed care plans.

If the conditions in this paragraph are met between January 1 and June 30 of a calendar
year, claims shall be submitted to and paid by the commissioner beginning on January 1 of
the following year. If the conditions in this paragraph are met between July 1 and December
31 of a calendar year, claims shall be submitted to and paid by the commissioner beginning
on July 1 of the following year.

Sec. 8.

Minnesota Statutes 2020, section 256B.0941, is amended by adding a subdivision
to read:


new text begin Subd. 2a. new text end

new text begin Sleeping hours. new text end

new text begin During normal sleeping hours, a psychiatric residential
treatment facility provider must provide at least one staff person for every six residents
present within a living unit. A provider must adjust sleeping-hour staffing levels based on
the clinical needs of the residents in the facility.
new text end

Sec. 9.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 1, is amended
to read:


Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given them.

(a) "Children's therapeutic services and supports" means the flexible package of mental
health services for children who require varying therapeutic and rehabilitative levels of
intervention to treat a diagnosed emotional disturbance, as defined in section 245.4871,
subdivision 15
, or a diagnosed mental illness, as defined in section 245.462, subdivision
20. The services are time-limited interventions that are delivered using various treatment
modalities and combinations of services designed to reach treatment outcomes identified
in the individual treatment plan.

(b) "Clinical trainee" means a staff person who is qualified according to section 245I.04,
subdivision 6
.

(c) "Crisis planning" has the meaning given in section 245.4871, subdivision 9a.

(d) "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.

(e) "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.

(f) "Standard diagnostic assessment" means the assessment described in 245I.10,
subdivision 6
.

(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).

(i) "Emotional disturbance" has the meaning given in section 245.4871, subdivision 15.

deleted text begin (j) "Individual behavioral plan" means a plan of intervention, treatment, and services
for a child written by a mental health professional or a clinical trainee or mental health
practitioner under the treatment supervision of a mental health professional, to guide the
work of the mental health behavioral aide. The individual behavioral plan may be
incorporated into the child's individual treatment plan so long as the behavioral plan is
separately communicable to the mental health behavioral aide.
deleted text end

deleted text begin (k)deleted text endnew text begin (j)new text end "Individual treatment plan" means the plan described in section 245I.10,
subdivisions 7
and 8.

deleted text begin (l)deleted text endnew text begin (k)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 (m)deleted text endnew text begin (l)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 (n)deleted text endnew text begin (m)new text end "Mental health practitioner" means a staff person who is qualified according to
section 245I.04, subdivision 4.

deleted text begin (o)deleted text endnew text begin (n)new text end "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

deleted text begin (p)deleted text endnew text begin (o)new text end "Mental health service plan development" includes:

(1) deleted text beginthedeleted text end developmentdeleted text begin, review,deleted text end and revision of a child's individual treatment plandeleted text begin, including
involvement of the client or client's parents, primary caregiver, or other person authorized
to consent to mental health services for the client, and including arrangement of treatment
and support activities specified in the individual treatment plan
deleted text end; and

(2) administering and reporting the standardized outcome measurements in section
245I.10, subdivision 6, paragraph (d), clauses (3) and (4), and other standardized outcome
measurements approved by the commissioner, as periodically needed to evaluate the
effectiveness of treatment.

deleted text begin (q)deleted text endnew text begin (p)new text end "Mental illness," for persons at least age 18 but under age 21, has the meaning
given in section 245.462, subdivision 20, paragraph (a).

deleted text begin (r)deleted text endnew text begin (q)new text end "Psychotherapy" means the treatment described in section 256B.0671, subdivision
11
.

deleted text begin (s)deleted text endnew text begin (r)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 (t)deleted text endnew text begin (s)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 (u)deleted text endnew text begin (t)new text end "Treatment supervision" means the supervision described in section 245I.06.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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 2021 Supplement, 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. The standard diagnostic assessment must:

(1) determine whether a child under age 18 has a diagnosis of emotional disturbance or,
if the person is between the ages of 18 and 21, whether the person has a mental illness;

(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.

new text begin (c) Children's therapeutic services and supports include development and rehabilitative
services that support a child's developmental treatment needs.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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 2021 Supplement, section 256B.0943, subdivision 4, is
amended to read:


Subd. 4.

Provider entity certification.

(a) The commissioner shall establish an initial
provider entity application and certification process and recertification process to determine
whether a provider entity has an administrative and clinical infrastructure that meets the
requirements in subdivisions 5 and 6. A provider entity must be certified for the three core
rehabilitation services of psychotherapy, skills training, and crisis planning. The
commissioner shall recertify a provider entity deleted text beginat leastdeleted text end every three years new text beginusing the individual
provider's certification anniversary or the calendar year end, whichever is later. The
commissioner may approve a recertification extension, in the interest of sustaining services,
when a certain date for recertification is identified
new text end. The commissioner shall establish a
process for decertification of a provider entity and shall require corrective action, medical
assistance repayment, or decertification of a provider entity that no longer meets the
requirements in this section or that fails to meet the clinical quality standards or administrative
standards provided by the commissioner in the application and certification process.

new text begin (b) The commissioner must provide the following to providers for the certification,
recertification, and decertification processes:
new text end

new text begin (1) a structured listing of required provider certification criteria;
new text end

new text begin (2) a formal written letter with a determination of certification, recertification, or
decertification, signed by the commissioner or the appropriate division director; and
new text end

new text begin (3) a formal written communication outlining the process for necessary corrective action
and follow-up by the commissioner, if applicable.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end For purposes of this section, a provider entity must meet the standards in this
section and chapter 245I, as required under section 245I.011, subdivision 5, and be:

(1) an Indian health services facility or a facility owned and operated by a tribe or tribal
organization operating as a 638 facility under Public Law 93-638 certified by the state;

(2) a county-operated entity certified by the state; or

(3) a noncounty entity certified by the state.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 12.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 6, is
amended to read:


Subd. 6.

Provider entity clinical infrastructure requirements.

(a) To be an eligible
provider entity under this section, a provider entity must have a clinical infrastructure that
utilizes diagnostic assessment, individual treatment plans, service delivery, and individual
treatment plan review that are culturally competent, child-centered, and family-driven to
achieve maximum benefit for the client. The provider entity must review, and update as
necessary, the clinical policies and procedures every three years, must distribute the policies
and procedures to staff initially and upon each subsequent update, and must train staff
accordingly.

(b) The clinical infrastructure written policies and procedures must include policies and
procedures for meeting the requirements in this subdivision:

(1) providing or obtaining a client's standard diagnostic assessment, including a standard
diagnostic assessment. When required components of the standard diagnostic assessment
are not provided in an outside or independent assessment or cannot be attained immediately,
the provider entity must determine the missing information within 30 days and amend the
child's standard diagnostic assessment or incorporate the information into the child's
individual treatment plan;

(2) developing an individual treatment plan;

deleted text begin (3) developing an individual behavior plan that documents and describes interventions
to be provided by the mental health behavioral aide. The individual behavior plan must
include:
deleted text end

deleted text begin (i) detailed instructions on the psychosocial skills to be practiced;
deleted text end

deleted text begin (ii) time allocated to each intervention;
deleted text end

deleted text begin (iii) methods of documenting the child's behavior;
deleted text end

deleted text begin (iv) methods of monitoring the child's progress in reaching objectives; and
deleted text end

deleted text begin (v) goals to increase or decrease targeted behavior as identified in the individual treatment
plan;
deleted text end

deleted text begin (4)deleted text endnew text begin (3)new text end providing treatment supervision plans for staff according to section 245I.06.
Treatment supervision does not include the authority to make or terminate court-ordered
placements of the child. A treatment supervisor must be available for urgent consultation
as required by the individual client's needs or the situation;

deleted text begin (5) meeting day treatment program conditions in items (i) and (ii):
deleted text end

deleted text begin (i) the treatment supervisor must be present and available on the premises more than 50
percent of the time in a provider's standard working week during which the supervisee is
providing a mental health service; and
deleted text end

deleted text begin (ii) every 30 days, the treatment supervisor must review and sign the record indicating
the supervisor has reviewed the client's care for all activities in the preceding 30-day period;
deleted text end

deleted text begin (6) meeting the treatment supervision standards in items (i) and (ii) for all other services
provided under CTSS:
deleted text end

deleted text begin (i) the mental health professional is required to be present at the site of service delivery
for observation as clinically appropriate when the clinical trainee, mental health practitioner,
or mental health behavioral aide is providing CTSS services; and
deleted text end

deleted text begin (ii) when conducted, the on-site presence of the mental health professional must be
documented in the child's record and signed by the mental health professional who accepts
full professional responsibility;
deleted text end

deleted text begin (7) providing direction to a mental health behavioral aide. For entities that employ mental
health behavioral aides, the treatment supervisor must be employed by the provider entity
or other provider certified to provide mental health behavioral aide services to ensure
necessary and appropriate oversight for the client's treatment and continuity of care. The
staff giving direction must begin with the goals on the individual treatment plan, and instruct
the mental health behavioral aide on how to implement therapeutic activities and interventions
that will lead to goal attainment. The staff giving direction must also instruct the mental
health behavioral aide about the client's diagnosis, functional status, and other characteristics
that are likely to affect service delivery. Direction must also include determining that the
mental health behavioral aide has the skills to interact with the client and the client's family
in ways that convey personal and cultural respect and that the aide actively solicits
information relevant to treatment from the family. The aide must be able to clearly explain
or demonstrate the activities the aide is doing with the client and the activities' relationship
to treatment goals. Direction is more didactic than is supervision and requires the staff
providing it to continuously evaluate the mental health behavioral aide's ability to carry out
the activities of the individual treatment plan and the individual behavior plan. When
providing direction, the staff must:
deleted text end

deleted text begin (i) review progress notes prepared by the mental health behavioral aide for accuracy and
consistency with diagnostic assessment, treatment plan, and behavior goals and the staff
must approve and sign the progress notes;
deleted text end

deleted text begin (ii) identify changes in treatment strategies, revise the individual behavior plan, and
communicate treatment instructions and methodologies as appropriate to ensure that treatment
is implemented correctly;
deleted text end

deleted text begin (iii) demonstrate family-friendly behaviors that support healthy collaboration among
the child, the child's family, and providers as treatment is planned and implemented;
deleted text end

deleted text begin (iv) ensure that the mental health behavioral aide is able to effectively communicate
with the child, the child's family, and the provider;
deleted text end

deleted text begin (v) record the results of any evaluation and corrective actions taken to modify the work
of the mental health behavioral aide; and
deleted text end

deleted text begin (vi) ensure deleted text end new text begin (4) requiring a mental health professional to determine the level of supervision
for a behavioral health aide and to document and sign the supervision determination in the
behavioral health aide's supervision plan;
new text end

new text begin (5) ensuringnew text end the immediate accessibility of a mental health professional, clinical trainee,
or mental health practitioner to the behavioral aide during service delivery;

deleted text begin (8)deleted text endnew text begin (6)new text end providing service delivery that implements the individual treatment plan and
meets the requirements under subdivision 9; and

deleted text begin (9)deleted text endnew text begin (7)new text end individual treatment plan review. The review must determine the extent to which
the services have met each of the goals and objectives in the treatment plan. The review
must assess the client's progress and ensure that services and treatment goals continue to
be necessary and appropriate to the client and the client's family or foster family.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 13.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 7, is
amended to read:


Subd. 7.

Qualifications of individual and team providers.

(a) An individual or team
provider working within the scope of the provider's practice or qualifications may provide
service components of children's therapeutic services and supports that are identified as
medically necessary in a client's individual treatment plan.

(b) An individual provider must be qualified as a:

(1) mental health professional;

(2) clinical trainee;

(3) mental health practitioner;

(4) mental health certified family peer specialist; or

(5) mental health behavioral aide.

(c) A day treatment team must include deleted text beginat leastdeleted text end one mental health professional or clinical
trainee deleted text beginand one mental health practitionerdeleted text end.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 14.

Minnesota Statutes 2021 Supplement, 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. deleted text beginThe program must be available year-round at least three to five days per week,
two or three hours per day, unless the normal five-day school week is shortened by a holiday,
weather-related cancellation, or other districtwide reduction in a school week. A child
transitioning into or out of day treatment must receive a minimum treatment of one day a
week for a two-hour time block. The two-hour time block must include at least one hour of
patient and/or family or group psychotherapy.
deleted text end 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 deliverdeleted text begin,deleted text end or arrange
fordeleted text begin,deleted text end medically necessary psychotherapydeleted text begin,deleted text end unless the child's parent or caregiver chooses not
to receive it new text beginor 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
new text end. deleted text beginWhen a provider delivering other services to a child under this section deems
it not medically necessary to provide psychotherapy to the child for a period of 90 days or
longer, the provider entity must document the medical reasons why psychotherapy is not
necessary.
deleted text end 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;

deleted text begin (iii) the mental health professional delivering or supervising the delivery of skills training
must document any underlying psychiatric condition and must document how skills training
is being used in conjunction with psychotherapy to address the underlying condition;
deleted text end

deleted text begin (iv) skills training delivered to the child's family must teach skills needed by parents to
enhance the child's skill development, to help the child utilize daily life skills taught by a
mental health professional, clinical trainee, or mental health practitioner, and to develop or
maintain a home environment that supports the child's progressive use of skills;
deleted text end

deleted text begin (v)deleted text endnew text begin (iii)new text end 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;

deleted text begin (vi)deleted text endnew text begin (iv)new text end 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

deleted text begin (vii)deleted text endnew text begin (v)new text end 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 deleted text beginand individual behavior plandeleted text enddeleted text begin, and which
are designed to improve the functioning of the child in the progressive use of developmentally
appropriate psychosocial skills. Activities involve working directly with the child, child-peer
groupings, or child-family groupings to practice, repeat, reintroduce, and master the skills
defined in subdivision 1, paragraph (t), as previously taught by a mental health professional,
clinical trainee, or mental health practitioner including:
deleted text endnew text begin.
new text end

deleted text begin (i) providing cues or prompts in skill-building peer-to-peer or parent-child interactions
so that the child progressively recognizes and responds to the cues independently;
deleted text end

deleted text begin (ii) performing as a practice partner or role-play partner;
deleted text end

deleted text begin (iii) reinforcing the child's accomplishments;
deleted text end

deleted text begin (iv) generalizing skill-building activities in the child's multiple natural settings;
deleted text end

deleted text begin (v) assigning further practice activities; and
deleted text end

deleted text begin (vi) intervening as necessary to redirect the child's target behavior and to de-escalate
behavior that puts the child or other person at risk of injury.
deleted text end

To be eligible for medical assistance payment, mental health behavioral aide services must
be delivered to a child who has been diagnosed with an emotional disturbance or a mental
illness, as provided in subdivision 1, paragraph (a). deleted text beginThe mental health behavioral aide must
implement treatment strategies in the individual treatment plan and the individual behavior
plan as developed by the mental health professional, clinical trainee, or mental health
practitioner providing direction for the mental health behavioral aide.
deleted text end 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.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 15.

Minnesota Statutes 2021 Supplement, section 256B.0943, subdivision 11, is
amended to read:


Subd. 11.

Documentation and billing.

new text begin(a)new text end A provider entity must document the services
it provides under this section. The provider entity must ensure that documentation complies
with Minnesota Rules, parts 9505.2175 and 9505.2197. Services billed under this section
that are not documented according to this subdivision shall be subject to monetary recovery
by the commissioner. Billing for covered service components under subdivision 2, paragraph
(b), must not include anything other than direct service time.

new text begin (b) Required documentation must be completed for each individual provider and service
modality for each day a child receives a service under subdivision 2, paragraph (b).
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023, 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. 16.

Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 2, is
amended to read:


Subd. 2.

Definitions.

For purposes of this section, the following terms have the meanings
given them.

(a) "Intensive nonresidential rehabilitative mental health services" means child
rehabilitative mental health services as defined in section 256B.0943, except that these
services are provided by a multidisciplinary staff using a total team approach consistent
with assertive community treatment, as adapted for youth, and are directed to recipients
who are eight years of age or older and under deleted text begin26deleted text endnew text begin 21new text end years of age who require intensive
services to prevent admission to an inpatient psychiatric hospital or placement in a residential
treatment facility or who require intensive services to step down from inpatient or residential
care to community-based care.

(b) "Co-occurring mental illness and substance use disorder" means a dual diagnosis of
at least one form of mental illness and at least one substance use disorder. Substance use
disorders include alcohol or drug abuse or dependence, excluding nicotine use.

(c) "Standard diagnostic assessment" means the assessment described in section 245I.10,
subdivision 6
.

(d) "Medication education services" means services provided individually or in groups,
which focus on:

(1) educating the client and client's family or significant nonfamilial supporters about
mental illness and symptoms;

(2) the role and effects of medications in treating symptoms of mental illness; and

(3) the side effects of medications.

Medication education is coordinated with medication management services and does not
duplicate it. Medication education services are provided by physicians, pharmacists, or
registered nurses with certification in psychiatric and mental health care.

(e) "Mental health professional" means a staff person who is qualified according to
section 245I.04, subdivision 2.

(f) "Provider agency" means a for-profit or nonprofit organization established to
administer an assertive community treatment for youth team.

(g) "Substance use disorders" means one or more of the disorders defined in the diagnostic
and statistical manual of mental disorders, current edition.

(h) "Transition services" means:

(1) activities, materials, consultation, and coordination that ensures continuity of the
client's care in advance of and in preparation for the client's move from one stage of care
or life to another by maintaining contact with the client and assisting the client to establish
provider relationships;

(2) providing the client with knowledge and skills needed posttransition;

(3) establishing communication between sending and receiving entities;

(4) supporting a client's request for service authorization and enrollment; and

(5) establishing and enforcing procedures and schedules.

A youth's transition from the children's mental health system and services to the adult
mental health system and services and return to the client's home and entry or re-entry into
community-based mental health services following discharge from an out-of-home placement
or inpatient hospital stay.

(i) "Treatment team" means all staff who provide services to recipients under this section.

(j) "Family peer specialist" means a staff person who is qualified under section
256B.0616.

Sec. 17.

Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 3, is
amended to read:


Subd. 3.

Client eligibility.

An eligible recipient is an individual who:

(1) is eight years of age or older and under deleted text begin26deleted text endnew text begin 21new text end years of age;

(2) is diagnosed with a serious mental illness or co-occurring mental illness and substance
use disorder, for which intensive nonresidential rehabilitative mental health services are
needed;

(3) has received a level of care assessment as defined in section 245I.02, subdivision
19
, that indicates a need for intensive integrated intervention without 24-hour medical
monitoring and a need for extensive collaboration among multiple providers;

(4) has received a functional assessment as defined in section 245I.02, subdivision 17,
that indicates functional impairment and a history of difficulty in functioning safely and
successfully in the community, school, home, or job; or who is likely to need services from
the adult mental health system during adulthood; and

(5) has had a recent standard diagnostic assessment that documents that intensive
nonresidential rehabilitative mental health services are medically necessary to ameliorate
identified symptoms and functional impairments and to achieve individual transition goals.

Sec. 18.

Minnesota Statutes 2021 Supplement, section 256B.0947, subdivision 5, is
amended to read:


Subd. 5.

Standards for intensive nonresidential rehabilitative providers.

(a) Services
must meet the standards in this section and chapter 245I as required in section 245I.011,
subdivision 5
.

(b) The treatment team must have specialized training in providing services to the specific
age group of youth that the team serves. An individual treatment team must serve youth
who are: (1) at least eight years of age or older and under 16 years of age, or (2) at least 14
years of age or older and under deleted text begin26deleted text endnew text begin 21new text end years of age.

(c) The treatment team for intensive nonresidential rehabilitative mental health services
comprises both permanently employed core team members and client-specific team members
as follows:

(1) Based on professional qualifications and client needs, clinically qualified core team
members are assigned on a rotating basis as the client's lead worker to coordinate a client's
care. The core team must comprise at least four full-time equivalent direct care staff and
must minimally include:

(i) a mental health professional who serves as team leader to provide administrative
direction and treatment supervision to the team;

(ii) an advanced-practice registered nurse with certification in psychiatric or mental
health care or a board-certified child and adolescent psychiatrist, either of which must be
credentialed to prescribe medications;

(iii) a licensed alcohol and drug counselor who is also trained in mental health
interventions; and

(iv) a mental health certified peer specialist who is qualified according to section 245I.04,
subdivision 10
, and is also a former children's mental health consumer.

(2) The core team may also include any of the following:

(i) additional mental health professionals;

(ii) a vocational specialist;

(iii) an educational specialist with knowledge and experience working with youth
regarding special education requirements and goals, special education plans, and coordination
of educational activities with health care activities;

(iv) a child and adolescent psychiatrist who may be retained on a consultant basis;

(v) a clinical trainee qualified according to section 245I.04, subdivision 6;

(vi) a mental health practitioner qualified according to section 245I.04, subdivision 4;

(vii) a case management service provider, as defined in section 245.4871, subdivision
4
;

(viii) a housing access specialist; and

(ix) a family peer specialist as defined in subdivision 2, paragraph (j).

(3) A treatment team may include, in addition to those in clause (1) or (2), ad hoc
members not employed by the team who consult on a specific client and who must accept
overall clinical direction from the treatment team for the duration of the client's placement
with the treatment team and must be paid by the provider agency at the rate for a typical
session by that provider with that client or at a rate negotiated with the client-specific
member. Client-specific treatment team members may include:

(i) the mental health professional treating the client prior to placement with the treatment
team;

(ii) the client's current substance use counselor, if applicable;

(iii) a lead member of the client's individualized education program team or school-based
mental health provider, if applicable;

(iv) a representative from the client's health care home or primary care clinic, as needed
to ensure integration of medical and behavioral health care;

(v) the client's probation officer or other juvenile justice representative, if applicable;
and

(vi) the client's current vocational or employment counselor, if applicable.

(d) The treatment supervisor shall be an active member of the treatment team and shall
function as a practicing clinician at least on a part-time basis. The treatment team shall meet
with the treatment supervisor at least weekly to discuss recipients' progress and make rapid
adjustments to meet recipients' needs. The team meeting must include client-specific case
reviews and general treatment discussions among team members. Client-specific case
reviews and planning must be documented in the individual client's treatment record.

(e) The staffing ratio must not exceed ten clients to one full-time equivalent treatment
team position.

(f) The treatment team shall serve no more than 80 clients at any one time. Should local
demand exceed the team's capacity, an additional team must be established rather than
exceed this limit.

(g) Nonclinical staff shall have prompt access in person or by telephone to a mental
health practitioner, clinical trainee, or mental health professional. The provider shall have
the capacity to promptly and appropriately respond to emergent needs and make any
necessary staffing adjustments to ensure the health and safety of clients.

(h) The intensive nonresidential rehabilitative mental health services provider shall
participate in evaluation of the assertive community treatment for youth (Youth ACT) model
as conducted by the commissioner, including the collection and reporting of data and the
reporting of performance measures as specified by contract with the commissioner.

(i) A regional treatment team may serve multiple counties.

Sec. 19.

Minnesota Statutes 2020, section 626.5571, subdivision 1, is amended to read:


Subdivision 1.

Establishment of team.

A county may establish a multidisciplinary adult
protection team comprised of the director of the local welfare agency or designees, the
county attorney or designees, the county sheriff or designees, and representatives of health
care. In addition, representatives of mental health or other appropriate human service
agencies, new text begincommunity corrections agencies, new text endrepresentatives from local tribal governments,
new text begin local law enforcement agencies or designees thereof, new text endand adult advocate groups may be
added to the adult protection team.

Sec. 20.

new text begin [626.8477] MENTAL HEALTH AND HEALTH RECORDS; WRITTEN
POLICY REQUIRED.
new text end

new text begin The chief officer of every state and local law enforcement agency that seeks or uses
mental health data under section 13.46, subdivision 7, paragraph (c), or health records under
section 144.294, subdivision 2, must establish and enforce a written policy governing its
use. At a minimum, the written policy must incorporate the requirements of sections 13.46,
subdivision 7, paragraph (c), and 144.294, subdivision 2, and access procedures, retention
policies, and data security safeguards that, at a minimum, meet the requirements of chapter
13 and any other applicable law.
new text end

Sec. 21.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:


Subd. 33.

Grant Programs; Chemical
Dependency Treatment Support Grants

Appropriations by Fund
General
4,273,000
4,274,000
Lottery Prize
1,733,000
1,733,000
Opiate Epidemic
Response
500,000
500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
are from the lottery prize fund for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants.
$2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders. The general fund base for this
appropriation is $2,000,000 in fiscal year 2024
and $0 in fiscal year 2025

(c) new text beginGrant to Anoka County for Enhanced
Treatment Program.
new text end
new text begin $125,000 in fiscal year
2023 is from the general fund for a grant to
Anoka County for an enhanced treatment
program for substance use disorder. This
paragraph does not expire.
new text end

new text begin (d) new text endBase Level Adjustment. The general fund
base is $4,636,000 in fiscal year 2024 and
$2,636,000 in fiscal year 2025. The opiate
epidemic response fund base is $500,000 in
fiscal year 2024 and $0 in fiscal year 2025.

Sec. 22.

Laws 2021, First Special Session chapter 7, article 17, section 1, subdivision 2,
is amended to read:


Subd. 2.

Eligibility.

An individual is eligible for the transition to community initiative
if the individual does not meet eligibility criteria for the medical assistance program under
section 256B.056 or 256B.057, but who meets at least one of the following criteria:

(1) the person otherwise 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
or a secure treatment setting, but the person's discharge from the Anoka Metro Regional
Treatment Center, the Minnesota Security Hospital, or a community behavioral health
hospital would be substantially delayed without additional resources available through the
transitions to community initiative;

(3) the person is in a community hospital deleted text beginand on the waiting list for the Anoka Metro
Regional Treatment Center
deleted text end, but alternative community living options would be appropriate
for the person, and the person has received approval from the commissioner; or

(4)(i) the person 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) the person expresses
a desire to move; and (iii) the person has received approval from the commissioner.

Sec. 23. new text beginREVIEW OF HUMAN SERVICES STRUCTURE; RECOMMENDATION
FOR 2023 LEGISLATIVE SESSION.
new text end

new text begin (a) No later than September 1, 2022, the addiction and recovery director must contract
with a consultant to conduct an independent review of the structure of the Department of
Human Services, with a focus on substance use disorder and mental health treatment access
and service delivery. The review must be completed no later than December 31, 2022.
new text end

new text begin (b) In addition to the duties prescribed by Minnesota Statutes, section 4.046, the Opioids,
Substance Use, and Addiction Subcabinet must submit a recommendation to the legislature
for the creation of a permanent Office of Opioid Use, Substance Use, and Addiction,
including proposed statutory language that establishes the office and provides initial goals.
This recommendation must be submitted to the chairs and ranking minority members of the
legislative committees with jurisdiction over opioid and substance use disorder treatment
and prevention no later than December 31, 2022.
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. 24. new text beginIMPACT ON EXECUTIVE ORDER.
new text end

new text begin Sections 1 and 23 supersede the requirements of Executive Order No. 22-07, filed April
7, 2022. To the extent a conflict exists between that executive order and this act, the
provisions of this act prevail.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 25. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the terms "medication-assisted treatment" and
"medication-assisted therapy" or similar terms to "substance use disorder treatment with
medications for opioid use disorder" whenever the terms appear in Minnesota Statutes and
Minnesota Rules. The revisor may make technical and other necessary grammatical changes
related to the term change.
new text end

Sec. 26. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 256B.0943, subdivision 8a, new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

ARTICLE 7

CONTINUING CARE FOR OLDER ADULTS POLICY

Section 1.

Minnesota Statutes 2020, section 245A.14, subdivision 14, is amended to read:


Subd. 14.

Attendance records for publicly funded services.

(a) A child care center
licensed under this chapter and according to Minnesota Rules, chapter 9503, must maintain
documentation of actual attendance for each child receiving care for which the license holder
is reimbursed by a governmental program. The records must be accessible to the
commissioner during the program's hours of operation, they must be completed on the actual
day of attendance, and they must include:

(1) the first and last name of the child;

(2) the time of day that the child was dropped off; and

(3) the time of day that the child was picked up.

(b) A family child care provider licensed under this chapter and according to Minnesota
Rules, chapter 9502, must maintain documentation of actual attendance for each child
receiving care for which the license holder is reimbursed for the care of that child by a
governmental program. The records must be accessible to the commissioner during the
program's hours of operation, they must be completed on the actual day of attendance, and
they must include:

(1) the first and last name of the child;

(2) the time of day that the child was dropped off; and

(3) the time of day that the child was picked up.

(c) An adult day services program licensed under this chapter and according to Minnesota
Rules, parts 9555.5105 to 9555.6265, must maintain documentation of actual attendance
for each adult day service recipient for which the license holder is reimbursed by a
governmental program. The records must be accessible to the commissioner during the
program's hours of operation, they must be completed on the actual day of attendance, and
they must include:

(1) the first, middle, and last name of the recipient;

(2) the time of day that the recipient was dropped off; and

(3) the time of day that the recipient was picked up.

(d) deleted text beginThe commissioner shall not issue a correction for attendance record errors that occur
before August 1, 2013.
deleted text endnew text begin Adult day services programs licensed under this chapter that are
designated for remote adult day services must maintain documentation of actual participation
for each adult day service recipient for whom the license holder is reimbursed by a
governmental program. The records must be accessible to the commissioner during the
program's hours of operation, must be completed on the actual day service is provided, and
must include the:
new text end

new text begin (1) first, middle, and last name of the recipient;
new text end

new text begin (2) time of day the remote services started;
new text end

new text begin (3) time of day that the remote services ended; and
new text end

new text begin (4) means by which the remote services were provided, through audio remote services
or through audio and video remote services.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 2.

new text begin [245A.70] REMOTE ADULT DAY SERVICES.
new text end

new text begin (a) For the purposes of sections 245A.70 to 245A.75, the following terms have the
meanings given.
new text end

new text begin (b) "Adult day care" and "adult day services" have the meanings given in section 245A.02,
subdivision 2a.
new text end

new text begin (c) "Remote adult day services" means an individualized and coordinated set of services
provided via live two-way communication by an adult day care or adult day services center.
new text end

new text begin (d) "Live two-way communication" means real-time audio or audio and video
transmission of information between a participant and an actively involved staff member.
new text end

Sec. 3.

new text begin [245A.71] APPLICABILITY AND SCOPE.
new text end

new text begin Subdivision 1. new text end

new text begin Licensing requirements. new text end

new text begin Adult day care centers or adult day services
centers that provide remote adult day services must be licensed under this chapter and
comply with the requirements set forth in this section.
new text end

new text begin Subd. 2. new text end

new text begin Standards for licensure. new text end

new text begin License holders seeking to provide remote adult day
services must submit a request in the manner prescribed by the commissioner. Remote adult
day services must not be delivered until approved by the commissioner. The designation to
provide remote services is voluntary for license holders. Upon approval, the designation of
approval for remote adult day services must be printed on the center's license, and identified
on the commissioner's public website.
new text end

new text begin Subd. 3. new text end

new text begin Federal requirements. new text end

new text begin Adult day care centers or adult day services centers
that provide remote adult day services to participants receiving alternative care under section
256B.0913, essential community supports under section 256B.0922, or home and
community-based services waivers under chapter 256S or section 256B.092 or 256B.49
must comply with federally approved waiver plans.
new text end

new text begin Subd. 4. new text end

new text begin Service limitations. new text end

new text begin Remote adult day services must be provided during the
days and hours of in-person services specified on the license of the adult day care center or
adult day services center.
new text end

Sec. 4.

new text begin [245A.72] RECORD REQUIREMENTS.
new text end

new text begin Adult day care centers and adult day services centers providing remote adult day services
must comply with participant record requirements set forth in Minnesota Rules, part
9555.9660. The center must document how remote services will help a participant reach
the short- and long-term objectives in the participant's plan of care.
new text end

Sec. 5.

new text begin [245A.73] REMOTE ADULT DAY SERVICES STAFF.
new text end

new text begin Subdivision 1. new text end

new text begin Staff ratios. new text end

new text begin (a) A staff person who provides remote adult day services
without two-way interactive video must only provide services to one participant at a time.
new text end

new text begin (b) A staff person who provides remote adult day services through two-way interactive
video must not provide services to more than eight participants at one time.
new text end

new text begin Subd. 2. new text end

new text begin Staff training. new text end

new text begin A center licensed under section 245A.71 must document training
provided to each staff person regarding the provision of remote services in the staff person's
record. The training must be provided prior to a staff person delivering remote adult day
services without supervision. The training must include:
new text end

new text begin (1) how to use the equipment, technology, and devices required to provide remote adult
day services via live two-way communication;
new text end

new text begin (2) orientation and training on each participant's plan of care as directly related to remote
adult day services; and
new text end

new text begin (3) direct observation by a manager or supervisor of the staff person while providing
supervised remote service delivery sufficient to assess staff competency.
new text end

Sec. 6.

new text begin [245A.74] INDIVIDUAL SERVICE PLANNING.
new text end

new text begin Subdivision 1. new text end

new text begin Eligibility. new text end

new text begin (a) A person must be eligible for and receiving in-person
adult day services to receive remote adult day services from the same provider. The same
provider must deliver both in-person adult day services and remote adult day services to a
participant.
new text end

new text begin (b) The license holder must update the participant's plan of care according to Minnesota
Rules, part 9555.9700.
new text end

new text begin (c) For a participant who chooses to receive remote adult day services, the license holder
must document in the participant's plan of care the participant's proposed schedule and
frequency for receiving both in-person and remote services. The license holder must also
document in the participant's plan of care that remote services:
new text end

new text begin (1) are chosen as a service delivery method by the participant or the participant's legal
representative;
new text end

new text begin (2) will meet the participant's assessed needs;
new text end

new text begin (3) are provided within the scope of adult day services; and
new text end

new text begin (4) will help the participant achieve identified short and long-term objectives specific
to the provision of remote adult day services.
new text end

new text begin Subd. 2. new text end

new text begin Participant daily service limitations. new text end

new text begin In a 24-hour period, a participant may
receive:
new text end

new text begin (1) a combination of in-person adult day services and remote adult day services on the
same day but not at the same time;
new text end

new text begin (2) a combination of in-person and remote adult day services that does not exceed 12
hours in total; and
new text end

new text begin (3) up to six hours of remote adult day services.
new text end

new text begin Subd. 3. new text end

new text begin Minimum in-person requirement. new text end

new text begin A participant who receives remote services
must receive services in-person as assigned in the participant's plan of care at least quarterly.
new text end

Sec. 7.

new text begin [245A.75] SERVICE AND PROGRAM REQUIREMENTS.
new text end

new text begin Remote adult day services must be in the scope of adult day services provided in
Minnesota Rules, part 9555.9710, subparts 3 to 7.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 8.

Minnesota Statutes 2020, section 256R.02, subdivision 4, is amended to read:


Subd. 4.

Administrative costs.

"Administrative costs" means the identifiable costs for
administering the overall activities of the nursing home. These costs include salaries and
wages of the administrator, assistant administrator, business office employees, security
guards, new text beginpurchasing and inventory employees, new text endand associated fringe benefits and payroll
taxes, fees, contracts, or purchases related to business office functions, licenses, permits
except as provided in the external fixed costs category, employee recognition, travel including
meals and lodging, all training except as specified in subdivision 17, voice and data
communication or transmission, office supplies, property and liability insurance and other
forms of insurance except insurance that is a fringe benefit under subdivision 22, personnel
recruitment, legal services, accounting services, management or business consultants, data
processing, information technology, website, central or home office costs, business meetings
and seminars, postage, fees for professional organizations, subscriptions, security services,
new text begin nonpromotional new text endadvertising, board of directors fees, working capital interest expense, bad
debts, bad debt collection fees, and costs incurred for travel and deleted text beginhousingdeleted text endnew text begin lodgingnew text end for persons
employed by a new text beginMinnesota-registered new text endsupplemental nursing services agency as defined in
section 144A.70, subdivision 6.

Sec. 9.

Minnesota Statutes 2020, section 256R.02, subdivision 17, is amended to read:


Subd. 17.

Direct care costs.

"Direct care costs" means costs for the wages of nursing
administration, direct care registered nurses, licensed practical nurses, certified nursing
assistants, trained medication aides, employees conducting training in resident care topics
and associated fringe benefits and payroll taxes; services from a new text beginMinnesota-registered
new text end supplemental nursing services agencynew text begin up to the maximum allowable charges under section
144A.74, excluding associated lodging and travel costs
new text end; supplies that are stocked at nursing
stations or on the floor and distributed or used individually, including, but not limited to:
new text begin rubbing new text endalcoholnew text begin or alcohol swabsnew text end, applicators, cotton balls, incontinence pads, disposable
ice bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas,
enema equipment, new text beginpersonal hygiene new text endsoap, medication cups, diapers, deleted text beginplastic waste bags,deleted text end
sanitary products, new text begindisposable new text endthermometers, hypodermic needles and syringes, deleted text beginclinical
reagents or similar diagnostic agents,
deleted text end drugs deleted text beginthat are not paiddeleted text endnew text begin not payablenew text end on a separate fee
schedule by the medical assistance program or any other payer, and deleted text begintechnology relateddeleted text endnew text begin
clinical software costs specific
new text end to the provision of nursing care to residents, such as electronic
charting systems; costs of materials used for resident care training, and training courses
outside of the facility attended by direct care staff on resident care topics; and costs for
nurse consultants, pharmacy consultants, and medical directors. Salaries and payroll taxes
for nurse consultants who work out of a central office must be allocated proportionately by
total resident days or by direct identification to the nursing facilities served by those
consultants.

Sec. 10.

Minnesota Statutes 2020, section 256R.02, subdivision 18, is amended to read:


Subd. 18.

Employer health insurance costs.

"Employer health insurance costs" meansnew text begin:
new text end

new text begin (1) new text endpremium expenses for group coverage;

new text begin (2) new text endactual expenses incurred for self-insured plans, including deleted text beginreinsurance;deleted text endnew text begin actual claims
paid, stop-loss premiums, and plan fees. Actual expenses incurred for self-insured plans
does not include allowances for future funding unless the plan meets the Medicare
requirements for reporting on a premium basis when the Medicare regulations define the
actual costs;
new text end and

new text begin (3) new text endemployer contributions tonew text begin employer-sponsored individual coverage health
reimbursement arrangements as provided by Code of Federal Regulations, title 45, section
146.123,
new text end employee health reimbursementnew text begin accounts,new text end and health savings accounts. deleted text beginPremium
and expense costs and contributions are allowable for (1) all employees and (2) the spouse
and dependents of those employees who are employed on average at least 30 hours per
week.
deleted text end

Sec. 11.

Minnesota Statutes 2020, section 256R.02, subdivision 22, is amended to read:


Subd. 22.

Fringe benefit costs.

"Fringe benefit costs" means the costs for group life,
dental, workers' compensation, short- and long-term disability, long-term care insurance,
accident insurance, supplemental insurance, legal assistance insurance, profit sharing,new text begin child
care costs,
new text end health insurance costs not covered under subdivision 18, including costs associated
with part-time employee family members or retirees, and pension and retirement plan
contributions, except for the Public Employees Retirement Association costs.

Sec. 12.

Minnesota Statutes 2020, section 256R.02, subdivision 29, is amended to read:


Subd. 29.

Maintenance and plant operations costs.

"Maintenance and plant operations
costs" means the costs for the salaries and wages of the maintenance supervisor, engineers,
heating-plant employees, and other maintenance employees and associated fringe benefits
and payroll taxes. It also includes identifiable costs for maintenance and operation of the
building and grounds, including, but not limited to, fuel, electricity, new text beginplastic waste bags,
new text end medical waste and garbage removal, water, sewer, supplies, tools, deleted text beginanddeleted text end repairsnew text begin, and minor
equipment not requiring capitalization under Medicare guidelines
new text end.

Sec. 13.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision
to read:


new text begin Subd. 32a. new text end

new text begin Minor equipment. new text end

new text begin "Minor equipment" means equipment that does not qualify
as either fixed equipment or depreciable movable equipment as defined in section 256R.261.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256R.02, subdivision 42a, is amended to read:


Subd. 42a.

Real estate taxes.

"Real estate taxes" means the real estate tax liability shown
on the annual property tax deleted text beginstatementdeleted text endnew text begin statementsnew text end of the nursing facility for the reporting
period. The term does not include personnel costs or fees for late payment.

Sec. 15.

Minnesota Statutes 2020, section 256R.02, subdivision 48a, is amended to read:


Subd. 48a.

Special assessments.

"Special assessments" means the actual special
assessments and related interest paid during the reporting periodnew text begin that are not voluntary costsnew text end.
The term does not include personnel costs deleted text beginordeleted text endnew text begin,new text end fees for late paymentnew text begin, or special assessments
for projects that are reimbursed in the property rate
new text end.

Sec. 16.

Minnesota Statutes 2020, section 256R.02, is amended by adding a subdivision
to read:


new text begin Subd. 53. new text end

new text begin Vested. new text end

new text begin "Vested" means the existence of a legally fixed unconditional right
to a present or future benefit.
new text end

Sec. 17.

Minnesota Statutes 2020, section 256R.07, subdivision 1, is amended to read:


Subdivision 1.

Criteria.

A nursing facility deleted text beginshalldeleted text endnew text begin mustnew text end keep adequate documentation. In
order to be adequate, documentation must:

(1) be maintained in orderly, well-organized files;

(2) not include documentation of more than one nursing facility in one set of files unless
transactions may be traced by the commissioner to the nursing facility's annual cost report;

(3) include a paid invoice or copy of a paid invoice with date of purchase, vendor name
and address, purchaser name and delivery destination address, listing of items or services
purchased, cost of items purchased, account number to which the cost is posted, and a
breakdown of any allocation of costs between accounts or nursing facilities. If any of the
information is not available, the nursing facility deleted text beginshalldeleted text endnew text begin mustnew text end document its good faith attempt
to obtain the information;

(4) include contracts, agreements, amortization schedules, mortgages, other debt
instruments, and all other documents necessary to explain the nursing facility's costs or
revenues; deleted text beginand
deleted text end

(5) new text begininclude signed and dated position descriptions; and
new text end

new text begin (6) new text endbe retained by the nursing facility to support the five most recent annual cost reports.
The commissioner may extend the period of retention if the field audit was postponed
because of inadequate record keeping or accounting practices as in section 256R.13,
subdivisions 2
and 4, the records are necessary to resolve a pending appeal, or the records
are required for the enforcement of sections 256R.04; 256R.05, subdivision 2; 256R.06,
subdivisions 2
, 6, and 7; 256R.08, subdivisions 1 deleted text begintodeleted text endnew text begin andnew text end 3; and 256R.09, subdivisions 3 and
4.

Sec. 18.

Minnesota Statutes 2020, section 256R.07, subdivision 2, is amended to read:


Subd. 2.

Documentation of compensation.

Compensation for personal services,
regardless of whether treated as identifiable costs or costs that are not identifiable, must be
documented on payroll records. Payrolls must be supported by time and attendance or
equivalent records for individual employees. Salaries and wages of employees which are
allocated to more than one cost category must be supported by time distribution records.
deleted text begin The method used must produce a proportional distribution of actual time spent, or an accurate
estimate of time spent performing assigned duties. The nursing facility that chooses to
estimate time spent must use a statistically valid method. The compensation must reflect
an amount proportionate to a full-time basis if the services are rendered on less than a
full-time basis.
deleted text endnew text begin Salary allocations are allowable using the Medicare-approved allocation
basis and methodology only if the salary costs cannot be directly determined, including
when employees provide shared services to noncovered operations.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256R.07, subdivision 3, is amended to read:


Subd. 3.

Adequate documentation supporting nursing facility payrolls.

Payroll
records supporting compensation costs claimed by nursing facilities must be supported by
affirmative time and attendance records prepared by each individual at intervals of not more
than one month. The requirements of this subdivision are met when documentation is
provided under either clause (1) or (2) deleted text beginas followsdeleted text end:

(1) the affirmative time and attendance record must identify the individual's name; the
days worked during each pay period; the number of hours worked each day; and the number
of hours taken each day by the individual for vacation, sick, and other leave. The affirmative
time and attendance record must include a signed verification by the individual and the
individual's supervisor, if any, that the entries reported on the record are correct; or

(2) if the affirmative time and attendance records identifying the individual's name, the
days worked each pay period, the number of hours worked each day, and the number of
hours taken each day by the individual for vacation, sick, and other leave are deleted text beginplaced on
microfilm
deleted text endnew text begin stored electronicallynew text end, equipment must be made available for viewing and printing
deleted text begin them, or if the records are stored as automated data, summary data must be available for
viewing and printing
deleted text endnew text begin the recordsnew text end.

Sec. 20.

Minnesota Statutes 2020, section 256R.08, subdivision 1, is amended to read:


Subdivision 1.

Reporting of financial statements.

(a) No later than February 1 of each
year, a nursing facility deleted text beginshalldeleted text endnew text begin mustnew text end:

(1) provide the state agency with a copy of its audited financial statements or its working
trial balance;

(2) provide the state agency with a statement of ownership for the facility;

(3) provide the state agency with separate, audited financial statements or working trial
balances for every other facility owned in whole or in part by an individual or entity that
has an ownership interest in the facility;

(4) upon request, provide the state agency with separate, audited financial statements or
working trial balances for every organization with which the facility conducts business and
which is owned in whole or in part by an individual or entity which has an ownership interest
in the facility;

(5) provide the state agency with copies of leases, purchase agreements, and other
documents related to the lease or purchase of the nursing facility; and

(6) upon request, provide the state agency with copies of leases, purchase agreements,
and other documents related to the acquisition of equipment, goods, and services which are
claimed as allowable costs.

(b) Audited financial statements submitted under paragraph (a) must include a balance
sheet, income statement, statement of the rate or rates charged to private paying residents,
statement of retained earnings, statement of cash flows, notes to the financial statements,
audited applicable supplemental information, and the public accountant's report. Public
accountants must conduct audits in accordance with chapter 326A. The cost of an audit
deleted text begin shalldeleted text endnew text begin mustnew text end not be an allowable cost unless the nursing facility submits its audited financial
statements in the manner otherwise specified in this subdivision. A nursing facility must
permit access by the state agency to the public accountant's audit work papers that support
the audited financial statements submitted under paragraph (a).

(c) Documents or information provided to the state agency pursuant to this subdivision
deleted text begin shalldeleted text endnew text begin mustnew text end be publicnew text begin unless prohibited by the Health Insurance Portability and Accountability
Act or any other federal or state regulation. Data, notes, and preliminary drafts of reports
created, collected, and maintained by the audit offices of government entities, or persons
performing audits for government entities, and relating to an audit or investigation are
confidential data on individuals or protected nonpublic data until the final report has been
published or the audit or investigation is no longer being pursued actively, except that the
data must be disclosed as required to comply with section 6.67 or 609.456
new text end.

(d) If the requirements of paragraphs (a) and (b) are not met, the reimbursement rate
may be reduced to 80 percent of the rate in effect on the first day of the fourth calendar
month after the close of the reporting period and the reduction deleted text beginshalldeleted text endnew text begin mustnew text end continue until the
requirements are met.

Sec. 21.

Minnesota Statutes 2020, section 256R.09, subdivision 2, is amended to read:


Subd. 2.

Reporting of statistical and cost information.

All nursing facilities deleted text beginshalldeleted text endnew text begin mustnew text end
provide information annually to the commissioner on a form and in a manner determined
by the commissioner. The commissioner may separately require facilities to submit in a
manner specified by the commissioner documentation of statistical and cost information
included in the report to ensure accuracy in establishing payment rates and to perform audit
and appeal review functions under this chapter. The commissioner may also require nursing
facilities to provide statistical and cost information for a subset of the items in the annual
report on a semiannual basis. Nursing facilities deleted text beginshalldeleted text endnew text begin mustnew text end report only costs directly related
to the operation of the nursing facility. The facility deleted text beginshalldeleted text endnew text begin mustnew text end not include costs which are
separately reimbursed new text beginor reimbursable new text endby residents, medical assistance, or other payors.
Allocations of costs from central, affiliated, or corporate office and related organization
transactions shall be reported according to sections 256R.07, subdivision 3, and 256R.12,
subdivisions 1
to 7. The commissioner shall not grant facilities extensions to the filing
deadline.

Sec. 22.

Minnesota Statutes 2020, section 256R.09, subdivision 5, is amended to read:


Subd. 5.

Method of accounting.

new text begin(a) new text endThe accrual method of accounting in accordance
with generally accepted accounting principles is the only method acceptable for purposes
of satisfying the reporting requirements of this chapter. If a governmentally owned nursing
facility demonstrates that the accrual method of accounting is not applicable to its accounts
and that a cash or modified accrual method of accounting more accurately reports the nursing
facility's financial operations, the commissioner shall permit the governmentally owned
nursing facility to use a cash or modified accrual method of accounting.

new text begin (b) For reimbursement purposes, a provider must pay an accrued nonpayroll expense
within 180 days following the end of the reporting period. A provider must not report on a
subsequent cost report an expense disallowed by the commissioner under this paragraph
for nonpayment unless the commissioner grants a specific exception to the 180-day rule for
a documented contractual arrangement such as receivership, property tax installment
payments, or pension contributions.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256R.10, is amended by adding a subdivision
to read:


new text begin Subd. 8. new text end

new text begin Employer health insurance costs. new text end

new text begin (a) Employer health insurance costs are
allowable for (1) all employees and (2) the spouse and dependents of those employees who
are employed on average at least 30 hours per week.
new text end

new text begin (b) The commissioner must not treat employer contributions to employer-sponsored
individual coverage health reimbursement arrangements as allowable costs if the facility
does not provide the commissioner copies of the employer-sponsored individual coverage
health reimbursement arrangement plan documents and documentation of any health
insurance premiums and associated co-payments reimbursed under the arrangement.
Documentation of reimbursements must denote any reimbursements for health insurance
premiums or associated co-payments incurred by the spouses or dependents of employees
who work on average less than 30 hours per week.
new text end

Sec. 24.

Minnesota Statutes 2020, section 256R.13, subdivision 4, is amended to read:


Subd. 4.

Extended record retention requirements.

The commissioner shall extend the
period for retention of records under section 256R.09, subdivision 3, for purposes of
performing field audits as necessary to enforce sections 256R.04; 256R.05, subdivision 2;
256R.06, subdivisions 2, 6, and 7; 256R.08, subdivisions 1 deleted text begintodeleted text endnew text begin andnew text end 3; and 256R.09,
subdivisions 3 and 4, with written notice to the facility postmarked no later than 90 days
prior to the expiration of the record retention requirement.

Sec. 25.

Minnesota Statutes 2020, section 256R.16, subdivision 1, is amended to read:


Subdivision 1.

Calculation of a quality score.

(a) The commissioner shall determine
a quality score for each nursing facility using quality measures established in section
256B.439, according to methods determined by the commissioner in consultation with
stakeholders and experts, and using the most recently available data as provided in the
Minnesota Nursing Home Report Card. These methods deleted text beginshalldeleted text endnew text begin mustnew text end be exempt from the
rulemaking requirements under chapter 14.

(b) For each quality measure, a score deleted text beginshalldeleted text endnew text begin mustnew text end be determined with the number of points
assigned as determined by the commissioner using the methodology established according
to this subdivision. The determination of the quality measures to be used and the methods
of calculating scores may be revised annually by the commissioner.

(c) The quality score deleted text beginshalldeleted text endnew text begin mustnew text end include up to 50 points related to the Minnesota quality
indicators score derived from the minimum data set, up to 40 points related to the resident
quality of life score derived from the consumer survey conducted under section 256B.439,
subdivision 3, and up to ten points related to the state inspection results score.

(d) The commissioner, in cooperation with the commissioner of health, may adjust the
formula in paragraph (c), or the methodology for computing the total quality score, deleted text begineffective
July 1 of any year,
deleted text end with five months advance public notice. In changing the formula, the
commissioner shall consider quality measure priorities registered by report card users, advice
of stakeholders, and available research.

Sec. 26.

Minnesota Statutes 2020, section 256R.17, subdivision 3, is amended to read:


Subd. 3.

Resident assessment schedule.

(a) Nursing facilities deleted text beginshalldeleted text endnew text begin mustnew text end conduct and
submit case mix classification assessments according to the schedule established by the
commissioner of health under section 144.0724, subdivisions 4 and 5.

(b) The case mix classifications established under section 144.0724, subdivision 3a,
deleted text begin shall bedeleted text endnew text begin arenew text end effective the day of admission for new admission assessments. The effective
date for significant change assessments deleted text beginshall bedeleted text endnew text begin isnew text end the assessment reference date. The
effective date for annual and quarterly assessments deleted text beginshall bedeleted text endnew text begin and significant corrections
assessments is
new text end the first day of the month following assessment reference date.

Sec. 27.

Minnesota Statutes 2020, section 256R.26, subdivision 1, is amended to read:


Subdivision 1.

Determination of limited undepreciated replacement cost.

A facility's
limited URC is the lesser of:

(1) the facility's new text beginrecognized new text endURC from the appraisal; or

(2) the product of (i) the number of the facility's licensed beds three months prior to the
beginning of the rate year, (ii) the construction cost per square foot value, and (iii) 1,000
square feet.

Sec. 28.

Minnesota Statutes 2020, section 256R.261, subdivision 13, is amended to read:


Subd. 13.

Equipment allowance per bed value.

The equipment allowance per bed
value is $10,000 adjusted annually for rate years beginning on or after January 1, 2021, by
the percentage change indicated by the urban consumer price index for Minneapolis-St.
Paul, as published by the Bureau of Labor Statistics (series deleted text begin1967=100deleted text endnew text begin 1982-84=100new text end) for
the two previous Julys. The computation for this annual adjustment is based on the data that
is publicly available on November 1 immediately preceding the start of the rate year.

Sec. 29.

Minnesota Statutes 2020, section 256R.37, is amended to read:


256R.37 SCHOLARSHIPS.

deleted text begin (a) For the 27-month period beginning October 1, 2015, through December 31, 2017,
the commissioner shall allow a scholarship per diem of up to 25 cents for each nursing
facility with no scholarship per diem that is requesting a scholarship per diem to be added
to the external fixed payment rate to be used:
deleted text end

deleted text begin (1) for employee scholarships that satisfy the following requirements:
deleted text end

deleted text begin (i) scholarships are available to all employees who work an average of at least ten hours
per week at the facility except the administrator, and to reimburse student loan expenses
for newly hired registered nurses and licensed practical nurses, and training expenses for
nursing assistants as specified in section 144A.611, subdivisions 2 and 4, who are newly
hired; and
deleted text end

deleted text begin (ii) the course of study is expected to lead to career advancement with the facility or in
long-term care, including medical care interpreter services and social work; and
deleted text end

deleted text begin (2) to provide job-related training in English as a second language.
deleted text end

deleted text begin (b) All facilities may annually request a rate adjustment under this section by submitting
information to the commissioner on a schedule and in a form supplied by the commissioner.
The commissioner shall allow a scholarship payment rate equal to the reported and allowable
costs divided by resident days.
deleted text end

deleted text begin (c) In calculating the per diem under paragraph (b), the commissioner shall allow costs
related to tuition, direct educational expenses, and reasonable costs as defined by the
commissioner for child care costs and transportation expenses related to direct educational
expenses.
deleted text end

deleted text begin (d) The rate increase under this section is an optional rate add-on that the facility must
request from the commissioner in a manner prescribed by the commissioner. The rate
increase must be used for scholarships as specified in this section.
deleted text end

deleted text begin (e) For instances in which a rate adjustment will be 15 cents or greater, nursing facilities
that close beds during a rate year may request to have their scholarship adjustment under
paragraph (b) recalculated by the commissioner for the remainder of the rate year to reflect
the reduction in resident days compared to the cost report year.
deleted text end

new text begin (a) The commissioner shall provide a scholarship per diem rate calculated using the
criteria in paragraphs (b) to (d). The per diem rate must be based on the allowable costs the
facility paid for employee scholarships for any eligible employee, except the facility
administrator, who works an average of at least ten hours per week in the licensed nursing
facility building when the facility has paid expenses related to:
new text end

new text begin (1) an employee's course of study that is expected to lead to career advancement with
the facility or in the field of long-term care;
new text end

new text begin (2) an employee's job-related training in English as a second language;
new text end

new text begin (3) the reimbursement of student loan expenses for newly hired registered nurses and
licensed practical nurses; and
new text end

new text begin (4) the reimbursement of training, testing, and associated expenses for newly hired
nursing assistants as specified in section 144A.611, subdivisions 2 and 4. The reimbursement
of nursing assistant expenses under this clause is not subject to the ten-hour minimum work
requirement under this paragraph.
new text end

new text begin (b) Allowable scholarship costs include: tuition, student loan reimbursement, other direct
educational expenses, and reasonable costs for child care and transportation expenses directly
related to education, as defined by the commissioner.
new text end

new text begin (c) The commissioner shall provide a scholarship per diem rate equal to the allowable
scholarship costs divided by resident days. The commissioner shall compute the scholarship
per diem rate annually and include the scholarship per diem rate in the external fixed costs
payment rate.
new text end

new text begin (d) When the resulting scholarship per diem rate is 15 cents or more, nursing facilities
that close beds during a rate year may request to have the scholarship rate recalculated. This
recalculation is effective from the date of the bed closure through the remainder of the rate
year and reflects the estimated reduction in resident days compared to the previous cost
report year.
new text end

new text begin (e) Facilities seeking to have the facility's scholarship expenses recognized for the
payment rate computation in section 256R.25 may apply annually by submitting information
to the commissioner on a schedule and in a form supplied by the commissioner.
new text end

Sec. 30.

Minnesota Statutes 2020, section 256R.39, is amended to read:


256R.39 QUALITY IMPROVEMENT INCENTIVE PROGRAM.

The commissioner shall develop a quality improvement incentive program in consultation
with stakeholders. The annual funding pool available for quality improvement incentive
payments deleted text beginshalldeleted text endnew text begin mustnew text end be equal to 0.8 percent of all operating payments, not including any
rate components resulting from equitable cost-sharing for publicly owned nursing facility
program participation under section 256R.48, critical access nursing facility program
participation under section 256R.47, or performance-based incentive payment program
participation under section 256R.38. deleted text beginFor the period from October 1, 2015, to December 31,
2016, rate adjustments provided under this section shall be effective for 15 months. Beginning
January 1, 2017,
deleted text endnew text begin Annew text end annual rate deleted text beginadjustmentsdeleted text endnew text begin adjustmentnew text end provided under this section deleted text beginshalldeleted text endnew text begin
must
new text end be effective for one rate year.

Sec. 31.

Minnesota Statutes 2021 Supplement, section 256S.205, is amended to read:


256S.205 CUSTOMIZED LIVING SERVICES; DISPROPORTIONATE SHARE
RATE ADJUSTMENTS.

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms in this
subdivision have the meanings given.

(b) "Application year" means a year in which a facility submits an application for
designation as a disproportionate share facility.

(c) deleted text begin"Assisted living facility" or "facility" means an assisted living facility licensed under
chapter 144G
deleted text endnew text begin "Customized living resident" means a resident of a facility who is receiving
either 24-hour customized living services or customized living services authorized under
the elderly waiver, the brain injury waiver, or the community access for disability inclusion
waiver
new text end.

(d) "Disproportionate share facility" means deleted text beginan assisted livingdeleted text endnew text begin anew text end facility designated by
the commissioner under subdivision 4.

new text begin (e) "Facility" means either an assisted living facility licensed under chapter 144G or a
setting that is exempt from assisted living licensure under section 144G.08, subdivision 7,
clauses (10) to (13).
new text end

new text begin (f) "Rate year" means January 1 to December 31 of the year following an application
year.
new text end

Subd. 2.

Rate adjustment application.

deleted text beginAn assisted livingdeleted text endnew text begin Anew text end facility may apply to the
commissioner for designation as a disproportionate share facility. Applications must be
submitted annually between deleted text beginOctoberdeleted text endnew text begin Septembernew text end 1 and deleted text beginOctober 31deleted text endnew text begin September 30new text end. The
applying facility must apply in a manner determined by the commissioner. The applying
facility must document deleted text beginas a percentage the census of elderly waiver participantsdeleted text endnew text begin each of the
following on the application:
new text end

new text begin (1) the number of customized living residents in the facility on September 1 of the
application year, broken out by specific waiver program; and
new text end

new text begin (2) the total number of peoplenew text end residing in the facility on deleted text beginOctoberdeleted text endnew text begin Septembernew text end 1 of the
application year.

Subd. 3.

Rate adjustment eligibility criteria.

Only facilities deleted text beginwith a census of at least
80 percent elderly waiver participants
deleted text endnew text begin satisfying all of the following conditionsnew text end on deleted text beginOctoberdeleted text endnew text begin
September
new text end 1 of the application year are eligible for designation as a disproportionate share
facilitynew text begin:
new text end

new text begin (1) at least 83.5 percent of the residents of the facility are customized living residents;
and
new text end

new text begin (2) at least 70 percent of the customized living residents are elderly waiver participantsnew text end.

Subd. 4.

Designation as a disproportionate share facility.

new text begin(a) new text endBy deleted text beginNovemberdeleted text endnew text begin Octobernew text end
15 of each application year, the commissioner must designate as a disproportionate share
facility a facility that complies with the application requirements of subdivision 2 and meets
the eligibility criteria of subdivision 3.

new text begin (b) An annual designation is effective for one rate year.
new text end

Subd. 5.

Rate adjustment; rate floor.

(a) Notwithstanding the 24-hour customized
living monthly service rate limits under section 256S.202, subdivision 2, and the component
service rates established under section 256S.201, subdivision 4, the commissioner must
establish a rate floor equal to $119 per resident per day for 24-hour customized living
services providednew text begin to an elderly waiver participantnew text end in a designated disproportionate share
facility deleted text beginfor the purpose of ensuring the minimal level of staffing required to meet the health
and safety needs of elderly waiver participants
deleted text end.

new text begin (b) The commissioner must apply the rate floor to the services described in paragraph
(a) provided during the rate year.
new text end

deleted text begin (b)deleted text endnew text begin (c)new text end The commissioner must adjust the rate floor deleted text beginat least annually in the manner
described under section deleted text begin256S.18, subdivisions 5deleted text end and 6
deleted text endnew text begin by the same amount and at the same
time as any adjustment to the 24-hour customized living monthly service rate limits under
section 256S.202, subdivision 2
new text end.

deleted text begin (c)deleted text endnew text begin (d)new text end The commissioner shall not implement the rate floor under this section if the
customized living rates established under sections 256S.21 to 256S.215 will be implemented
at 100 percent on January 1 of the year following an application year.

Subd. 6.

Budget cap disregard.

The value of the rate adjustment under this section
must not be included in an elderly waiver client's monthly case mix budget cap.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 1, 2022, or upon federal
approval, whichever is later, and applies to services provided on or after January 1, 2023,
or on or after the date upon which federal approval is obtained, whichever is later. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 32. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 245A.03, subdivision 5; and 256R.08, subdivision 2, new text end new text begin
and
new text end new text begin Minnesota Rules, part 9555.6255, new text end new text begin are repealed.
new text end

ARTICLE 8

CHILD AND VULNERABLE ADULT PROTECTION

Section 1.

Minnesota Statutes 2020, section 242.19, subdivision 2, is amended to read:


Subd. 2.

Dispositions.

When a child has been committed to the commissioner of
corrections by a juvenile court, upon a finding of delinquency, the commissioner may for
the purposes of treatment and rehabilitation:

(1) order the child's confinement to the Minnesota Correctional Facility-Red Wing,
which shall accept the child, or to a group foster home under the control of the commissioner
of corrections, or to private facilities or facilities established by law or incorporated under
the laws of this state that may care for delinquent children;

(2) order the child's release on parole under such supervisions and conditions as the
commissioner believes conducive to law-abiding conduct, treatment and rehabilitation;

(3) order reconfinement or renewed parole as often as the commissioner believes to be
desirable;

(4) revoke or modify any order, except an order of discharge, as often as the commissioner
believes to be desirable;

(5) discharge the child when the commissioner is satisfied that the child has been
rehabilitated and that such discharge is consistent with the protection of the public;

(6) if the commissioner finds that the child is eligible for probation or parole and it
appears from the commissioner's investigation that conditions in the child's or the guardian's
home are not conducive to the child's treatment, rehabilitation, or law-abiding conduct, refer
the child, together with the commissioner's findings, to a local social services agency or a
licensed child-placing agency for placement in a foster care or, when appropriate, for
initiation of child in need of protection or services proceedings as provided in sections
260C.001 to 260C.421. The commissioner of corrections shall reimburse local social services
agencies for foster care costs they incur for the child while on probation or parole to the
extent that funds for this purpose are made available to the commissioner by the legislature.
The juvenile court deleted text beginshalldeleted text end new text beginmay new text endorder the parents of a child on probation or parole to pay the
costs of foster care under section 260B.331, subdivision 1, new text beginif the local social services agency
has determined that requiring reimbursement is in the child's best interests,
new text end according to
their ability to pay, and to the extent that the commissioner of corrections has not reimbursed
the local social services agency.

Sec. 2.

Minnesota Statutes 2020, section 260.012, is amended to read:


260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY
REUNIFICATION; REASONABLE EFFORTS.

(a) Once a child alleged to be in need of protection or services is under the court's
jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate
servicesnew text begin and practicesnew text end, by the social services agency are made to prevent placement or to
eliminate the need for removal and to reunite the child with the child's family at the earliest
possible time, and the court must ensure that the responsible social services agency makes
reasonable efforts to finalize an alternative permanent plan for the child as provided in
paragraph (e). In determining reasonable efforts to be made with respect to a child and in
making those reasonable efforts, the child's best interests, health, and safety must be of
paramount concern. Reasonable efforts to prevent placement and for rehabilitation and
reunification are always required except upon a determination by the court that a petition
has been filed stating a prima facie case that:

(1) the parent has subjected a child to egregious harm as defined in section 260C.007,
subdivision 14
;

(2) the parental rights of the parent to another child have been terminated involuntarily;

(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
(a), clause (2);

(4) the parent's custodial rights to another child have been involuntarily transferred to a
relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (d),
clause (1), section 260C.515, subdivision 4, or a similar law of another jurisdiction;

(5) the parent has committed sexual abuse as defined in section 260E.03, against the
child or another child of the parent;

(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or

(7) the provision of services or further services for the purpose of reunification is futile
and therefore unreasonable under the circumstances.

(b) When the court makes one of the prima facie determinations under paragraph (a),
either permanency pleadings under section 260C.505, or a termination of parental rights
petition under sections 260C.141 and 260C.301 must be filed. A permanency hearing under
sections 260C.503 to 260C.521 must be held within 30 days of this determination.

(c) In the case of an Indian child, in proceedings under sections 260B.178, 260C.178,
260C.201, 260C.202, 260C.204, 260C.301, or 260C.503 to 260C.521, the juvenile court
must make findings and conclusions consistent with the Indian Child Welfare Act of 1978,
United States Code, title 25, section 1901 et seq., as to the provision of active efforts. In
cases governed by the Indian Child Welfare Act of 1978, United States Code, title 25, section
1901, the responsible social services agency must provide active efforts as required under
United States Code, title 25, section 1911(d).

(d) "Reasonable efforts to prevent placement" means:

(1) the agency has made reasonable efforts to prevent the placement of the child in foster
care by working with the family to develop and implement a safety plannew text begin that is individualized
to the needs of the child and the child's family and may include support persons from the
child's extended family, kin network, and community
new text end; or

(2) new text beginthe agency has demonstrated to the court that, new text endgiven the particular circumstances of
the child and family at the time of the child's removal, there are no services or efforts
available deleted text beginwhichdeleted text endnew text begin thatnew text end could allow the child to safely remain in the home.

(e) "Reasonable efforts to finalize a permanent plan for the child" means due diligence
by the responsible social services agency to:

(1) reunify the child with the parent or guardian from whom the child was removed;

(2) assess a noncustodial parent's ability to provide day-to-day care for the child and,
where appropriate, provide services necessary to enable the noncustodial parent to safely
provide the care, as required by section 260C.219;

(3) conduct a relative search to identify and provide notice to adult relativesnew text begin, and engage
relatives in case planning and permanency planning,
new text end as required under section 260C.221;

new text begin (4) consider placing the child with relatives in the order specified in section 260C.212,
subdivision 2, paragraph (a);
new text end

deleted text begin (4)deleted text endnew text begin (5)new text end place siblings removed from their home in the same home for foster care or
adoption, or transfer permanent legal and physical custody to a relative. Visitation between
siblings who are not in the same foster care, adoption, or custodial placement or facility
shall be consistent with section 260C.212, subdivision 2; and

deleted text begin (5)deleted text endnew text begin (6)new text end when the child cannot return to the parent or guardian from whom the child was
removed, to plan for and finalize a safe and legally permanent alternative home for the child,
and considers permanent alternative homes for the child inside or outside of the state,
preferably new text beginwith a relative in the order specified in section 260C.212, subdivision 2, paragraph
(a),
new text endthrough adoption or transfer of permanent legal and physical custody of the child.

(f) Reasonable efforts are made upon the exercise of due diligence by the responsible
social services agency to use culturally appropriate and available services to meet the
new text begin individualized new text endneeds of the child and the child's family. Services may include those provided
by the responsible social services agency and other culturally appropriate services available
in the community. new text beginThe responsible social services agency must select services for a child
and the child's family by collaborating with the child's family and, if appropriate, the child.
new text end At each stage of the proceedings deleted text beginwheredeleted text endnew text begin whennew text end the court is required to review the
appropriateness of the responsible social services agency's reasonable efforts as described
in paragraphs (a), (d), and (e), the social services agency has the burden of demonstrating
that:

(1) deleted text beginitdeleted text end new text beginthe agency new text endhas made reasonable efforts to prevent placement of the child in foster
carenew text begin, including that the agency considered or established a safety plan according to paragraph
(d), clause (1)
new text end;

(2) deleted text beginitdeleted text endnew text begin the agencynew text end has made reasonable efforts to eliminate the need for removal of the
child from the child's home and to reunify the child with the child's family at the earliest
possible time;

new text begin (3) the agency has made reasonable efforts to finalize a permanent plan for the child
pursuant to paragraph (e);
new text end

deleted text begin (3) itdeleted text end new text begin(4) the agency new text endhas made reasonable efforts to finalize an alternative permanent
home for the child, and deleted text beginconsidersdeleted text endnew text begin considerednew text end permanent alternative homes for the child
deleted text begin inside or outsidedeleted text endnew text begin in or outnew text end of the statenew text begin, preferably with a relative in the order specified in
section 260C.212, subdivision 2, paragraph (a)
new text end; or

deleted text begin (4)deleted text endnew text begin (5)new text end reasonable efforts to prevent placement and to reunify the child with the parent
or guardian are not required. The agency may meet this burden by stating facts in a sworn
petition filed under section 260C.141, by filing an affidavit summarizing the agency's
reasonable efforts or factsnew text begin thatnew text end the agency believes demonstrate new text beginthat new text endthere is no need for
reasonable efforts to reunify the parent and child, or through testimony or a certified report
required under juvenile court rules.

(g) Once the court determines that reasonable efforts for reunification are not required
because the court has made one of the prima facie determinations under paragraph (a), the
court may only require new text beginthe agency to make new text endreasonable efforts for reunification after a hearing
according to section 260C.163, deleted text beginwheredeleted text endnew text begin ifnew text end the court findsnew text begin thatnew text end there is not clear and convincing
evidence of the facts upon which the court based deleted text beginitsdeleted text endnew text begin the court'snew text end prima facie determination.
deleted text begin In this case whendeleted text endnew text begin Ifnew text end there is clear and convincing evidence that the child is in need of
protection or services, the court may find the child in need of protection or services and
order any of the dispositions available under section 260C.201, subdivision 1. Reunification
of a child with a parent is not required if the parent has been convicted of:

(1) a violation of, or an attempt or conspiracy to commit a violation of, sections 609.185
to 609.20; 609.222, subdivision 2; or 609.223 in regard to another child of the parent;

(2) a violation of section 609.222, subdivision 2; or 609.223, in regard to the child;

(3) a violation of, or an attempt or conspiracy to commit a violation of, United States
Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent;

(4) committing sexual abuse as defined in section 260E.03, against the child or another
child of the parent; or

(5) an offense that requires registration as a predatory offender under section 243.166,
subdivision 1b
, paragraph (a) or (b).

(h) The juvenile court, in proceedings under sections 260B.178, 260C.178, 260C.201,
260C.202, 260C.204, 260C.301, or 260C.503 to 260C.521, shall make findings and
conclusions as to the provision of reasonable efforts. When determining whether reasonable
efforts have been madenew text begin by the agencynew text end, the court shall consider whether services to the child
and family were:

new text begin (1) selected in collaboration with the child's family and, if appropriate, the child;
new text end

new text begin (2) tailored to the individualized needs of the child and child's family;
new text end

deleted text begin (1)deleted text endnew text begin (3)new text end relevant to the safety deleted text beginanddeleted text endnew text begin,new text end protectionnew text begin, and well-beingnew text end of the child;

deleted text begin (2)deleted text endnew text begin (4)new text end adequate to meet the new text beginindividualized new text endneeds of the child and family;

deleted text begin (3)deleted text endnew text begin (5)new text end culturally appropriate;

deleted text begin (4)deleted text endnew text begin (6)new text end available and accessible;

deleted text begin (5)deleted text endnew text begin (7)new text end consistent and timely; and

deleted text begin (6)deleted text endnew text begin (8)new text end realistic under the circumstances.

In the alternative, the court may determine that new text beginthe new text endprovision of services or further services
for the purpose of rehabilitation is futile and therefore unreasonable under the circumstances
or that reasonable efforts are not required as provided in paragraph (a).

(i) This section does not prevent out-of-home placement for new text beginthe new text endtreatment of a child with
a mental disability when it is determined to be medically necessary as a result of the child's
diagnostic assessment or new text beginthe child's new text endindividual treatment plan indicates that appropriate and
necessary treatment cannot be effectively provided outside of a residential or inpatient
treatment program and the level or intensity of supervision and treatment cannot be
effectively and safely provided in the child's home or community and it is determined that
a residential treatment setting is the least restrictive setting that is appropriate to the needs
of the child.

(j) If continuation of reasonable efforts to prevent placement or reunify the child with
the parent or guardian from whom the child was removed is determined by the court to be
inconsistent with the permanent plan for the child or upon the court making one of the prima
facie determinations under paragraph (a), reasonable efforts must be made to place the child
in a timely manner in a safe and permanent home and to complete whatever steps are
necessary to legally finalize the permanent placement of the child.

(k) Reasonable efforts to place a child for adoption or in another permanent placement
may be made concurrently with reasonable efforts to prevent placement or to reunify the
child with the parent or guardian from whom the child was removed. When the responsible
social services agency decides to concurrently make reasonable efforts for both reunification
and permanent placement away from the parent under paragraph (a), the agency shall disclose
deleted text begin itsdeleted text endnew text begin the agency'snew text end decision and both plans for concurrent reasonable efforts to all parties and
the court. When the agency discloses deleted text beginitsdeleted text endnew text begin the agency'snew text end decision to proceed deleted text beginondeleted text endnew text begin withnew text end both plans
for reunification and permanent placement away from the parent, the court's review of the
agency's reasonable efforts shall include the agency's efforts under both plans.

Sec. 3.

Minnesota Statutes 2020, section 260B.331, subdivision 1, is amended to read:


Subdivision 1.

Care, examination, or treatment.

(a)(1) Whenever legal custody of a
child is transferred by the court to a local social services agency, or

(2) whenever legal custody is transferred to a person other than the local social services
agency, but under the supervision of the local social services agency, and

(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 child, these costs are a charge upon the welfare funds of
the county in which proceedings are held upon certification of the judge of juvenile court.

(b) The court deleted text beginshalldeleted text endnew text begin maynew text end order, and the local social services agency deleted text beginshalldeleted text endnew text begin maynew text end require,
the parents or custodian of a child, while the child is under the age of 18, to use deleted text beginthe totaldeleted text end
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 benefits and child support.
When the child is over the age of 18, and continues to receive care, examination, or treatment,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the local social services agency deleted text beginshalldeleted text endnew text begin maynew text end 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.new text begin The
local social services agency shall determine whether requiring reimbursement, either through
child support or parental fees, for the cost of care, examination, or treatment from income
and resources attributable to the child is in the child's best interests. In determining whether
to require reimbursement, the local social services agency shall consider:
new text end

new text begin (1) whether requiring reimbursement would compromise a parent's ability to meet the
child's treatment and rehabilitation needs before the child returns to the parent's home;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after the child returns home; and
new text end

new text begin (3) whether redirecting existing child support payments or changing the representative
payee of social security benefits to the local social services agency would limit the parent's
ability to maintain financial stability for the child upon the child's return home.
new text end

(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 deleted text beginshalldeleted text endnew text begin maynew text end inquire
into the ability of the parents to deleted text beginsupport the childdeleted text endnew text begin reimburse the county for the cost of care,
examination, or treatment
new text end and, after giving the parents a reasonable opportunity to be heard,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the local social services agency deleted text beginshalldeleted text endnew text begin maynew text end require, the parents
to contribute to the cost of care, examination, or treatment of the child. deleted text beginExcept in delinquency
cases where the victim is a member of the child's immediate family,
deleted text end 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 local social services agency and approved by the
commissioner of human services. deleted text beginIn delinquency cases where the victim is a member of the
child's immediate family,
deleted text end The court shall deleted text beginuse the fee schedule but may alsodeleted text end take into account
deleted text begin the seriousness of the offense and any expenses which the parents have incurred as a result
of the offense
deleted text endnew text begin any expenses that the parents may have incurred as a result of the offense,
including but not limited to co-payments for mental health treatment and attorney fees
new text end. The
income of a stepparent who has not adopted a child shall be excluded in calculating the
parental contribution under this section.new text begin The local social services agency shall determine
whether requiring reimbursement from the parents, either through child support or parental
fees, for the cost of care, examination, or treatment from income and resources attributable
to the child is in the child's best interests. In determining whether to require reimbursement,
the local social services agency shall consider:
new text end

new text begin (1) whether requiring reimbursement would compromise a parent's ability to meet the
child's treatment and rehabilitation needs before the child returns to the parent's home;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after the child returns home; and
new text end

new text begin (3) whether requiring reimbursement would compromise the parent's ability to meet the
needs of the family.
new text end

(d)new text begin If the local social services agency determines that requiring reimbursement is in the
child's best interests,
new text end 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.

Sec. 4.

Minnesota Statutes 2020, section 260C.001, subdivision 3, is amended to read:


Subd. 3.

Permanency, termination of parental rights, and adoption.

The purpose of
the laws relating to permanency, termination of parental rights, and children who come
under the guardianship of the commissioner of human services is to ensure that:

(1) when required and appropriate, reasonable efforts have been made by the social
services agency to reunite the child with the child's parents in a home that is safe and
permanent;

(2) if placement with the parents is not reasonably foreseeable, to secure for the child a
safe and permanent placement according to the requirements of section 260C.212, subdivision
2, preferably deleted text beginwith adoptive parentsdeleted text endnew text begin with a relative through an adoption or a transfer of
permanent legal and physical custody
new text end or, if that is not possible or in the best interests of the
child, deleted text begina fit and willing relative through transfer of permanent legal and physical custody to
that relative
deleted text endnew text begin with a nonrelative caregiver through adoptionnew text end; and

(3) when a child is under the guardianship of the commissioner of human services,
reasonable efforts are made to finalize an adoptive home for the child in a timely manner.

Nothing in this section requires reasonable efforts to prevent placement or to reunify
the child with the parent or guardian to be made in circumstances where the court has
determined that the child has been subjected to egregious harm, when the child is an
abandoned infant, the parent has involuntarily lost custody of another child through a
proceeding under section 260C.515, subdivision 4, or similar law of another state, the
parental rights of the parent to a sibling have been involuntarily terminated, or the court has
determined that reasonable efforts or further reasonable efforts to reunify the child with the
parent or guardian would be futile.

The paramount consideration in all proceedings for permanent placement of the child
under sections 260C.503 to 260C.521, or the termination of parental rights is the 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
the Indian Child Welfare Act of 1978, United States Code, title 25, section 1901, et seq.

Sec. 5.

Minnesota Statutes 2020, section 260C.007, subdivision 27, is amended to read:


Subd. 27.

Relative.

"Relative" means a person related to the child by blood, marriage,
or adoption; the legal parent, guardian, or custodian of the child's siblings; or an individual
who is an important friend new text beginof the child or of the child's parent or custodian, including an
individual
new text endwith whom the child has resided or had significant contactnew text begin or who has a significant
relationship to the child or the child's parent or custodian
new text end.

Sec. 6.

Minnesota Statutes 2020, section 260C.151, subdivision 6, is amended to read:


Subd. 6.

Immediate custody.

If the court makes individualized, explicit findings, based
on the notarized petition or sworn affidavit, that there are reasonable grounds to believe
new text begin that new text endthe child is in surroundings or conditions deleted text beginwhichdeleted text endnew text begin thatnew text end endanger the child's health, safety,
or welfare that require that responsibility for the child's care and custody be immediately
assumed by the responsible social services agency and that continuation of the child in the
custody of the parent or guardian is contrary to the child's welfare, the court may order that
the officer serving the summons take the child into immediate custody for placement of the
child in foster carenew text begin, preferably with a relativenew text end. In ordering that responsibility for the care,
custody, and control of the child be assumed by the responsible social services agency, the
court is ordering emergency protective care as that term is defined in the juvenile court
rules.

Sec. 7.

Minnesota Statutes 2020, section 260C.152, subdivision 5, is amended to read:


Subd. 5.

Notice to foster parents and preadoptive parents and relatives.

The foster
parents, if any, of a child and any preadoptive parent or relative providing care for the child
must be provided notice of and a right to be heard in any review or hearing to be held with
respect to the child. Any other relative may also request, and must be granted, a notice and
the deleted text beginopportunitydeleted text endnew text begin rightnew text end to be heard under this section. This subdivision does not require that
a foster parent, preadoptive parent, deleted text beginordeleted text end relative providing care for the childnew text begin, or any other
relative
new text end be made a party to a review or hearing solely on the basis of the notice and right to
be heard.

Sec. 8.

Minnesota Statutes 2020, section 260C.175, subdivision 2, is amended to read:


Subd. 2.

Notice to parent or custodiannew text begin and child; emergency placement with
relative
new text end.

deleted text beginWheneverdeleted text endnew text begin (a) At the time thatnew text end a peace officer takes a child into custody fornew text begin relative
placement or
new text end shelter care deleted text beginor relative placementdeleted text end pursuant to subdivision 1, section 260C.151,
subdivision 5
, or section 260C.154, the officer shall notify the new text beginchild's new text endparent or custodiannew text begin
and the child, if the child is ten years of age or older,
new text end that under section 260C.181, subdivision
2
, the parent or custodiannew text begin or the childnew text end may request deleted text beginthatdeleted text endnew text begin to placenew text end the child deleted text beginbe placeddeleted text end with a
relative deleted text beginor a designated caregiver under chapter 257Adeleted text endnew text begin as defined in section 260C.007,
subdivision 27,
new text end instead of in a shelter care facility.

new text begin (b) When a child who is not alleged to be delinquent is taken into custody pursuant to
subdivision 1, clause (1) or (2), item (ii), and placement with an identified relative is
requested, the peace officer shall coordinate with the responsible social services agency to
ensure the child's safety and well-being and comply with section 260C.181, subdivision 2.
new text end

new text begin (c) new text endThe officer also shall give the parent or custodian of the child a list of names,
addresses, and telephone numbers of social services agencies that offer child welfare services.
If the parent or custodian was not present when the child was removed from the residence,
the list shall be left with an adult on the premises or left in a conspicuous place on the
premises if no adult is present. If the officer has reason to believe the parent or custodian
is not able to read and understand English, the officer must provide a list that is written in
the language of the parent or custodian. The list shall be prepared by the commissioner of
human services. The commissioner shall prepare lists for each county and provide each
county with copies of the list without charge. The list shall be reviewed annually by the
commissioner and updated if it is no longer accurate. Neither the commissioner nor any
peace officer or the officer's employer shall be liable to any person for mistakes or omissions
in the list. The list does not constitute a promise that any agency listed will deleted text beginin factdeleted text end assist the
parent or custodian.

Sec. 9.

Minnesota Statutes 2020, section 260C.176, subdivision 2, is amended to read:


Subd. 2.

Reasons for detention.

(a) If the child is not released as provided in subdivision
1, the person taking the child into custody shall notify the court as soon as possible of the
detention of the child and the reasons for detention.

(b) No child taken into custody and placed in anew text begin relative's home ornew text end shelter care facility
deleted text begin or relative's homedeleted text end by a peace officer pursuant to section 260C.175, subdivision 1, clause
(1) or (2), item (ii), may be held in custody longer than 72 hours, excluding Saturdays,
Sundays and holidays, unless a petition has been filed and the judge or referee determines
pursuant to section 260C.178 that the child shall remain in custody or unless the court has
made a finding of domestic abuse perpetrated by a minor after a hearing under Laws 1997,
chapter 239, article 10, sections 2 to 26, in which case the court may extend the period of
detention for an additional seven days, within which time the social services agency shall
conduct an assessment and shall provide recommendations to the court regarding voluntary
services or file a child in need of protection or services petition.

Sec. 10.

Minnesota Statutes 2020, section 260C.178, subdivision 1, is amended to read:


Subdivision 1.

Hearing and release requirements.

(a) If a child was taken into custody
under section 260C.175, subdivision 1, clause (1) or (2), item (ii), the court shall hold a
hearing within 72 hours of the timenew text begin thatnew text end the child was taken into custody, excluding
Saturdays, Sundays, and holidays, to determine whether the child should continuenew text begin to benew text end in
custody.

(b) Unless there is reason to believe that the child would endanger self or others or not
return for a court hearing, or that the child's health or welfare would be immediately
endangered, the child shall be released to the custody of a parent, guardian, custodian, or
other suitable person, subject to reasonable conditions of release including, but not limited
to, a requirement that the child undergo a chemical use assessment as provided in section
260C.157, subdivision 1.

(c) If the court determines new text beginthat new text endthere is reason to believe that the child would endanger
self or others or not return for a court hearing, or that the child's health or welfare would be
immediately endangered if returned to the care of the parent or guardian who has custody
and from whom the child was removed, the court shall order the childnew text begin:
new text end

new text begin (1) into the care of the child's noncustodial parent and order the noncustodial parent to
comply with any conditions that the court determines appropriate to ensure the safety and
care of the child, including requiring the noncustodial parent to cooperate with paternity
establishment proceedings if the noncustodial parent has not been adjudicated the child's
father; or
new text end

new text begin (2)new text end into foster care as defined in section 260C.007, subdivision 18, under the legal
responsibility of the responsible social services agency or responsible probation or corrections
agency for the purposes of protective care as that term is used in the juvenile court rules deleted text beginor
into the home of a noncustodial parent and order the noncustodial parent to comply with
any conditions the court determines to be appropriate to the safety and care of the child,
including cooperating with paternity establishment proceedings in the case of a man who
has not been adjudicated the child's father
deleted text end. The court shall not give the responsible social
services legal custody and order a trial home visit at any time prior to adjudication and
disposition under section 260C.201, subdivision 1, paragraph (a), clause (3), but may order
the child returned to the care of the parent or guardian who has custody and from whom the
child was removed and order the parent or guardian to comply with any conditions the court
determines to be appropriate to meet the safety, health, and welfare of the child.

(d) In determining whether the child's health or welfare would be immediately
endangered, the court shall consider whether the child would reside with a perpetrator of
domestic child abuse.

(e) The court, before determining whether a child should be placed in or continue in
foster care under the protective care of the responsible agency, shall also make a
determination, consistent with section 260.012 as to whether reasonable efforts were made
to prevent placement or whether reasonable efforts to prevent placement are not required.
In the case of an Indian child, the court shall determine whether active efforts, according
to section 260.762 and the Indian Child Welfare Act of 1978, United States Code, title 25,
section 1912(d), were made to prevent placement. The court shall enter a finding that the
responsible social services agency has made reasonable efforts to prevent placement when
the agency establishes either:

(1) that deleted text beginitdeleted text end new text beginthe agency new text endhas actually provided services or made efforts in an attempt to
prevent the child's removal but that such services or efforts have not proven sufficient to
permit the child to safely remain in the home; or

(2) that there are no services or other efforts that could be made at the time of the hearing
that could safely permit the child to remain home or to return home. new text beginThe court shall not
make a reasonable efforts determination under this clause unless the court is satisfied that
the agency has sufficiently demonstrated to the court that there were no services or other
efforts that the agency was able to provide at the time of the hearing enabling the child to
safely remain home or to safely return home.
new text endWhen reasonable efforts to prevent placement
are required and there are services or other efforts that could be ordered deleted text beginwhichdeleted text endnew text begin thatnew text end would
permit the child to safely return home, the court shall order the child returned to the care of
the parent or guardian and the services or efforts put in place to ensure the child's safety.
When the court makes a prima facie determination that one of the circumstances under
paragraph (g) exists, the court shall determine that reasonable efforts to prevent placement
and to return the child to the care of the parent or guardian are not required.

new text begin (f) new text endIf the court finds the social services agency's preventive or reunification efforts have
not been reasonable but 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.

deleted text begin (f)deleted text endnew text begin (g)new text end The court may not order or continue the foster care placement of the child unless
the court makes explicit, individualized findings that continued custody of the child by the
parent or guardian would be contrary to the welfare of the child and that placement is in the
best interest of the child.

deleted text begin (g)deleted text endnew text begin (h)new text end At the emergency removal hearing, or at any time during the course of the
proceeding, and upon notice and request of the county attorney, the court shall determine
whether a petition has been filed stating a prima facie case that:

(1) the parent has subjected a child to egregious harm as defined in section 260C.007,
subdivision 14
;

(2) the parental rights of the parent to another child have been involuntarily terminated;

(3) the child is an abandoned infant under section 260C.301, subdivision 2, paragraph
(a), clause (2);

(4) the parents' custodial rights to another child have been involuntarily transferred to a
relative under Minnesota Statutes 2010, section 260C.201, subdivision 11, paragraph (e),
clause (1); section 260C.515, subdivision 4; or a similar law of another jurisdiction;

(5) the parent has committed sexual abuse as defined in section 260E.03, against the
child or another child of the parent;

(6) the parent has committed an offense that requires registration as a predatory offender
under section 243.166, subdivision 1b, paragraph (a) or (b); or

(7) the provision of services or further services for the purpose of reunification is futile
and therefore unreasonable.

deleted text begin (h)deleted text endnew text begin (i)new text end When a petition to terminate parental rights is required under section 260C.301,
subdivision 4, or 260C.503, subdivision 2, but the county attorney has determined not to
proceed with a termination of parental rights petition, and has instead filed a petition to
transfer permanent legal and physical custody to a relative under section 260C.507, the
court shall schedule a permanency hearing within 30 days of the filing of the petition.

deleted text begin (i)deleted text endnew text begin (j)new text end If the county attorney has filed a petition under section 260C.307, the court shall
schedule a trial under section 260C.163 within 90 days of the filing of the petition except
when the county attorney determines that the criminal case shall proceed to trial first under
section 260C.503, subdivision 2, paragraph (c).

deleted text begin (j)deleted text endnew text begin (k)new text end If the court determines the child should be ordered into foster care and the child's
parent refuses to give information to the responsible social services agency regarding the
child's father or relatives of the child, the court may order the parent to disclose the names,
addresses, telephone numbers, and other identifying information to the responsible social
services agency for the purpose of complying with sectionsnew text begin 260C.150,new text end 260C.151, 260C.212,
260C.215, new text begin260C.219, new text endand 260C.221.

deleted text begin (k)deleted text endnew text begin (l)new text end If a child ordered into foster care has siblings, whether full, half, or step, who are
also ordered into foster care, the court shall inquire of the responsible social services agency
of the efforts to place the children together as required by section 260C.212, subdivision 2,
paragraph (d), if placement together is in each child's best interests, unless a child is in
placement for treatment or a child is placed with a previously noncustodial parent who is
not a parent to all siblings. If the children are not placed together at the time of the hearing,
the court shall inquire at each subsequent hearing of the agency's reasonable efforts to place
the siblings together, as required under section 260.012. If any sibling is not placed with
another sibling or siblings, the agency must develop a plan to facilitate visitation or ongoing
contact among the siblings as required under section 260C.212, subdivision 1, unless it is
contrary to the safety or well-being of any of the siblings to do so.

deleted text begin (l)deleted text endnew text begin (m)new text end When the court has ordered the child into new text beginthe care of a noncustodial parent or in
new text end foster care deleted text beginor into the home of a noncustodial parentdeleted text end, the court may order a chemical
dependency evaluation, mental health evaluation, medical examination, and parenting
assessment for the parent as necessary to support the development of a plan for reunification
required under subdivision 7 and section 260C.212, subdivision 1, or the child protective
services plan under section 260E.26, and Minnesota Rules, part 9560.0228.

Sec. 11.

Minnesota Statutes 2020, section 260C.181, subdivision 2, is amended to read:


Subd. 2.

Least restrictive setting.

Notwithstanding the provisions of subdivision 1, if
the child had been taken into custody pursuant to section 260C.175, subdivision 1, clause
(1) or (2), item (ii), and is not alleged to be delinquent, the child shall be detained in the
least restrictive setting consistent with the child's health and welfare and in closest proximity
to the child's family as possible. Placement may be with a child's relativedeleted text begin, a designateddeleted text end
deleted text begin caregiver under chapter 257A,deleted text end ornew text begin,new text endnew text begin if no placement is available with a relative,new text end in a shelter
care facility. The placing officer shall comply with this section and shall document why a
less restrictive setting will or will not be in the best interests of the child for placement
purposes.

Sec. 12.

Minnesota Statutes 2020, section 260C.193, subdivision 3, is amended to read:


Subd. 3.

Best interests of the child.

(a) The policy of the state is to ensure that the best
interests of children in foster care, who experience new text begina new text endtransfer of permanent legal and physical
custody to a relative under section 260C.515, subdivision 4, or adoption under this chapter,
are met bynew text begin:
new text end

new text begin (1) considering placement of a child with relatives in the order specified in section
260C.212, subdivision 2, paragraph (a); and
new text end

new text begin (2)new text end requiring individualized determinations under section 260C.212, subdivision 2,
paragraph (b), of the needs of the child and of how the selected home will serve the needs
of the child.

(b) No later than three months after a child is ordered new text beginto be new text endremoved from the care of a
parent in the hearing required under section 260C.202, the court shall review and enter
findings regarding whether the responsible social services agency deleted text beginmadedeleted text end:

(1) deleted text begindiligent effortsdeleted text end new text beginexercised due diligencenew text end to identify deleted text beginanddeleted text endnew text begin,new text end search fornew text begin, notify, and engagenew text end
relatives as required under section 260C.221; and

(2) new text beginmade a placement consistent with section 260C.212, subdivision 2, that is based on
new text end an individualized determination deleted text beginas required under section 260C.212, subdivision 2,deleted text end new text beginof the
child's needs
new text endto select a home that meets the needs of the child.

(c) If the court finds new text beginthat new text endthe agency has not deleted text beginmade effortsdeleted text end new text beginexercised due diligencenew text end as
required under section 260C.221, deleted text beginanddeleted text end new text beginthe court shall order the agency to make reasonable
efforts. If
new text endthere is a relative who qualifies to be licensed to provide family foster care under
chapter 245A, the court may order the child new text beginto be new text endplaced with the relative consistent with
the child's best interests.

(d) If the agency's efforts under section 260C.221 are found new text beginby the court new text endto be sufficient,
the court shall 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
appropriately engage relatives who subsequently come to the agency's attention.new text begin A court's
finding that the agency has made reasonable efforts under this paragraph does not relieve
the agency of the duty to continue notifying relatives who come to the agency's attention
and engaging and considering relatives who respond to the notice under section 260C.221
in child placement and case planning decisions.
new text end

(e) If the child's birth parent deleted text beginor parentsdeleted text end explicitly deleted text beginrequestdeleted text endnew text begin requestsnew text end that a new text beginspecific new text endrelative
deleted text begin or important frienddeleted text end not be considerednew text begin for placement of the childnew text end, the court shall honor that
request if it is consistent with the best interests of the child and consistent with the
requirements of section 260C.221.new text begin The court shall not waive relative search, notice, and
consideration requirements, unless section 260C.139 applies.
new text end If the child's birth parent deleted text beginor
parents express
deleted text endnew text begin expressesnew text end a preference for placing the child in a foster or adoptive home of
the same or a similar religious background deleted text begintodeleted text endnew text begin asnew text end that of the birth parent or parents, the court
shall order placement of the child with an individual who meets the birth parent's religious
preference.

(f) Placement of a child deleted text begincannotdeleted text endnew text begin must notnew text end be delayed or denied based on race, color, or
national origin of the foster parent or the child.

(g) Whenever possible, siblings requiring foster care placement deleted text beginshoulddeleted text endnew text begin shallnew text end be placed
together unless it is determined not to be in the best interests ofnew text begin one or more of thenew text end siblings
after weighing the benefits of separate placement against the benefits of sibling connections
for each sibling. new text beginThe agency shall consider section 260C.008 when making this determination.
new text end If siblings were not placed together according to section 260C.212, subdivision 2, paragraph
(d), the responsible social services agency shall report to the court the efforts made to place
the siblings together and why the efforts were not successful. If the court is not satisfied
that the agency has made reasonable efforts to place siblings together, the court must order
the agency to make further reasonable efforts. If siblings are not placed together, the court
shall order the responsible social services agency to implement the plan for visitation among
siblings required as part of the out-of-home placement plan under section 260C.212.

(h) This subdivision does not affect the Indian Child Welfare Act, United States Code,
title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation Act, sections
260.751 to 260.835.

Sec. 13.

Minnesota Statutes 2020, 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, deleted text beginitdeleted text endnew text begin the courtnew text end 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 deleted text beginfordeleted text endnew text begin ofnew text end 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 thenew text begin
placement
new text end considerationnew text begin ordernew text end for relativesdeleted text begin,deleted text endnew text begin andnew text end the best interest factors in section 260C.212,
subdivision 2deleted text begin, paragraph (b)deleted text end
, 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 new text beginthat new text endthe 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 deleted text beginwhichdeleted text endnew text begin thatnew text end 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 emotional disturbance 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 Laws 1997,
chapter 239, article 10, section 2.

(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.

Sec. 14.

Minnesota Statutes 2020, 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 thenew text begin relative and sibling placement
considerations and best interest
new text end factors in section 260C.212, subdivision 2deleted text begin, paragraph (b)deleted text end,
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 1deleted text begin;deleted text endnew text begin. The court's findings must
include a description of the agency's efforts to:
new text end

new text begin (A) identify and locate the child's noncustodial or nonresident parent;
new text end

new text begin (B) assess the noncustodial or nonresident parent's ability to provide day-to-day care of
the child; and
new text end

new text begin (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;
new text end

(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 new text beginof the child, considering the order in
section 260C.212, subdivision 2, paragraph (a),
new text endin the home of an unlicensed relative,
according to the requirements of section 245A.035, a licensed relative, or other licensed
foster care providernew text begin,new text end 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 childnew text begin. 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
new text end; 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
emotional disturbance 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 deleted text beginwhichdeleted text endnew text begin thatnew text end
is for reunification with the child's parent or guardian and a secondary plan deleted text beginwhichdeleted text endnew text begin thatnew text end is
for an alternative, legally permanent home for the child in the event reunification cannot
be achieved in a timely manner.

Sec. 15.

Minnesota Statutes 2020, section 260C.202, is amended to read:


260C.202 COURT REVIEW OF 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. 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, shall be governed by section 260C.607. 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.

(b) No later than three months after the child's placement in foster care, the court shall
review agency efforts new text beginto search for and notify relatives new text endpursuant to section 260C.221, and
order that the new text beginagency's new text endefforts new text beginbegin immediately, or new text endcontinuenew text begin,new text end if the agency has failed to
performnew text begin, or has not adequately performed,new text end 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 new text beginconsider 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,
new text endengage deleted text beginotherdeleted text endnew text begin, and considernew text end relatives who came to the agency's attention after
new text begin sending the initial new text endnotice under section 260C.221 deleted text beginwas sentdeleted text end.

(c) 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.

(d) When the court deleted text beginorders transfer ofdeleted text endnew text begin transfers thenew text end custodynew text begin of a childnew text end 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.

(e) 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.

Sec. 16.

Minnesota Statutes 2020, section 260C.203, is amended to read:


260C.203 ADMINISTRATIVE OR COURT REVIEW OF PLACEMENTS.

(a) Unless the court is conducting the reviews required under section 260C.202, there
shall be an administrative review of the out-of-home placement plan of each child placed
in foster care no later than 180 days after the initial placement of the child in foster care
and at least every six months thereafter if the child is not returned to the home of the parent
or parents within that time. The out-of-home placement plan must be monitored and updated
new text begin by the responsible social services agency new text endat each administrative review. The administrative
review shall be conducted by the responsible social services agency using a panel of
appropriate persons at least one of whom is not responsible for the case management of, or
the delivery of services to, either the child or the parents who are the subject of the review.
The administrative review shall be open to participation by the parent or guardian of the
child and the child, as appropriate.

(b) As an alternative to the administrative review required in paragraph (a), the court
may, as part of any hearing required under the Minnesota Rules of Juvenile Protection
Procedure, conduct a hearing to monitor and update the out-of-home placement plan pursuant
to the procedure and standard in section 260C.201, subdivision 6, paragraph (d). The party
requesting review of the out-of-home placement plan shall give parties to the proceeding
notice of the request to review and update the out-of-home placement plan. A court review
conducted pursuant to section 260C.141, subdivision 2; 260C.193; 260C.201, subdivision
1; 260C.202; 260C.204; 260C.317; or 260D.06 shall satisfy the requirement for the review
so long as the other requirements of this section are met.

(c) As appropriate to the stage of the proceedings and relevant court orders, the
responsible social services agency or the court shall review:

(1) the safety, permanency needs, and well-being of the child;

(2) the continuing necessity for and appropriateness of the placementnew text begin, including whether
the placement is consistent with the child's best interests and other placement considerations,
including relative and sibling placement considerations under section 260C.212, subdivision
2
new text end;

(3) the extent of compliance with the out-of-home placement plannew text begin required under section
260C.212, subdivisions 1 and 1a, including services and resources that the agency has
provided to the child and child's parents, services and resources that other agencies and
individuals have provided to the child and child's parents, and whether the out-of-home
placement plan is individualized to the needs of the child and child's parents
new text end;

(4) the extent of progress that has been made toward alleviating or mitigating the causes
necessitating placement in foster care;

(5) the projected date by which the child may be returned to and safely maintained in
the home or placed permanently away from the care of the parent or parents or guardian;
and

(6) the appropriateness of the services provided to the child.

(d) When a child is age 14 or older:

(1) in addition to any administrative review conducted by the responsible social services
agency, at the in-court review required under section 260C.317, subdivision 3, clause (3),
or 260C.515, subdivision 5 or 6, the court shall review the independent living plan required
under section 260C.212, subdivision 1, paragraph (c), clause (12), and the provision of
services to the child related to the well-being of the child as the child prepares to leave foster
care. The review shall include the actual plans related to each item in the plan necessary to
the child's future safety and well-being when the child is no longer in foster care; and

(2) consistent with the requirements of the independent living plan, the court shall review
progress toward or accomplishment of the following goals:

(i) the child has obtained a high school diploma or its equivalent;

(ii) the child has completed a driver's education course or has demonstrated the ability
to use public transportation in the child's community;

(iii) the child is employed or enrolled in postsecondary education;

(iv) the child has applied for and obtained postsecondary education financial aid for
which the child is eligible;

(v) the child has health care coverage and health care providers to meet the child's
physical and mental health needs;

(vi) the child has applied for and obtained disability income assistance for which the
child is eligible;

(vii) the child has obtained affordable housing with necessary supports, which does not
include a homeless shelter;

(viii) the child has saved sufficient funds to pay for the first month's rent and a damage
deposit;

(ix) the child has an alternative affordable housing plan, which does not include a
homeless shelter, if the original housing plan is unworkable;

(x) the child, if male, has registered for the Selective Service; and

(xi) the child has a permanent connection to a caring adult.

Sec. 17.

Minnesota Statutes 2020, 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 deleted text beginwhichdeleted text endnew text begin thatnew text end 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 complyingnew text begin, is not making
progress with or engaging
new text end with new text beginservices in new text endthe out-of-home placement plannew text begin,new text end 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 parentnew text begin, consistent with section 260C.212, subdivision 2,
paragraph (a),
new text end 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
245A 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 human services 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.

(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. 18.

Minnesota Statutes 2021 Supplement, section 260C.212, subdivision 1, is amended
to read:


Subdivision 1.

Out-of-home placement; plan.

(a) An out-of-home placement plan shall
be prepared within 30 days after any child is placed in foster care by court order or a
voluntary placement agreement between the responsible social services agency and the
child's parent pursuant to section 260C.227 or chapter 260D.

(b) An out-of-home placement plan means a written document deleted text beginwhichdeleted text endnew text begin individualized to
the needs of the child and the child's parents or guardians that
new text end is prepared by the responsible
social services agency jointly with deleted text beginthe parent or parents or guardian of the childdeleted text endnew text begin the child's
parents or guardians
new text end and in consultation with the child's guardian ad litemdeleted text begin,deleted text endnew text begin;new text end the child's tribe,
if the child is an Indian childdeleted text begin,deleted text endnew text begin;new text end the child's foster parent or representative of the foster care
facilitydeleted text begin,deleted text endnew text begin;new text end and, deleted text beginwheredeleted text endnew text begin whennew text end appropriate, the child. When a child is age 14 or older, the child
may include two other individuals on the team preparing the child's out-of-home placement
plan. The child may select one member of the case planning team to be designated as the
child's advisor and to advocate with respect to the application of the reasonable and prudent
parenting standards. The responsible social services agency may reject an individual selected
by the child if the agency has good cause to believe that the individual would not act in the
best interest of the child. For a child in voluntary foster care for treatment under chapter
260D, preparation of the out-of-home placement plan shall additionally include the child's
mental health treatment provider. For a child 18 years of age or older, the responsible social
services agency shall involve the child and the child's parents as appropriate. As appropriate,
the plan shall be:

(1) submitted to the court for approval under section 260C.178, subdivision 7;

(2) ordered by the court, either as presented or modified after hearing, under section
260C.178, subdivision 7, or 260C.201, subdivision 6; and

(3) signed by the parent or parents or guardian of the child, the child's guardian ad litem,
a representative of the child's tribe, the responsible social services agency, and, if possible,
the child.

(c) The out-of-home placement plan shall be explained new text beginby the responsible social services
agency
new text endto all persons involved in deleted text beginitsdeleted text endnew text begin the plan'snew text end implementation, including the child who has
signed the plan, and shall set forth:

(1) a description of the foster care home or facility selected, including how the
out-of-home placement plan is designed to achieve a safe placement for the child in the
least restrictive, most family-likedeleted text begin,deleted text end setting available deleted text beginwhichdeleted text endnew text begin thatnew text end is in close proximity to the
home of the deleted text beginparent ordeleted text endnew text begin child'snew text end parents or deleted text beginguardian of the childdeleted text endnew text begin guardiansnew text end when the case plan
goal is reunificationdeleted text begin,deleted text endnew text begin;new text end and how the placement is consistent with the best interests and special
needs of the child according to the factors under subdivision 2, paragraph (b);

(2) the specific reasons for the placement of the child in foster care, and when
reunification is the plan, a description of the problems or conditions in the home of the
parent or parents deleted text beginwhichdeleted text endnew text begin thatnew text end necessitated removal of the child from home and the changes
the parent or parents must make for the child to safely return home;

(3) a description of the services offered and provided to prevent removal of the child
from the home and to reunify the family including:

(i) the specific actions to be taken by the parent or parents of the child to eliminate or
correct the problems or conditions identified in clause (2), and the time period during which
the actions are to be taken; and

(ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made to
achieve a safe and stable home for the child including social and other supportive services
to be provided or offered to the parent or parents or guardian of the child, the child, and the
residential facility during the period the child is in the residential facility;

(4) a description of any services or resources that were requested by the child or the
child's parent, guardian, foster parent, or custodian since the date of the child's placement
in the residential facility, and whether those services or resources were provided and if not,
the basis for the denial of the services or resources;

(5) the visitation plan for the parent or parents or guardian, other relatives as defined in
section 260C.007, subdivision 26b or 27, and siblings of the child if the siblings are not
placed together in foster care, and whether visitation is consistent with the best interest of
the child, during the period the child is in foster care;

(6) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize adoption as the permanency plan for the child through reasonable efforts
to place the child for adoptionnew text begin pursuant to section 260C.605new text end. At a minimum, the
documentation must include consideration of whether adoption is in the best interests of
the childdeleted text begin,deleted text endnew text begin andnew text end child-specific recruitment efforts such as new text begina new text endrelative searchnew text begin, consideration of
relatives for adoptive placement,
new text end and the use of state, regional, and national adoption
exchanges to facilitate orderly and timely placements in and outside of the state. A copy of
this documentation shall be provided to the court in the review required under section
260C.317, subdivision 3, paragraph (b);

(7) when a child cannot return to or be in the care of either parent, documentation of
steps to finalize the transfer of permanent legal and physical custody to a relative as the
permanency plan for the child. This documentation must support the requirements of the
kinship placement agreement under section 256N.22 and must include the reasonable efforts
used to determine that it is not appropriate for the child to return home or be adopted, and
reasons why permanent placement with a relative through a Northstar kinship assistance
arrangement is in the child's best interest; how the child meets the eligibility requirements
for Northstar kinship assistance payments; agency efforts to discuss adoption with the child's
relative foster parent and reasons why the relative foster parent chose not to pursue adoption,
if applicable; and agency efforts to discuss with the child's parent or parents the permanent
transfer of permanent legal and physical custody or the reasons why these efforts were not
made;

(8) efforts to ensure the child's educational stability while in foster care for a child who
attained the minimum age for compulsory school attendance under state law and is enrolled
full time in elementary or secondary school, or instructed in elementary or secondary
education at home, or instructed in an independent study elementary or secondary program,
or incapable of attending school on a full-time basis due to a medical condition that is
documented and supported by regularly updated information in the child's case plan.
Educational stability efforts include:

(i) efforts to ensure that the child remains in the same school in which the child was
enrolled prior to placement or upon the child's move from one placement to another, including
efforts to work with the local education authorities to ensure the child's educational stability
and attendance; or

(ii) if it is not in the child's best interest to remain in the same school that the child was
enrolled in prior to placement or move from one placement to another, efforts to ensure
immediate and appropriate enrollment for the child in a new school;

(9) the educational records of the child including the most recent information available
regarding:

(i) the names and addresses of the child's educational providers;

(ii) the child's grade level performance;

(iii) the child's school record;

(iv) a statement about how the child's placement in foster care takes into account
proximity to the school in which the child is enrolled at the time of placement; and

(v) any other relevant educational information;

(10) the efforts by the responsible social services agency to ensure the oversight and
continuity of health care services for the foster child, including:

(i) the plan to schedule the child's initial health screens;

(ii) how the child's known medical problems and identified needs from the screens,
including any known communicable diseases, as defined in section 144.4172, subdivision
2, shall be monitored and treated while the child is in foster care;

(iii) how the child's medical information shall be updated and shared, including the
child's immunizations;

(iv) who is responsible to coordinate and respond to the child's health care needs,
including the role of the parent, the agency, and the foster parent;

(v) who is responsible for oversight of the child's prescription medications;

(vi) how physicians or other appropriate medical and nonmedical professionals shall be
consulted and involved in assessing the health and well-being of the child and determine
the appropriate medical treatment for the child; and

(vii) the responsibility to ensure that the child has access to medical care through either
medical insurance or medical assistance;

(11) the health records of the child including information available regarding:

(i) the names and addresses of the child's health care and dental care providers;

(ii) a record of the child's immunizations;

(iii) the child's known medical problems, including any known communicable diseases
as defined in section 144.4172, subdivision 2;

(iv) the child's medications; and

(v) any other relevant health care information such as the child's eligibility for medical
insurance or medical assistance;

(12) an independent living plan for a child 14 years of age or older, developed in
consultation with the child. The child may select one member of the case planning team to
be designated as the child's advisor and to advocate with respect to the application of the
reasonable and prudent parenting standards in subdivision 14. The plan should include, but
not be limited to, the following objectives:

(i) educational, vocational, or employment planning;

(ii) health care planning and medical coverage;

(iii) transportation including, where appropriate, assisting the child in obtaining a driver's
license;

(iv) money management, including the responsibility of the responsible social services
agency to ensure that the child annually receives, at no cost to the child, a consumer report
as defined under section 13C.001 and assistance in interpreting and resolving any inaccuracies
in the report;

(v) planning for housing;

(vi) social and recreational skills;

(vii) establishing and maintaining connections with the child's family and community;
and

(viii) regular opportunities to engage in age-appropriate or developmentally appropriate
activities typical for the child's age group, taking into consideration the capacities of the
individual child;

(13) for a child in voluntary foster care for treatment under chapter 260D, diagnostic
and assessment information, specific services relating to meeting the mental health care
needs of the child, and treatment outcomes;

(14) for a child 14 years of age or older, a signed acknowledgment that describes the
child's rights regarding education, health care, visitation, safety and protection from
exploitation, and court participation; receipt of the documents identified in section 260C.452;
and receipt of an annual credit report. The acknowledgment shall state that the rights were
explained in an age-appropriate manner to the child; and

(15) for a child placed in a qualified residential treatment program, the plan must include
the requirements in section 260C.708.

(d) The parent or parents or guardian and the child each shall have the right to legal
counsel in the preparation of the case plan and shall be informed of the right at the time of
placement of the child. The child shall also have the right to a guardian ad litem. If unable
to employ counsel from their own resources, the court shall appoint counsel upon the request
of the parent or parents or the child or the child's legal guardian. The parent or parents may
also receive assistance from any person or social services agency in preparation of the case
plan.

new text begin (e) new text endAfter the plan has been agreed upon by the parties involved or approved or ordered
by the court, the foster parents shall be fully informed of the provisions of the case plan and
shall be provided a copy of the plan.

new text begin (f) new text endUpon the child's discharge from foster care, the responsible social services agency
must provide the child's parent, adoptive parent, or permanent legal and physical custodian,
and the child, if the child is 14 years of age or older, with a current copy of the child's health
and education record. If a child meets the conditions in subdivision 15, paragraph (b), the
agency must also provide the child with the child's social and medical history. The responsible
social services agency may give a copy of the child's health and education record and social
and medical history to a child who is younger than 14 years of age, if it is appropriate and
if subdivision 15, paragraph (b), applies.

Sec. 19.

Minnesota Statutes 2021 Supplement, section 260C.212, subdivision 2, is amended
to read:


Subd. 2.

Placement decisions based on best interests of the child.

(a) The policy of
the state of Minnesota is to ensure that the child's best interests are met by requiring an
individualized determination of the needs of the child new text beginin consideration of paragraphs (a) to
(f),
new text endand of how the selected placement will serve the new text begincurrent and future new text endneeds of the child
being placed. The authorized child-placing agency shall place a child, released by court
order or by voluntary release by the parent or parents, in a family foster home selected by
considering placement with relatives deleted text beginand important friendsdeleted text end in the following order:

(1) with an individual who is related to the child by blood, marriage, or adoption,
including the legal parent, guardian, or custodian of the child's deleted text beginsiblingsdeleted text endnew text begin siblingnew text end; or

new text begin (2) with an individual who is an important friend of the child or of the child's parent or
custodian, including an individual with whom the child has resided or had significant contact
or who has a significant relationship to the child or the child's parent or custodian.
new text end

deleted text begin (2) deleted text end deleted text begin with an individual who is an important friend with whom the child has resided deleted text end deleted text begin or
had significant contact.
deleted text end

For an Indian child, the agency shall follow the order of placement preferences in the Indian
Child Welfare Act of 1978, United States Code, title 25, section 1915.

(b) Among the factors the agency shall consider in determining the new text begincurrent and future
new text end needs of the child are the following:

(1) the child's current functioning and behaviors;

(2) the medical needs of the child;

(3) the educational needs of the child;

(4) the developmental needs of the child;

(5) the child's history and past experience;

(6) the child's religious and cultural needs;

(7) the child's connection with a community, school, and faith community;

(8) the child's interests and talents;

(9) the child's deleted text beginrelationship to current caretakers,deleted text endnew text begin current and long-term needs regarding
relationships with
new text end parents, siblings, deleted text beginanddeleted text end relativesnew text begin, and other caretakersnew text end;

(10) the reasonable preference of the child, if the court, or the child-placing agency in
the case of a voluntary placement, deems the child to be of sufficient age to express
preferences; and

(11) for an Indian child, the best interests of an Indian child as defined in section 260.755,
subdivision 2a
.

new text begin When placing a child in foster care or in a permanent placement based on an individualized
determination of the child's needs, the agency must not use one factor in this paragraph to
the exclusion of all others, and the agency shall consider that the factors in paragraph (b)
may be interrelated.
new text end

(c) Placement of a child cannot be delayed or denied based on race, color, or national
origin of the foster parent or the child.

(d) Siblings should be placed together for foster care and adoption at the earliest possible
time unless it is documented that a joint placement would be contrary to the safety or
well-being of any of the siblings or unless it is not possible after reasonable efforts by the
responsible social services agency. In cases where siblings cannot be placed together, the
agency is required to provide frequent visitation or other ongoing interaction between
siblings unless the agency documents that the interaction would be contrary to the safety
or well-being of any of the siblings.

(e) Except for emergency placement as provided for in section 245A.035, the following
requirements must be satisfied before the approval of a foster or adoptive placement in a
related or unrelated home: (1) a completed background study under section 245C.08; and
(2) a completed review of the written home study required under section 260C.215,
subdivision 4
, clause (5), or 260C.611, to assess the capacity of the prospective foster or
adoptive parent to ensure the placement will meet the needs of the individual child.

(f) The agency must determine whether colocation with a parent who is receiving services
in a licensed residential family-based substance use disorder treatment program is in the
child's best interests according to paragraph (b) and include that determination in the child's
case plan under subdivision 1. The agency may consider additional factors not identified
in paragraph (b). The agency's determination must be documented in the child's case plan
before the child is colocated with a parent.

(g) The agency must establish a juvenile treatment screening team under section 260C.157
to determine whether it is necessary and appropriate to recommend placing a child in a
qualified residential treatment program, as defined in section 260C.007, subdivision 26d.

Sec. 20.

Minnesota Statutes 2020, section 260C.212, subdivision 4a, is amended to read:


Subd. 4a.

Monthly caseworker visits.

(a) Every child in foster care or on a trial home
visit shall be visited by the child's caseworker or another person who has responsibility for
visitation of the child on a monthly basis, with the majority of visits occurring in the child's
residence. The responsible social services agency may designate another person responsible
for monthly case visits. For the purposes of this section, the following definitions apply:

(1) "visit" is defined as a face-to-face contact between a child and the child's caseworker;

(2) "visited on a monthly basis" is defined as at least one visit per calendar month;

(3) "the child's caseworker" is defined as the person who has responsibility for managing
the child's foster care placement case as assigned by the responsible social services agency;

(4) "another person" means the professional staff whom the responsible social services
agency has assigned in the out-of-home placement plan or case plan. Another person must
be professionally trained to assess the child's safety, permanency, well-being, and case
progress. The agency may not designate the guardian ad litem, the child foster care provider,
residential facility staff, or a qualified individual as defined in section 260C.007,
subdivision26b
, as another person; and

(5) "the child's residence" is defined as the home where the child is residing, and can
include the foster home, child care institution, or the home from which the child was removed
if the child is on a trial home visit.

(b) Caseworker visits shall be of sufficient substance and duration to address issues
pertinent to case planning and service delivery to ensure the safety, permanency, and
well-being of the child, including whether the child is enrolled and attending school as
required by law.

new text begin (c) Every effort shall be made by the responsible social services agency and professional
staff to have the monthly visit with the child outside the presence of the child's parents,
foster parents, or facility staff. There may be situations related to the child's needs when a
caseworker visit cannot occur with the child alone. The reason the caseworker visit occurred
in the presence of others must be documented in the case record and may include:
new text end

new text begin (1) that the child exhibits intense emotion or behavior indicating that visiting without
the presence of the parent, foster parent, or facility staff would be traumatic for the child;
new text end

new text begin (2) that despite a caseworker's efforts, the child declines to visit with the caseworker
outside the presence of the parent, foster parent, or facility staff; and
new text end

new text begin (3) that the child has a specific developmental delay, physical limitation, incapacity,
medical device, or significant medical need, such that the parent, foster parent, or facility
staff is required to be present with the child during the visit.
new text end

Sec. 21.

Minnesota Statutes 2020, section 260C.221, is amended to read:


260C.221 RELATIVE SEARCHnew text begin AND ENGAGEMENT; PLACEMENT
CONSIDERATION
new text end.

new text begin Subdivision 1. new text end

new text begin Relative search requirements. new text end

(a) The responsible social services agency
shall exercise due diligence to identify and notify adult relatives new text beginand current caregivers of
a child's sibling,
new text endprior to placement or within 30 days after the child's removal from the
parentnew text begin, regardless of whether a child is placed in a relative's home, as required under
subdivision 2
new text end. deleted text beginThe county agency shall consider placement with a relative under this section
without delay and whenever the child must move from or be returned to foster care.
deleted text end The
relative search required by this section shall be comprehensive in scope. deleted text beginAfter a finding
that the agency has made reasonable efforts to conduct the relative search under this
paragraph, the agency has the continuing responsibility to appropriately involve relatives,
who have responded to the notice required under this paragraph, in planning for the child
and to continue to consider relatives according to the requirements of section 260C.212,
subdivision 2
. At any time during the course of juvenile protection proceedings, the court
may order the agency to reopen its search for relatives when it is in the child's best interest
to do so.
deleted text end

(b) The relative search required by this section shall include both maternal and paternal
adult relatives of the child; all adult grandparents; all legal parents, guardians, or custodians
of the child's siblings; and any other adult relatives suggested by the child's parents, subject
to the exceptions due to family violence in new text beginsubdivision 5, new text endparagraph deleted text begin(c)deleted text endnew text begin (b)new text end. The search shall
also include getting information from the child in an age-appropriate manner about who the
child considers to be family members and important friends with whom the child has resided
or had significant contact. The relative search required under this section must fulfill the
agency's duties under the Indian Child Welfare Act regarding active efforts to prevent the
breakup of the Indian family under United States Code, title 25, section 1912(d), and to
meet placement preferences under United States Code, title 25, section 1915.

new text begin (c) The responsible social services agency has a continuing responsibility to search for
and identify relatives of a child and send the notice to relatives that is required under
subdivision 2, unless the court has relieved the agency of this duty under subdivision 5,
paragraph (e).
new text end

new text begin Subd. 2. new text end

new text begin Relative notice requirements. new text end

new text begin(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.
new text endThenew text begin responsible social services agency
must notify
new text end relatives deleted text beginmust be notifieddeleted text end:

(1) of the need for a foster home for the child, the option to become a placement resource
for the child, new text beginthe order of placement that the agency will consider under section 260C.212,
subdivision 2, paragraph (a),
new text endand 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.204new text begin, until the relative provides a current address to the responsible social
services agency and the court
new text end. A decision by a relative not to be identified as a potential
permanent placement resource or participate in planning for the child deleted text beginat the beginning of
the case
deleted text end shall not affect whether the relative is considered for placement ofnew text begin, or as a
permanency resource for,
new text end the child with that relative deleted text beginlaterdeleted text endnew text begin 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
new text end;

(3) that the relative may participate in the care and planning for the child, new text beginas specified
in subdivision 3,
new text endincluding that the opportunity for such participation may be lost by failing
to respond to the notice sent under this subdivisiondeleted text begin. "Participate in the care and planning"
includes, but is not limited to, participation in case planning for the parent and child,
identifying the strengths and needs of the parent and child, supervising visits, providing
respite and vacation visits for the child, providing transportation to appointments, suggesting
other relatives who might be able to help support the case plan, and to the extent possible,
helping to maintain the child's familiar and regular activities and contact with friends and
relatives
deleted text end;

(4) of the family foster care licensing new text beginand adoption home study new text endrequirements, including
how to complete an application and 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 245A.04 and
supports that are available for relatives and children who reside in a family foster home;
deleted text begin and
deleted 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 deleted text beginor opportunitydeleted text end to be heard by the court
as required under section 260C.152, subdivision 5deleted text begin.deleted text endnew text begin;
new text end

new text begin (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; and
new text end

new text begin (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 26d.
new text end

new text begin (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.
new text end

new text begin (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 end

new text begin Subd. 3. new text end

new text begin Relative engagement requirements. new text end

new text begin (a) A relative who responds to the notice
under subdivision 2 has the opportunity to participate in care and planning for a child, which
must not be limited based solely on the relative's prior inconsistent participation or
nonparticipation in care and planning for the child. Care and planning for a child may include
but is not limited to:
new text end

new text begin (1) participating in case planning for the child and child's parent, including identifying
services and resources that meet the individualized needs of the child and child's parent. A
relative's participation in case planning may be in person, via phone call, or by electronic
means;
new text end

new text begin (2) identifying the strengths and needs of the child and child's parent;
new text end

new text begin (3) asking the responsible social services agency to consider the relative for placement
of the child according to subdivision 4;
new text end

new text begin (4) acting as a support person for the child, the child's parents, and the child's current
caregiver;
new text end

new text begin (5) supervising visits;
new text end

new text begin (6) providing respite care for the child and having vacation visits with the child;
new text end

new text begin (7) providing transportation;
new text end

new text begin (8) suggesting other relatives who may be able to participate in the case plan or that the
agency may consider for placement of the child. The agency shall send a notice to each
relative identified by other relatives according to subdivision 2, paragraph (b), unless a
relative received this notice earlier in the case;
new text end

new text begin (9) helping to maintain the child's familiar and regular activities and contact with the
child's friends and relatives, including providing supervision of the child at family gatherings
and events; and
new text end

new text begin (10) participating in the child's family and permanency team if the child is placed in a
qualified residential treatment program as defined in section 260C.007, subdivision 26d.
new text end

new text begin (b) The responsible social services agency shall make reasonable efforts to contact and
engage relatives who respond to the notice required under this section. Upon a request by
a relative or party to the proceeding, the court may conduct a review of the agency's
reasonable efforts to contact and engage relatives who respond to the notice. If the court
finds that the agency did not make reasonable efforts to contact and engage relatives who
respond to the notice, the court may order the agency to make reasonable efforts to contact
and engage relatives who respond to the notice in care and planning for the child.
new text end

new text begin Subd. 4. new text end

new text begin Placement considerations. new text end

new text begin (a) The responsible social services agency shall
consider placing a child with a relative under this section without delay and when the child:
new text end

new text begin (1) enters foster care;
new text end

new text begin (2) must be moved from the child's current foster setting;
new text end

new text begin (3) must be permanently placed away from the child's parent; or
new text end

new text begin (4) returns to foster care after permanency has been achieved for the child.
new text end

new text begin (b) The agency shall consider placing a child with relatives:
new text end

new text begin (1) in the order specified in section 260C.212, subdivision 2, paragraph (a); and
new text end

new text begin (2) based on the child's best interests using the factors in section 260C.212, subdivision
2.
new text end

new text begin (c) The agency shall document how the agency considered relatives in the child's case
record.
new text end

new text begin (d) Any relative who requests to be a placement option for a child in foster care has the
right to be considered for placement of the child according to section 260C.212, subdivision
2, paragraph (a), unless the court finds that placing the child with a specific relative would
endanger the child, sibling, parent, guardian, or any other family member under subdivision
5, paragraph (b).
new text end

new text begin (e) When adoption is the responsible social services agency's permanency goal for the
child, the agency shall consider adoptive placement of the child with a relative in the order
specified under section 260C.212, subdivision 2, paragraph (a).
new text end

new text begin Subd. 5. new text end

new text begin Data disclosure; court review. new text end

deleted text begin(c)deleted text endnew text begin (a)new text end A responsible social services agency
may disclose private data, as defined in section 13.02 and chapter 260E, to relatives of the
child for the purpose of locating and assessing a suitable placement and may use any
reasonable means of identifying and locating relatives including the Internet or other
electronic means of conducting a search. The agency shall disclose data that is necessary
to facilitate possible placement with relatives and to ensure that the relative is informed of
the needs of the child so the relative can participate in planning for the child and be supportive
of services to the child and family.

new text begin (b) new text endIf the child's parent refuses to give the responsible social services agency information
sufficient to identify the maternal and paternal relatives of the child, the agency shall ask
the juvenile court to order the parent to provide the necessary informationnew text begin and shall use
other resources to identify the child's maternal and paternal relatives
new text end. If a parent makes an
explicit request that a specific relative not be contacted or considered for placement due to
safety reasonsnew text begin,new text end including past family or domestic violence, the agency shall bring the parent's
request to the attention of the court to determine whether the parent's request is consistent
with the best interests of the child deleted text beginanddeleted text endnew text begin.new text end The agency shall not contact the specific relative
when the juvenile court finds that contacting new text beginor placing the child with new text endthe specific relative
would endanger the parent, guardian, child, sibling, or any family member. new text beginUnless section
260C.139 applies to the child's case, a court shall not waive or relieve the responsible social
services agency of reasonable efforts to:
new text end

new text begin (1) conduct a relative search;
new text end

new text begin (2) notify relatives;
new text end

new text begin (3) contact and engage relatives in case planning; and
new text end

new text begin (4) consider relatives for placement of the child.
new text end

new text begin (c) Notwithstanding chapter 13, the agency shall disclose data to the court about particular
relatives that the agency has identified, contacted, or considered for the child's placement
for the court to review the agency's due diligence.
new text end

(d) At a regularly scheduled hearing not later than three months after the child's placement
in foster care and as required in deleted text beginsectiondeleted text endnew text begin sections 260C.193 andnew text end 260C.202, the agency shall
report to the court:

(1) deleted text beginitsdeleted text endnew text begin the agency'snew text end efforts to identify maternal and paternal relatives of the child and to
engage the relatives in providing support for the child and family, and document that the
relatives have been provided the notice required under deleted text beginparagraph (a)deleted text endnew text begin subdivision 2new text end; and

(2) deleted text beginitsdeleted text endnew text begin the agency'snew text end decision regarding placing the child with a relative as required under
section 260C.212, subdivision 2deleted text begin, and to askdeleted text endnew text begin. If the responsible social services agency decides
that relative placement is not in the child's best interests at the time of the hearing, the agency
shall inform the court of the agency's decision, including:
new text end

new text begin (i) why the agency decided against relative placement of the child; and
new text end

new text begin (ii) the agency's efforts to engagenew text end relatives deleted text beginto visit or maintain contact with the child in
order
deleted text endnew text begin as required under subdivision 3new text end to support family connections for the childdeleted text begin, when
placement with a relative is not possible or appropriate
deleted text end.

deleted text begin (e) Notwithstanding chapter deleted text end deleted text begin 13 deleted text end deleted text begin , the agency shall disclose data about particular relatives
identified, searched for, and contacted for the purposes of the court's review of the agency's
due diligence.
deleted text end

deleted text begin (f)deleted text endnew text begin (e)new text end When the court is satisfied that the agency has exercised due diligence to identify
relatives and provide the notice required in deleted text beginparagraph (a)deleted text endnew text begin subdivision 2new text end, the court may find
that new text beginthe agency made new text endreasonable efforts deleted text beginhave been madedeleted text end to conduct a relative search to
identify and provide notice to adult relatives as required under section 260.012, paragraph
(e), clause (3). new text beginA finding under this paragraph does not relieve the responsible social services
agency of the ongoing duty to contact, engage, and consider relatives under this section nor
is it a basis for the court to rule out any relative from being a foster care or permanent
placement option for the child. The agency has the continuing responsibility to:
new text end

new text begin (1) involve relatives who respond to the notice in planning for the child; and
new text end

new text begin (2) continue considering relatives for the child's placement while taking the child's short-
and long-term permanency goals into consideration, according to the requirements of section
260C.212, subdivision 2.
new text end

new text begin (f) At any time during the course of juvenile protection proceedings, the court may order
the agency to reopen the search for relatives when it is in the child's best interests.
new text end

new text begin (g) new text endIf the court is not satisfied that the agency has exercised due diligence to identify
relatives and provide the notice required in deleted text beginparagraph (a)deleted text endnew text begin subdivision 2new text end, the court may order
the agency to continue its search and notice efforts and to report back to the court.

deleted text begin (g) When the placing agency determines that permanent placement proceedings are
necessary because there is a likelihood that the child will not return to a parent's care, the
agency must send the notice provided in paragraph (h), may ask the court to modify the
duty of the agency to send the notice required in paragraph (h), or may ask the court to
completely relieve the agency of the requirements of paragraph (h). The relative notification
requirements of paragraph (h) do not apply when the child is placed with an appropriate
relative or a foster home that has committed to adopting the child or taking permanent legal
and physical custody of the child and the agency approves of that foster home for permanent
placement of the child. The actions ordered by the court under this section must be consistent
with the best interests, safety, permanency, and welfare of the child.
deleted text end

(h) deleted text beginUnless required under the Indian Child Welfare Act or relieved of this duty by the
court under paragraph (f),
deleted text end When the agency determines that it is necessary to prepare for
permanent placement determination proceedings, or in anticipation of filing a termination
of parental rights petition, the agency shall send notice to deleted text beginthedeleted text end relativesnew text begin who responded to a
notice under this section sent at any time during the case
new text end, any adult with whom the child is
currently residing, any adult with whom the child has resided for one year or longer in the
past, and any adults who have maintained a relationship or exercised visitation with the
child as identified in the agency case plan. The notice must state that a permanent home is
sought for the child and that the individuals receiving the notice may indicate to the agency
their interest in providing a permanent home. The notice must state that within 30 days of
receipt of the notice an individual receiving the notice must indicate to the agency the
individual's interest in providing a permanent home for the child or that the individual may
lose the opportunity to be considered for a permanent placement.new text begin A relative's failure to
respond or timely respond to the notice is not a basis for ruling out the relative from being
a permanent placement option for the child, should the relative request to be considered for
permanent placement at a later date.
new text end

Sec. 22.

Minnesota Statutes 2020, section 260C.331, subdivision 1, is amended to read:


Subdivision 1.

Care, examination, or treatment.

(a) Except where parental rights are
terminated,

(1) whenever legal custody of a child is transferred by the court to a responsible social
services agency,

(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 agency, 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 child, these costs are a charge upon the welfare funds of
the county in which proceedings are held upon certification of the judge of juvenile court.

(b) The court deleted text beginshalldeleted text endnew text begin maynew text end order, and the responsible social services agency deleted text beginshalldeleted text endnew text begin maynew text end
require, the parents or custodian of a child, while the child is under the age of 18, to use deleted text beginthe
total
deleted text end 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 benefits and child support.
When the child is over the age of 18, and continues to receive care, examination, or treatment,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the responsible social services agency deleted text beginshalldeleted text endnew text begin maynew text end 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 deleted text beginfrom sources other than Supplemental Security Income
and child support
deleted text end that are needed to complete the requirements listed in section 260C.203.new text begin
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:
new text end

new text begin (1) whether requiring reimbursement would compromise the parent's ability to meet the
requirements of the reunification plan;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after reunification; and
new text end

new text begin (3) whether redirecting existing child support payments or changing the representative
payee of social security benefits to the responsible social services agency would limit the
parent's ability to maintain financial stability for the child.
new text end

(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 deleted text beginshalldeleted text endnew text begin maynew text end inquire
into the ability of the parents to deleted text beginsupport the childdeleted text endnew text begin reimburse the county for the cost of care,
examination, or treatment
new text end and, after giving the parents a reasonable opportunity to be heard,
the court deleted text beginshalldeleted text endnew text begin maynew text end order, and the responsible social services agency deleted text beginshalldeleted text endnew text begin maynew text end 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 human services. The income of a stepparent who has not
adopted a child shall be excluded in calculating the parental contribution under this section.new text begin
In determining whether to require reimbursement, the responsible social services agency
shall consider:
new text end

new text begin (1) whether requiring reimbursement would compromise the parent's ability to meet the
requirements of the reunification plan;
new text end

new text begin (2) whether requiring reimbursement would compromise the parent's ability to meet the
child's needs after reunification; and
new text end

new text begin (3) whether requiring reimbursement would compromise the parent's ability to meet the
needs of the family.
new text end

(d)new text begin If the responsible social services agency determines that reimbursement is in the
child's best interest,
new text end 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).

Sec. 23.

Minnesota Statutes 2020, section 260C.513, is amended to read:


260C.513 PERMANENCY DISPOSITIONS WHEN CHILD CANNOT RETURN
HOME.

(a) deleted text beginTermination of parental rights and adoption, or guardianship to the commissioner of
human services through a consent to adopt, are preferred permanency options for a child
who cannot return home. If the court finds that termination of parental rights and guardianship
to the commissioner is not in the child's best interests, the court may transfer permanent
legal and physical custody of the child to a relative when that order is in the child's best
interests.
deleted text endnew text begin For a child who cannot return home, a permanency placement with a relative is
preferred. A permanency placement with a relative includes termination of parental rights
and adoption by a relative, guardianship to the commissioner of human services through a
consent to adopt with a relative, or a transfer of permanent legal and physical custody to a
relative. The court must consider the best interests of the child and section 260C.212,
subdivision 2, paragraph (a), when making a permanency determination.
new text end

(b) When the court has determined that permanent placement of the child away from
the parent is necessary, the court shall consider permanent alternative homes that are available
both inside and outside the state.

Sec. 24.

Minnesota Statutes 2021 Supplement, section 260C.605, subdivision 1, is amended
to read:


Subdivision 1.

Requirements.

(a) Reasonable efforts to finalize the adoption of a child
under the guardianship of the commissioner shall be made by the responsible social services
agency responsible for permanency planning for the child.

(b) Reasonable efforts to make a placement in a home according to the placement
considerations under section 260C.212, subdivision 2, with a relative or foster parent who
will commit to being the permanent resource for the child in the event the child cannot be
reunified with a parent are required under section 260.012 and may be made concurrently
with reasonable, or if the child is an Indian child, active efforts to reunify the child with the
parent.

(c) Reasonable efforts under paragraph (b) must begin as soon as possible when the
child is in foster care under this chapter, but not later than the hearing required under section
260C.204.

(d) Reasonable efforts to finalize the adoption of the child include:

new text begin (1) considering the child's preference for an adoptive family;
new text end

deleted text begin (1)deleted text endnew text begin (2)new text end using age-appropriate engagement strategies to plan for adoption with the child;

deleted text begin (2)deleted text endnew text begin (3)new text end identifying an appropriate prospective adoptive parent for the child by updating
the child's identified needs using the factors in section 260C.212, subdivision 2;

deleted text begin (3)deleted text endnew text begin (4)new text end making an adoptive placement that meets the child's needs by:

(i) completing or updating the relative search required under section 260C.221 and giving
notice of the need for an adoptive home for the child to:

(A) relatives who have kept the agency or the court apprised of their whereabouts deleted text beginand
who have indicated an interest in adopting the child
deleted text end; or

(B) relatives of the child who are located in an updated search;

(ii) an updated search is required whenever:

(A) there is no identified prospective adoptive placement for the child notwithstanding
a finding by the court that the agency made diligent efforts under section 260C.221, in a
hearing required under section 260C.202;

(B) the child is removed from the home of an adopting parent; or

(C) the court determines new text beginthat new text enda relative search by the agency is in the best interests of
the child;

(iii) engaging the child's new text beginrelatives or current or former new text endfoster deleted text beginparent and the child's
relatives identified as an adoptive resource during the search conducted under section
260C.221,
deleted text endnew text begin parentsnew text end to commit to being the prospective adoptive parent of the childnew text begin, and
considering the child's relatives for adoptive placement of the child in the order specified
under section 260C.212, subdivision 2, paragraph (a)
new text end; or

(iv) when there is no identified prospective adoptive parent:

(A) registering the child on the state adoption exchange as required in section 259.75
unless the agency documents to the court an exception to placing the child on the state
adoption exchange reported to the commissioner;

(B) reviewing all families with approved adoption home studies associated with the
responsible social services agency;

(C) presenting the child to adoption agencies and adoption personnel who may assist
with finding an adoptive home for the child;

(D) using newspapers and other media to promote the particular child;

(E) using a private agency under grant contract with the commissioner to provide adoption
services for intensive child-specific recruitment efforts; and

(F) making any other efforts or using any other resources reasonably calculated to identify
a prospective adoption parent for the child;

deleted text begin (4)deleted text endnew text begin (5)new text end updating and completing the social and medical history required under sections
260C.212, subdivision 15, and 260C.609;

deleted text begin (5)deleted text endnew text begin (6)new text end making, and keeping updated, appropriate referrals required by section 260.851,
the Interstate Compact on the Placement of Children;

deleted text begin (6)deleted text endnew text begin (7)new text end giving notice regarding the responsibilities of an adoptive parent to any prospective
adoptive parent as required under section 259.35;

deleted text begin (7)deleted text endnew text begin (8)new text end offering the adopting parent the opportunity to apply for or decline adoption
assistance under chapter 256N;

deleted text begin (8)deleted text endnew text begin (9)new text end certifying the child for adoption assistance, assessing the amount of adoption
assistance, and ascertaining the status of the commissioner's decision on the level of payment
if the adopting parent has applied for adoption assistance;

deleted text begin (9)deleted text endnew text begin (10)new text end placing the child with siblings. If the child is not placed with siblings, the agency
must document reasonable efforts to place the siblings together, as well as the reason for
separation. The agency may not cease reasonable efforts to place siblings together for final
adoption until the court finds further reasonable efforts would be futile or that placement
together for purposes of adoption is not in the best interests of one of the siblings; and

deleted text begin (10)deleted text endnew text begin (11)new text end working with the adopting parent to file a petition to adopt the child and with
the court administrator to obtain a timely hearing to finalize the adoption.

Sec. 25.

Minnesota Statutes 2020, section 260C.607, subdivision 2, is amended to read:


Subd. 2.

Notice.

Notice of review hearings shall be given by the court to:

(1) the responsible social services agency;

(2) the child, if the child is age ten and older;

(3) the child's guardian ad litem;

(4) counsel appointed for the child pursuant to section 260C.163, subdivision 3;

(5) relatives of the child who have kept the court informed of their whereabouts as
required in section 260C.221 and who have responded to the agency's notice under section
260C.221, deleted text beginindicating a willingness to provide an adoptive home for the childdeleted text end unless the
relative has been previously ruled out by the court as a suitable deleted text beginfoster parent ordeleted text end permanency
resource for the child;

(6) the current foster or adopting parent of the child;

(7) any foster or adopting parents of siblings of the child; and

(8) the Indian child's tribe.

Sec. 26.

Minnesota Statutes 2020, section 260C.607, subdivision 5, is amended to read:


Subd. 5.

Required placement by responsible social services agency.

(a) No petition
for adoption shall be filed for a child under the guardianship of the commissioner unless
the child sought to be adopted has been placed for adoption with the adopting parent by the
responsible social services agencynew text begin as required under section 260C.613, subdivision 1new text end. The
court may order the agency to make an adoptive placement using standards and procedures
under subdivision 6.

(b) Any relative or the child's foster parent who believes the responsible agency has not
reasonably considered the relative's or foster parent's request to be considered for adoptive
placement as required under section 260C.212, subdivision 2, and who wants to be considered
for adoptive placement of the child shall bring a request for consideration to the attention
of the court during a review required under this section. The child's guardian ad litem and
the child may also bring a request for a relative or the child's foster parent to be considered
for adoptive placement. After hearing from the agency, the court may order the agency to
take appropriate action regarding the relative's or foster parent's request for consideration
under section 260C.212, subdivision 2, paragraph (b).

Sec. 27.

Minnesota Statutes 2021 Supplement, section 260C.607, subdivision 6, is amended
to read:


Subd. 6.

Motion and hearing to order adoptive placement.

(a) At any time after the
district court orders the child under the guardianship of the commissioner of human services,
but not later than 30 days after receiving notice required under section 260C.613, subdivision
1, paragraph (c), that the agency has made an adoptive placement, a relative or the child's
foster parent may file a motion for an order for adoptive placement of a child who is under
the guardianship of the commissioner if the relative or the child's foster parent:

(1) has an adoption home study under section 259.41 new text beginor 260C.611 new text endapproving the relative
or foster parent for adoption deleted text beginand hasdeleted text endnew text begin. If the relative or foster parent does not have an adoption
home study, an affidavit attesting to efforts to complete an adoption home study may be
filed with the motion instead. The affidavit must be signed by the relative or foster parent
and the responsible social services agency or licensed child-placing agency completing the
adoption home study. The relative or foster parent must also have
new text end been a resident of
Minnesota for at least six months before filing the motion; the court may waive the residency
requirement for the moving party if there is a reasonable basis to do so; or

(2) is not a resident of Minnesota, but has an approved adoption home study by an agency
licensed or approved to complete an adoption home study in the state of the individual's
residence and the study is filed with the motion for adoptive placement.new text begin If the relative or
foster parent does not have an adoption home study in the relative or foster parent's state
of residence, an affidavit attesting to efforts to complete an adoption home study may be
filed with the motion instead. The affidavit must be signed by the relative or foster parent
and the agency completing the adoption home study.
new text end

(b) The motion shall be filed with the court conducting reviews of the child's progress
toward adoption under this section. The motion and supporting documents must make a
prima facie showing that the agency has been unreasonable in failing to make the requested
adoptive placement. The motion must be served according to the requirements for motions
under the Minnesota Rules of Juvenile Protection Procedure and shall be made on all
individuals and entities listed in subdivision 2.

(c) If the motion and supporting documents do not make a prima facie showing for the
court to determine whether the agency has been unreasonable in failing to make the requested
adoptive placement, the court shall dismiss the motion. If the court determines a prima facie
basis is made, the court shall set the matter for evidentiary hearing.

(d) At the evidentiary hearing, the responsible social services agency shall proceed first
with evidence about the reason for not making the adoptive placement proposed by the
moving party. new text beginWhen the agency presents evidence regarding the child's current relationship
with the identified adoptive placement resource, the court must consider the agency's efforts
to support the child's relationship with the moving party consistent with section 260C.221.
new text end The moving party then has the burden of proving by a preponderance of the evidence that
the agency has been unreasonable in failing to make the adoptive placement.

new text begin (e) The court shall review and enter findings regarding whether the agency, in making
an adoptive placement decision for the child:
new text end

new text begin (1) considered relatives for adoptive placement in the order specified under section
260C.212, subdivision 2, paragraph (a); and
new text end

new text begin (2) assessed how the identified adoptive placement resource and the moving party are
each able to meet the child's current and future needs, based on an individualized
determination of the child's needs, as required under sections 260C.212, subdivision 2, and
260C.613, subdivision 1, paragraph (b).
new text end

deleted text begin (e)deleted text endnew text begin (f)new text end At the conclusion of the evidentiary hearing, if the court finds that the agency has
been unreasonable in failing to make the adoptive placement and that the deleted text beginrelative or the
child's foster parent
deleted text endnew text begin moving partynew text end is the most suitable adoptive home to meet the child's
needs using the factors in section 260C.212, subdivision 2, paragraph (b), the court maynew text begin:
new text end

new text begin (1)new text end order the responsible social services agency to make an adoptive placement in the
home of the deleted text beginrelative or the child's foster parent.deleted text endnew text begin moving party if the moving party has an
approved adoption home study; or
new text end

new text begin (2) order the responsible social services agency to place the child in the home of the
moving party upon approval of an adoption home study. The agency must promote and
support the child's ongoing visitation and contact with the moving party until the child is
placed in the moving party's home. The agency must provide an update to the court after
90 days, including progress and any barriers encountered. If the moving party does not have
an approved adoption home study within 180 days, the moving party and the agency must
inform the court of any barriers to obtaining the approved adoption home study during a
review hearing under this section. If the court finds that the moving party is unable to obtain
an approved adoption home study, the court must dismiss the order for adoptive placement
under this subdivision and order the agency to continue making reasonable efforts to finalize
the adoption of the child as required under section 260C.605.
new text end

deleted text begin (f)deleted text endnew text begin (g)new text end If, in order to ensure that a timely adoption may occur, the court orders the
responsible social services agency to make an adoptive placement under this subdivision,
the agency shall:

(1) make reasonable efforts to obtain a fully executed adoption placement agreementnew text begin,
including assisting the moving party with the adoption home study process
new text end;

(2) work with the moving party regarding eligibility for adoption assistance as required
under chapter 256N; and

(3) if the moving party is not a resident of Minnesota, timely refer the matter for approval
of the adoptive placement through the Interstate Compact on the Placement of Children.

deleted text begin (g)deleted text endnew text begin (h)new text end Denial or granting of a motion for an order for adoptive placement after an
evidentiary hearing is an order which may be appealed by the responsible social services
agency, the moving party, the child, when age ten or over, the child's guardian ad litem,
and any individual who had a fully executed adoption placement agreement regarding the
child at the time the motion was filed if the court's order has the effect of terminating the
adoption placement agreement. An appeal shall be conducted according to the requirements
of the Rules of Juvenile Protection Procedure.

Sec. 28.

Minnesota Statutes 2020, section 260C.613, subdivision 1, is amended to read:


Subdivision 1.

Adoptive placement decisions.

(a) The responsible social services agency
has exclusive authority to make an adoptive placement of a child under the guardianship of
the commissioner. The child shall be considered placed for adoption when the adopting
parent, the agency, and the commissioner have fully executed an adoption placement
agreement on the form prescribed by the commissioner.

(b) The responsible social services agency shall use an individualized determination of
the child's currentnew text begin and futurenew text end needsnew text begin,new text end pursuant to section 260C.212, subdivision 2, paragraph
(b), to determine the most suitable adopting parent for the child in the child's best interests.new text begin
The responsible social services agency must consider adoptive placement of the child with
relatives in the order specified in section 260C.212, subdivision 2, paragraph (a).
new text end

(c) The responsible social services agency shall notify the court and parties entitled to
notice under section 260C.607, subdivision 2, when there is a fully executed adoption
placement agreement for the child.

(d) In the event an adoption placement agreement terminates, the responsible social
services agency shall notify the court, the parties entitled to notice under section 260C.607,
subdivision 2
, and the commissioner that the agreement and the adoptive placement have
terminated.

Sec. 29.

Minnesota Statutes 2020, section 260C.613, subdivision 5, is amended to read:


Subd. 5.

Required record keeping.

The responsible social services agency shall
document, in the records required to be kept under section 259.79, the reasons for the
adoptive placement decision regarding the child, including the individualized determination
of the child's needs based on the factors in section 260C.212, subdivision 2, paragraph (b)deleted text begin,deleted text endnew text begin;
the agency's consideration of relatives in the order specified in section 260C.212, subdivision
2, paragraph (a);
new text end and the assessment of how the selected adoptive placement meets the
identified needs of the child. The responsible social services agency shall retain in the
records required to be kept under section 259.79, copies of all out-of-home placement plans
made since the child was ordered under guardianship of the commissioner and all court
orders from reviews conducted pursuant to section 260C.607.

Sec. 30.

Minnesota Statutes 2021 Supplement, section 260E.20, subdivision 2, is amended
to read:


Subd. 2.

Face-to-face contact.

(a) Upon receipt of a screened in report, the local welfare
agency shall conduct a face-to-face contact with the child reported to be maltreated and
with the child's primary caregiver sufficient to complete a safety assessment and ensure the
immediate safety of the child.new text begin When it is possible and the report alleges substantial child
endangerment or sexual abuse, the local welfare agency is not required to provide notice
before conducting the initial face-to-face contact with the child and the child's primary
caregiver.
new text end

(b) The face-to-face contact with the child and primary caregiver shall occur immediately
if sexual abuse or substantial child endangerment is alleged and within five calendar days
for all other reports. If the alleged offender was not already interviewed as the primary
caregiver, the local welfare agency shall also conduct a face-to-face interview with the
alleged offender in the early stages of the assessment or investigation. Face-to-face contact
with the child and primary caregiver in response to a report alleging sexual abuse or
substantial child endangerment may be postponed for no more than five calendar days if
the child is residing in a location that is confirmed to restrict contact with the alleged offender
as established in guidelines issued by the commissioner, or if the local welfare agency is
pursuing a court order for the child's caregiver to produce the child for questioning under
section 260E.22, subdivision 5.

(c) At the initial contact with the alleged offender, the local welfare agency or the agency
responsible for assessing or investigating the report must inform the alleged offender of the
complaints or allegations made against the individual in a manner consistent with laws
protecting the rights of the person who made the report. The interview with the alleged
offender may be postponed if it would jeopardize an active law enforcement investigation.

(d) The local welfare agency or the agency responsible for assessing or investigating
the report must provide the alleged offender with an opportunity to make a statement. The
alleged offender may submit supporting documentation relevant to the assessment or
investigation.

Sec. 31.

Minnesota Statutes 2020, section 260E.22, subdivision 2, is amended to read:


Subd. 2.

Child interview procedure.

(a) The interview may take place at school or at
any facility or other place where the alleged victim or other children might be found or the
child may be transported to, and the interview may be conducted at a place appropriate for
the interview of a child designated by the local welfare agency or law enforcement agency.

(b)new text begin When it is possible and the report alleges substantial child endangerment or sexual
abuse,
new text end the interview may take place outside the presence of the alleged offender deleted text beginor parent,
legal custodian, guardian, or school official.
deleted text endnew text begin and may take place prior to any interviews of
the alleged offender.
new text end

deleted text begin (c) For a family assessment, it is the preferred practice to request a parent or guardian's
deleted text end deleted text begin permission to interview the child before conducting the child interview, unless doing so
deleted text end deleted text begin would compromise the safety assessment.
deleted text end

Sec. 32.

Minnesota Statutes 2020, section 260E.24, subdivision 2, is amended to read:


Subd. 2.

Determination after family assessment.

After conducting a family 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.new text begin The local welfare agency must document the information collected under
section 260E.20, subdivision 3, related to the completed family assessment in the child's or
family's case notes.
new text end

Sec. 33.

Minnesota Statutes 2020, section 477A.0126, is amended by adding a subdivision
to read:


new text begin Subd. 3a. new text end

new text begin Transfer of withheld aid amounts. new text end

new text begin (a) For aid payable in 2023 and later, the
commissioner must transfer the total amount of the aid reductions under subdivision 3,
paragraph (d), for that year to the Board of Regents of the University of Minnesota for the
Tribal and Training Certification Partnership in the College of Education and Human Service
Professions at the University of Minnesota, Duluth.
new text end

new text begin (b) In order to support consistent training and county compliance with the Indian Child
Welfare Act and the Minnesota Indian Family Preservation Act, the Tribal Training and
Certification Partnership must use funds transferred under this subdivision to (1) enhance
training on the Indian Child Welfare Act and Minnesota Indian Family Preservation Act
for county workers and state guardians ad litem, and (2) build indigenous child welfare
training for the Tribal child welfare workforce.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for aid payable in 2023 and later.
new text end

Sec. 34.

Minnesota Statutes 2020, section 477A.0126, subdivision 7, is amended to read:


Subd. 7.

Appropriation.

(a) $5,000,000 is annually appropriated to the commissioner
of revenue from the general fund to pay aidnew text begin and make transfers requirednew text end under this section.

(b) $390,000 is appropriated annually from the general fund to the commissioner of
human services to implement subdivision 6.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective for aid payable in 2023 and later.
new text end

Sec. 35.

Minnesota Statutes 2020, section 518.17, subdivision 1, is amended to read:


Subdivision 1.

Best interests of the child.

(a) In evaluating the best interests of the child
for purposes of determining issues of custody and parenting time, the court must consider
and evaluate all relevant factors, including:

(1) a child's physical, emotional, cultural, spiritual, and other needs, and the effect of
the proposed arrangements on the child's needs and development;

(2) any special medical, mental health, new text begindevelopmental disability, new text endor educational needs
that the child may have that may require special parenting arrangements or access to
recommended services;

(3) the reasonable preference of the child, if the court deems the child to be of sufficient
ability, age, and maturity to express an independent, reliable preference;

(4) whether domestic abuse, as defined in section 518B.01, has occurred in the parents'
or either parent's household or relationship; the nature and context of the domestic abuse;
and the implications of the domestic abuse for parenting and for the child's safety, well-being,
and developmental needs;

(5) any physical, mental, or chemical health issue of a parent that affects the child's
safety or developmental needs;

(6) the history and nature of each parent's participation in providing care for the child;

(7) the willingness and ability of each parent to provide ongoing care for the child; to
meet the child's ongoing developmental, emotional, spiritual, and cultural needs; and to
maintain consistency and follow through with parenting time;

(8) the effect on the child's well-being and development of changes to home, school,
and community;

(9) the effect of the proposed arrangements on the ongoing relationships between the
child and each parent, siblings, and other significant persons in the child's life;

(10) the benefit to the child in maximizing parenting time with both parents and the
detriment to the child in limiting parenting time with either parent;

(11) except in cases in which domestic abuse as described in clause (4) has occurred,
the disposition of each parent to support the child's relationship with the other parent and
to encourage and permit frequent and continuing contact between the child and the other
parent; and

(12) the willingness and ability of parents to cooperate in the rearing of their child; to
maximize sharing information and minimize exposure of the child to parental conflict; and
to utilize methods for resolving disputes regarding any major decision concerning the life
of the child.

(b) Clauses (1) to (9) govern the application of the best interests of the child factors by
the court:

(1) The court must make detailed findings on each of the factors in paragraph (a) based
on the evidence presented and explain how each factor led to its conclusions and to the
determination of custody and parenting time. The court may not use one factor to the
exclusion of all others, and the court shall consider that the factors may be interrelated.

(2) The court shall consider that it is in the best interests of the child to promote the
child's healthy growth and development through safe, stable, nurturing relationships between
a child and both parents.

(3) The court shall consider both parents as having the capacity to develop and sustain
nurturing relationships with their children unless there are substantial reasons to believe
otherwise. In assessing whether parents are capable of sustaining nurturing relationships
with their children, the court shall recognize that there are many ways that parents can
respond to a child's needs with sensitivity and provide the child love and guidance, and
these may differ between parents and among cultures.

(4) The court shall not consider conduct of a party that does not affect the party's
relationship with the child.

(5) Disability alone, as defined in section 363A.03, of a proposed custodian or the child
shall not be determinative of the custody of the child.

(6) The court shall consider evidence of a violation of section 609.507 in determining
the best interests of the child.

(7) There is no presumption for or against joint physical custody, except as provided in
clause (9).

(8) Joint physical custody does not require an absolutely equal division of time.

(9) The court shall use a rebuttable presumption that upon request of either or both
parties, joint legal custody is in the best interests of the child. However, the court shall use
a rebuttable presumption that joint legal custody or joint physical custody is not in the best
interests of the child if domestic abuse, as defined in section 518B.01, has occurred between
the parents. In determining whether the presumption is rebutted, the court shall consider
the nature and context of the domestic abuse and the implications of the domestic abuse for
parenting and for the child's safety, well-being, and developmental needs. Disagreement
alone over whether to grant sole or joint custody does not constitute an inability of parents
to cooperate in the rearing of their children as referenced in paragraph (a), clause (12).

(c) In a proceeding involving the custodial responsibility of a service member's child, a
court may not consider only a parent's past deployment or possible future deployment in
determining the best interests of the child. For purposes of this paragraph, "custodial
responsibility" has the meaning given in section 518E.102, paragraph (f).

new text begin EFFECTIVE DATE. new text end

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

Sec. 36.

Minnesota Statutes 2020, section 518A.43, subdivision 1, is amended to read:


Subdivision 1.

General factors.

Among other reasons, deviation from the presumptive
child support obligation computed under section 518A.34 is intended to encourage prompt
and regular payments of child support and to prevent either parent or the joint children from
living in poverty. In addition to the child support guidelines and other factors used to calculate
the child support obligation under section 518A.34, the court must take into consideration
the following factors in setting or modifying child support or in determining whether to
deviate upward or downward from the presumptive child support obligation:

(1) all earnings, income, circumstances, and resources of each parent, including real and
personal property, but excluding income from excess employment of the obligor or obligee
that meets the criteria of section 518A.29, paragraph (b);

(2) the extraordinary financial needs and resources, physical and emotional condition,
and educational needs of the child to be supported;

(3) the standard of living the child would enjoy if the parents were currently living
together, but recognizing that the parents now have separate households;

(4) whether the child resides in a foreign country for more than one year that has a
substantially higher or lower cost of living than this country;

(5) which parent receives the income taxation dependency exemption and the financial
benefit the parent receives from it;

(6) the parents' debts as provided in subdivision 2; deleted text beginand
deleted text end

(7) the obligor's total payments for court-ordered child support exceed the limitations
set forth in section 571.922deleted text begin.deleted text endnew text begin; and
new text end

new text begin (8) in cases involving court-ordered out-of-home placement, whether ordering and
redirecting a child support obligation to reimburse the county for the cost of care,
examination, or treatment would compromise the parent's ability to meet the requirements
of a reunification plan or the parent's ability to meet the child's needs after reunification.
new text end

Sec. 37.

Minnesota Statutes 2020, section 626.557, subdivision 4, is amended to read:


Subd. 4.

Reporting.

(a) Except as provided in paragraph (b), a mandated reporter shall
immediately make deleted text beginan oraldeleted text endnew text begin anew text end report to the common entry point. deleted text beginThe common entry point
may accept electronic reports submitted through a web-based reporting system established
by the commissioner. Use of a telecommunications device for the deaf or other similar
device shall be considered an oral report. The common entry point may not require written
reports.
deleted text end To the extent possible, the report must be of sufficient content to identify the
vulnerable adult, the caregiver, the nature and extent of the suspected maltreatment, any
evidence of previous maltreatment, the name and address of the reporter, the time, date,
and location of the incident, and any other information that the reporter believes might be
helpful in investigating the suspected maltreatment. A mandated reporter may disclose not
public data, as defined in section 13.02, and medical records under sections 144.291 to
144.298, to the extent necessary to comply with this subdivision.

(b) A boarding care home that is licensed under sections 144.50 to 144.58 and certified
under Title 19 of the Social Security Act, a nursing home that is licensed under section
144A.02 and certified under Title 18 or Title 19 of the Social Security Act, or a hospital
that is licensed under sections 144.50 to 144.58 and has swing beds certified under Code
of Federal Regulations, title 42, section 482.66, may submit a report electronically to the
common entry point instead of submitting an oral report. The report may be a duplicate of
the initial report the facility submits electronically to the commissioner of health to comply
with the reporting requirements under Code of Federal Regulations, title 42, section 483.12.
The commissioner of health may modify these reporting requirements to include items
required under paragraph (a) that are not currently included in the electronic reporting form.

Sec. 38.

Minnesota Statutes 2020, section 626.557, subdivision 9, is amended to read:


Subd. 9.

Common entry point designation.

(a) deleted text beginEach county board shall designate a
common entry point for reports of suspected maltreatment, for use until the commissioner
of human services establishes a common entry point. Two or more county boards may
jointly designate a single common entry point.
deleted text end The commissioner of human services shall
establish a common entry point deleted text begineffective July 1, 2015deleted text end. The common entry point is the unit
responsible for receiving the report of suspected maltreatment under this section.

(b) The common entry point must be available 24 hours per day to take calls from
reporters of suspected maltreatment. The common entry point shall use a standard intake
form that includes:

(1) the time and date of the report;

(2)new text begin the name, relationship, and identifying and contact information for the person believed
to be a vulnerable adult and the individual or facility alleged responsible for maltreatment;
new text end

new text begin (3)new text end the name, deleted text beginaddress, and telephone number of the person reporting;deleted text endnew text begin relationship, and
contact information for the:
new text end

new text begin (i) reporter;
new text end

new text begin (ii) initial reporter, witnesses, and persons who may have knowledge about the
maltreatment; and
new text end

new text begin (iii) legal surrogate and persons who may provide support to the vulnerable adult;
new text end

new text begin (4) the basis of vulnerability for the vulnerable adult;
new text end

deleted text begin (3)deleted text endnew text begin (5)new text end the time, date, and location of the incident;

deleted text begin (4) the names of the persons involved, including but not limited to, perpetrators, alleged
victims, and witnesses;
deleted text end

deleted text begin (5) whether there was a risk of imminent danger to the alleged victim;
deleted text end

new text begin (6) the immediate safety risk to the vulnerable adult;
new text end

deleted text begin (6)deleted text endnew text begin (7)new text end a description of the suspected maltreatment;

deleted text begin (7) the disability, if any, of the alleged victim;
deleted text end

deleted text begin (8) the relationship of the alleged perpetrator to the alleged victim;
deleted text end

new text begin (8) the impact of the suspected maltreatment on the vulnerable adult;
new text end

(9) whether a facility was involved and, if so, which agency licenses the facility;

deleted text begin (10) any action taken by the common entry point;
deleted text end

deleted text begin (11) whether law enforcement has been notified;
deleted text end

new text begin (10) the actions taken to protect the vulnerable adult;
new text end

new text begin (11) the required notifications and referrals made by the common entry point; and
new text end

(12) whether the reporter wishes to receive notification of the deleted text begininitial and final reports;
and
deleted text endnew text begin disposition.
new text end

deleted text begin (13) if the report is from a facility with an internal reporting procedure, the name, mailing
address, and telephone number of the person who initiated the report internally.
deleted text end

(c) The common entry point is not required to complete each item on the form prior to
dispatching the report to the appropriate lead investigative agency.

(d) The common entry point shall immediately report to a law enforcement agency any
incident in which there is reason to believe a crime has been committed.

(e) If a report is initially made to a law enforcement agency or a lead investigative agency,
those agencies shall take the report on the appropriate common entry point intake forms
and immediately forward a copy to the common entry point.

(f) The common entry point staff must receive training on how to screen and dispatch
reports efficiently and in accordance with this section.

(g) The commissioner of human services shall maintain a centralized database for the
collection of common entry point data, lead investigative agency data including maltreatment
report disposition, and appeals data. The common entry point shall have access to the
centralized database and must log the reports into the database deleted text beginand immediately identify
and locate prior reports of abuse, neglect, or exploitation
deleted text end.

(h) When appropriate, the common entry point staff must refer calls that do not allege
the abuse, neglect, or exploitation of a vulnerable adult to other organizations that might
resolve the reporter's concerns.

(i) A common entry point must be operated in a manner that enables the commissioner
of human services to:

(1) track critical steps in the reporting, evaluation, referral, response, disposition, and
investigative process to ensure compliance with all requirements for all reports;

(2) maintain data to facilitate the production of aggregate statistical reports for monitoring
patterns of abuse, neglect, or exploitation;

(3) serve as a resource for the evaluation, management, and planning of preventative
and remedial services for vulnerable adults who have been subject to abuse, neglect, or
exploitation;

(4) set standards, priorities, and policies to maximize the efficiency and effectiveness
of the common entry point; and

(5) track and manage consumer complaints related to the common entry point.

(j) The commissioners of human services and health shall collaborate on the creation of
a system for referring reports to the lead investigative agencies. This system shall enable
the commissioner of human services to track critical steps in the reporting, evaluation,
referral, response, disposition, investigation, notification, determination, and appeal processes.

Sec. 39.

Minnesota Statutes 2020, section 626.557, subdivision 9b, is amended to read:


Subd. 9b.

Response to reports.

Law enforcement is the primary agency to conduct
investigations of any incident in which there is reason to believe a crime has been committed.
Law enforcement shall initiate a response immediately. If the common entry point notified
a county agency for emergency adult protective services, law enforcement shall cooperate
with that county agency when both agencies are involved and shall exchange data to the
extent authorized in subdivision 12b, paragraph (g). County adult protection shall initiate
a response immediately. Each lead investigative agency shall complete the investigative
process for reports within its jurisdiction. A lead investigative agency, county, adult protective
agency, licensed facility, or law enforcement agency shall cooperate with other agencies in
the provision of protective services, coordinating its investigations, and assisting another
agency within the limits of its resources and expertise and shall exchange data to the extent
authorized in subdivision 12b, paragraph (g). The lead investigative agency shall obtain the
results of any investigation conducted by law enforcement officials. The lead investigative
agency has the right to enter facilities and inspect and copy records as part of investigations.
The lead investigative agency has access to not public data, as defined in section 13.02, and
medical records under sections 144.291 to 144.298, that are maintained by facilities to the
extent necessary to conduct its investigation. Each lead investigative agency shall develop
guidelines for prioritizing reports for investigation.new text begin When a county acts as a lead investigative
agency, the county shall make guidelines available to the public regarding which reports
the county prioritizes for investigation and adult protective services.
new text end

Sec. 40.

Minnesota Statutes 2020, section 626.557, subdivision 9c, is amended to read:


Subd. 9c.

Lead investigative agency; notifications, dispositions, determinations.

(a)
Upon request of the reporter, the lead investigative agency shall notify the reporter that it
has received the report, and provide information on the initial disposition of the report within
five business days of receipt of the report, provided that the notification will not endanger
the vulnerable adult or hamper the investigation.

new text begin (b) In making the initial disposition of a report alleging maltreatment of a vulnerable
adult, the lead investigative agency may consider previous reports of suspected maltreatment
and may request and consider public information, records maintained by a lead investigative
agency or licensed providers, and information from any person who may have knowledge
regarding the alleged maltreatment and the basis for the adult's vulnerability.
new text end

new text begin (c) When the county social service agency does not accept a report for adult protective
services or investigation, the agency may offer assistance to the reporter or the person who
was the subject of the report.
new text end

new text begin (d) While investigating reports and providing adult protective services, the lead
investigative agency may coordinate with entities identified under subdivision 12b, paragraph
(g), and may coordinate with support persons to safeguard the welfare of the vulnerable
adult and prevent further maltreatment of the vulnerable adult.
new text end

deleted text begin (b)deleted text endnew text begin (e)new text end Upon conclusion of every investigation it conducts, the lead investigative agency
shall make a final disposition as defined in section 626.5572, subdivision 8.

deleted text begin (c)deleted text endnew text begin (f)new text end When determining whether the facility or individual is the responsible party for
substantiated maltreatment or whether both the facility and the individual are responsible
for substantiated maltreatment, the lead investigative agency shall consider at least the
following mitigating factors:

(1) whether the actions of the facility or the individual caregivers were in accordance
with, and followed the terms of, an erroneous physician order, prescription, resident care
plan, or directive. This is not a mitigating factor when the facility or caregiver is responsible
for the issuance of the erroneous order, prescription, plan, or directive or knows or should
have known of the errors and took no reasonable measures to correct the defect before
administering care;

(2) the comparative responsibility between the facility, other caregivers, and requirements
placed upon the employee, including but not limited to, the facility's compliance with related
regulatory standards and factors such as the adequacy of facility policies and procedures,
the adequacy of facility training, the adequacy of an individual's participation in the training,
the adequacy of caregiver supervision, the adequacy of facility staffing levels, and a
consideration of the scope of the individual employee's authority; and

(3) whether the facility or individual followed professional standards in exercising
professional judgment.

deleted text begin (d)deleted text endnew text begin (g)new text end When substantiated maltreatment is determined to have been committed by an
individual who is also the facility license holder, both the individual and the facility must
be determined responsible for the maltreatment, and both the background study
disqualification standards under section 245C.15, subdivision 4, and the licensing actions
under section 245A.06 or 245A.07 apply.

deleted text begin (e)deleted text endnew text begin (h)new text end The lead investigative agency shall complete its final disposition within 60
calendar days. If the lead investigative agency is unable to complete its final disposition
within 60 calendar days, the lead investigative agency shall notify the following persons
provided that the notification will not endanger the vulnerable adult or hamper the
investigation: (1) the vulnerable adult or the vulnerable adult's guardian or health care agent,
when known, if the lead investigative agency knows them to be aware of the investigation;
and (2) the facility, where applicable. The notice shall contain the reason for the delay and
the projected completion date. If the lead investigative agency is unable to complete its final
disposition by a subsequent projected completion date, the lead investigative agency shall
again notify the vulnerable adult or the vulnerable adult's guardian or health care agent,
when known if the lead investigative agency knows them to be aware of the investigation,
and the facility, where applicable, of the reason for the delay and the revised projected
completion date provided that the notification will not endanger the vulnerable adult or
hamper the investigation. The lead investigative agency must notify the health care agent
of the vulnerable adult only if the health care agent's authority to make health care decisions
for the vulnerable adult is currently effective under section 145C.06 and not suspended
under section 524.5-310 and the investigation relates to a duty assigned to the health care
agent by the principal. A lead investigative agency's inability to complete the final disposition
within 60 calendar days or by any projected completion date does not invalidate the final
disposition.

deleted text begin (f) Within ten calendar days of completing the final dispositiondeleted text endnew text begin (i) When the lead
investigative agency is the Department of Health or the Department of Human Services
new text end,
the lead investigative agency shall provide a copy of the public investigation memorandum
under subdivision 12b, paragraph (b), clause (1), deleted text beginwhen required to be completed under this
section,
deleted text endnew text begin within ten calendar days of completing the final dispositionnew text end to the following persons:

(1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
unless the lead investigative agency knows that the notification would endanger the
well-being of the vulnerable adult;

(2) the reporter, if the reporter requested notification when making the report, provided
this notification would not endanger the well-being of the vulnerable adult;

(3) the deleted text beginalleged perpetratordeleted text endnew text begin person or facility alleged responsible for maltreatmentnew text end, if
known;

(4) the facility; and

(5) the ombudsman for long-term care, or the ombudsman for mental health and
developmental disabilities, as appropriate.

new text begin (j) When the lead investigative agency is a county agency, within ten calendar days of
completing the final disposition, the lead investigative agency shall provide notification of
the final disposition to the following persons:
new text end

new text begin (1) the vulnerable adult, or the vulnerable adult's guardian or health care agent, if known,
when the allegation is applicable to the authority of the vulnerable adult's guardian or health
care agent, unless the agency knows that the notification would endanger the well-being of
the vulnerable adult;
new text end

new text begin (2) the individual determined responsible for maltreatment, if known; and
new text end

new text begin (3) when the alleged incident involves a personal care assistant or provider agency, the
personal care provider organization under section 256B.0659. Upon implementation of
Community First Services and Supports (CFSS), this notification requirement applies to
the CFSS support worker or CFSS agency under section 256B.85.
new text end

deleted text begin (g)deleted text endnew text begin (k)new text end If, as a result of a reconsideration, review, or hearing, the lead investigative
agency changes the final disposition, or if a final disposition is changed on appeal, the lead
investigative agency shall notify the parties specified in paragraph deleted text begin(f)deleted text endnew text begin (k)new text end.

deleted text begin (h)deleted text endnew text begin (l)new text end The lead investigative agency shall notify the vulnerable adult who is the subject
of the report or the vulnerable adult's guardian or health care agent, if known, and any person
or facility determined to have maltreated a vulnerable adult, of their appeal or review rights
under this section or section 256.021.

deleted text begin (i)deleted text endnew text begin (m)new text end The lead investigative agency shall routinely provide investigation memoranda
for substantiated reports to the appropriate licensing boards. These reports must include the
names of substantiated perpetrators. The lead investigative agency may not provide
investigative memoranda for inconclusive or false reports to the appropriate licensing boards
unless the lead investigative agency's investigation gives reason to believe that there may
have been a violation of the applicable professional practice laws. If the investigation
memorandum is provided to a licensing board, the subject of the investigation memorandum
shall be notified and receive a summary of the investigative findings.

deleted text begin (j)deleted text endnew text begin (n)new text end In order to avoid duplication, licensing boards shall consider the findings of the
lead investigative agency in their investigations if they choose to investigate. This does not
preclude licensing boards from considering other information.

deleted text begin (k)deleted text endnew text begin (o)new text end The lead investigative agency must provide to the commissioner of human services
its final dispositions, including the names of all substantiated perpetrators. The commissioner
of human services shall establish records to retain the names of substantiated perpetrators.

Sec. 41.

Minnesota Statutes 2020, section 626.557, subdivision 9d, is amended to read:


Subd. 9d.

Administrative reconsideration; review panel.

(a) Except as provided under
paragraph (e), any individual or facility which a lead investigative agency determines has
maltreated a vulnerable adult, or the vulnerable adult or an interested person acting on behalf
of the vulnerable adult, regardless of the lead investigative agency's determination, who
contests the lead investigative agency's final disposition of an allegation of maltreatment,
may request the lead investigative agency to reconsider its final disposition. The request
for reconsideration must be submitted in writing to the lead investigative agency within 15
calendar days after receipt of notice of final disposition or, if the request is made by an
interested person who is not entitled to notice, within 15 days after receipt of the notice by
the vulnerable adult or the vulnerable adult's guardian or health care agent. If mailed, the
request for reconsideration must be postmarked and sent to the lead investigative agency
within 15 calendar days of the individual's or facility's receipt of the final disposition. If the
request for reconsideration is made by personal service, it must be received by the lead
investigative agency within 15 calendar days of the individual's or facility's receipt of the
final disposition. An individual who was determined to have maltreated a vulnerable adult
under this section and who was disqualified on the basis of serious or recurring maltreatment
under sections 245C.14 and 245C.15, may request reconsideration of the maltreatment
determination and the disqualification. The request for reconsideration of the maltreatment
determination and the disqualification must be submitted in writing within 30 calendar days
of the individual's receipt of the notice of disqualification under sections 245C.16 and
245C.17. If mailed, the request for reconsideration of the maltreatment determination and
the disqualification must be postmarked and sent to the lead investigative agency within 30
calendar days of the individual's receipt of the notice of disqualification. If the request for
reconsideration is made by personal service, it must be received by the lead investigative
agency within 30 calendar days after the individual's receipt of the notice of disqualification.

(b) Except as provided under paragraphs (e) and (f), if the lead investigative agency
denies the request or fails to act upon the request within 15 working days after receiving
the request for reconsideration, the person or facility entitled to a fair hearing under section
256.045, may submit to the commissioner of human services a written request for a hearing
under that statute. The vulnerable adult, or an interested person acting on behalf of the
vulnerable adult, may request a review by the Vulnerable Adult Maltreatment Review Panel
under section 256.021 if the lead investigative agency denies the request or fails to act upon
the request, or if the vulnerable adult or interested person contests a reconsidered disposition.new text begin
The Vulnerable Adult Maltreatment Review Panel shall not conduct a review if the interested
person making the request on behalf of the vulnerable adult is also the individual or facility
alleged responsible for the maltreatment of the vulnerable adult.
new text end The lead investigative
agency shall notify persons who request reconsideration of their rights under this paragraph.
The request must be submitted in writing to the review panel and a copy sent to the lead
investigative agency within 30 calendar days of receipt of notice of a denial of a request for
reconsideration or of a reconsidered disposition. The request must specifically identify the
aspects of the lead investigative agency determination with which the person is dissatisfied.

(c) If, as a result of a reconsideration or review, the lead investigative agency changes
the final disposition, it shall notify the parties specified in subdivision 9c, paragraph deleted text begin(f)deleted text endnew text begin (i)new text end.

(d) For purposes of this subdivision, "interested person acting on behalf of the vulnerable
adult" means a person designated in writing by the vulnerable adult to act on behalf of the
vulnerable adult, or a legal guardian or conservator or other legal representative, a proxy
or health care agent appointed under chapter 145B or 145C, or an individual who is related
to the vulnerable adult, as defined in section 245A.02, subdivision 13.

(e) If an individual was disqualified under sections 245C.14 and 245C.15, on the basis
of a determination of maltreatment, which was serious or recurring, and the individual has
requested reconsideration of the maltreatment determination under paragraph (a) and
reconsideration of the disqualification under sections 245C.21 to 245C.27, reconsideration
of the maltreatment determination and requested reconsideration of the disqualification
shall be consolidated into a single reconsideration. If reconsideration of the maltreatment
determination is denied and the individual remains disqualified following a reconsideration
decision, the individual may request a fair hearing under section 256.045. If an individual
requests a fair hearing on the maltreatment determination and the disqualification, the scope
of the fair hearing shall include both the maltreatment determination and the disqualification.

(f) If a maltreatment determination or a disqualification based on serious or recurring
maltreatment is the basis for a denial of a license under section 245A.05 or a licensing
sanction under section 245A.07, the license holder has the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. As provided for
under section 245A.08, the scope of the contested case hearing must include the maltreatment
determination, disqualification, and licensing sanction or denial of a license. In such cases,
a fair hearing must not be conducted under section 256.045. Except for family child care
and child foster care, reconsideration of a maltreatment determination under this subdivision,
and reconsideration of a disqualification under section 245C.22, must not be conducted
when:

(1) a denial of a license under section 245A.05, or a licensing sanction under section
245A.07, is based on a determination that the license holder is responsible for maltreatment
or the disqualification of a license holder based on serious or recurring maltreatment;

(2) the denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and

(3) the license holder appeals the maltreatment determination or disqualification, and
denial of a license or licensing sanction.

Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
determination or disqualification, but does not appeal the denial of a license or a licensing
sanction, reconsideration of the maltreatment determination shall be conducted under sections
260E.33 and 626.557, subdivision 9d, and reconsideration of the disqualification shall be
conducted under section 245C.22. In such cases, a fair hearing shall also be conducted as
provided under sections 245C.27, 260E.33, and 626.557, subdivision 9d.

If the disqualified subject is an individual other than the license holder and upon whom
a background study must be conducted under chapter 245C, the hearings of all parties may
be consolidated into a single contested case hearing upon consent of all parties and the
administrative law judge.

(g) Until August 1, 2002, an individual or facility that was determined by the
commissioner of human services or the commissioner of health to be responsible for neglect
under section 626.5572, subdivision 17, after October 1, 1995, and before August 1, 2001,
that believes that the finding of neglect does not meet an amended definition of neglect may
request a reconsideration of the determination of neglect. The commissioner of human
services or the commissioner of health shall mail a notice to the last known address of
individuals who are eligible to seek this reconsideration. The request for reconsideration
must state how the established findings no longer meet the elements of the definition of
neglect. The commissioner shall review the request for reconsideration and make a
determination within 15 calendar days. The commissioner's decision on this reconsideration
is the final agency action.

(1) For purposes of compliance with the data destruction schedule under subdivision
12b, paragraph (d), when a finding of substantiated maltreatment has been changed as a
result of a reconsideration under this paragraph, the date of the original finding of a
substantiated maltreatment must be used to calculate the destruction date.

(2) For purposes of any background studies under chapter 245C, when a determination
of substantiated maltreatment has been changed as a result of a reconsideration under this
paragraph, any prior disqualification of the individual under chapter 245C that was based
on this determination of maltreatment shall be rescinded, and for future background studies
under chapter 245C the commissioner must not use the previous determination of
substantiated maltreatment as a basis for disqualification or as a basis for referring the
individual's maltreatment history to a health-related licensing board under section 245C.31.

Sec. 42.

Minnesota Statutes 2020, section 626.557, subdivision 10, is amended to read:


Subd. 10.

Duties of county social service agency.

(a) When the common entry point
refers a report to the county social service agency as the lead investigative agency or makes
a referral to the county social service agency for emergency adult protective services, or
when another lead investigative agency requests assistance from the county social service
agency for adult protective services, the county social service agency shall immediately
assess and offer emergency and continuing protective social services for purposes of
preventing further maltreatment and for safeguarding the welfare of the maltreated vulnerable
adult. The county shall use deleted text beginadeleted text end standardized deleted text begintooldeleted text endnew text begin tools and the data systemnew text end made available by
the commissioner. The information entered by the county into the standardized tool must
be accessible to the Department of Human Services. In cases of suspected sexual abuse, the
county social service agency shall immediately arrange for and make available to the
vulnerable adult appropriate medical examination and treatment. When necessary in order
to protect the vulnerable adult from further harm, the county social service agency shall
seek authority to remove the vulnerable adult from the situation in which the maltreatment
occurred. The county social service agency may also investigate to determine whether the
conditions which resulted in the reported maltreatment place other vulnerable adults in
jeopardy of being maltreated and offer protective social services that are called for by its
determination.

new text begin (b) Within five business days of receipt of a report screened in by the county social
service agency for investigation, the county social service agency shall determine whether,
in addition to an assessment and services for the vulnerable adult, to also conduct an
investigation for final disposition of the individual or facility alleged to have maltreated the
vulnerable adult.
new text end

new text begin (c) The county social service agency must investigate for a final disposition the individual
or facility alleged to have maltreated a vulnerable adult for each report accepted as lead
investigative agency involving an allegation of abuse, caregiver neglect that resulted in
harm to the vulnerable adult, financial exploitation that may be criminal, or an allegation
against a caregiver under chapter 256B.
new text end

new text begin (d) An investigating county social service agency must make a final disposition for any
allegation when the county social service agency determines that a final disposition may
safeguard a vulnerable adult or may prevent further maltreatment.
new text end

new text begin (e) If the county social service agency learns of an allegation listed in paragraph (c) after
the determination in paragraph (a), the county social service agency must change the initial
determination and conduct an investigation for final disposition of the individual or facility
alleged to have maltreated the vulnerable adult.
new text end

deleted text begin (b)deleted text endnew text begin (f)new text end County social service agencies may enter facilities and inspect and copy records
as part of an investigation. The county social service agency has access to not public data,
as defined in section 13.02, and medical records under sections 144.291 to 144.298, that
are maintained by facilities to the extent necessary to conduct its investigation. The inquiry
is not limited to the written records of the facility, but may include every other available
source of information.

deleted text begin (c)deleted text endnew text begin (g)new text end When necessary in order to protect a vulnerable adult from serious harm, the
county social service agency shall immediately intervene on behalf of that adult to help the
family, vulnerable adult, or other interested person by seeking any of the following:

(1) a restraining order or a court order for removal of the perpetrator from the residence
of the vulnerable adult pursuant to section 518B.01;

(2) the appointment of a guardian or conservator pursuant to sections 524.5-101 to
524.5-502, or guardianship or conservatorship pursuant to chapter 252A;

(3) replacement of a guardian or conservator suspected of maltreatment and appointment
of a suitable person as guardian or conservator, pursuant to sections 524.5-101 to 524.5-502;
or

(4) a referral to the prosecuting attorney for possible criminal prosecution of the
perpetrator under chapter 609.

The expenses of legal intervention must be paid by the county in the case of indigent
persons, under section 524.5-502 and chapter 563.

In proceedings under sections 524.5-101 to 524.5-502, if a suitable relative or other
person is not available to petition for guardianship or conservatorship, a county employee
shall present the petition with representation by the county attorney. The county shall contract
with or arrange for a suitable person or organization to provide ongoing guardianship
services. If the county presents evidence to the court exercising probate jurisdiction that it
has made a diligent effort and no other suitable person can be found, a county employee
may serve as guardian or conservator. The county shall not retaliate against the employee
for any action taken on behalf of the deleted text beginward or protecteddeleted text end person new text beginsubject to guardianship or
conservatorship,
new text endeven if the action is adverse to the county's interest. Any person retaliated
against in violation of this subdivision shall have a cause of action against the county and
shall be entitled to reasonable attorney fees and costs of the action if the action is upheld
by the court.

Sec. 43.

Minnesota Statutes 2020, section 626.557, subdivision 10b, is amended to read:


Subd. 10b.

Investigations; guidelines.

new text begin(a) new text endEach lead investigative agency shall develop
guidelines for prioritizing reports for investigation.

new text begin (b)new text end When investigating a report, the lead investigative agency shall conduct the following
activitiesdeleted text begin,deleted text end as appropriate:

(1) interview of the deleted text beginalleged victimdeleted text endnew text begin vulnerable adultnew text end;

(2) interview of the reporter and others who may have relevant information;

(3) interview of the deleted text beginalleged perpetratordeleted text endnew text begin individual or facility alleged responsible for
maltreatment
new text end;new text begin and
new text end

deleted text begin (4) examination of the environment surrounding the alleged incident;
deleted text end

deleted text begin (5)deleted text endnew text begin (4)new text end review ofnew text begin records andnew text end pertinent documentation of the alleged incidentdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (6) consultation with professionals.
deleted text end

new text begin (c) The lead investigative agency shall conduct the following activities as appropriate
to further the investigation, to prevent further maltreatment, or to safeguard the vulnerable
adult:
new text end

new text begin (1) examining the environment surrounding the alleged incident;
new text end

new text begin (2) consulting with professionals; and
new text end

new text begin (3) communicating with state, federal, tribal, and other agencies including:
new text end

new text begin (i) service providers;
new text end

new text begin (ii) case managers;
new text end

new text begin (iii) ombudsmen; and
new text end

new text begin (iv) support persons for the vulnerable adult.
new text end

new text begin (d) The lead investigative agency may decide not to conduct an interview of a vulnerable
adult, reporter, or witness under paragraph (b) if:
new text end

new text begin (1) the vulnerable adult, reporter, or witness declines to have an interview with the
agency or is unable to be contacted despite the agency's diligent attempts;
new text end

new text begin (2) an interview of the vulnerable adult or reporter was conducted by law enforcement
or a professional trained in forensic interview and an additional interview will not further
the investigation;
new text end

new text begin (3) an interview of the witness will not further the investigation; or
new text end

new text begin (4) the agency has a reason to believe that the interview will endanger the vulnerable
adult.
new text end

Sec. 44.

Minnesota Statutes 2020, section 626.557, subdivision 12b, is amended to read:


Subd. 12b.

Data management.

(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this sectionnew text begin while providing
adult protective services
new text end are welfare data under section 13.46. new text beginInvestigative data collected
under this section are confidential data on individuals or protected nonpublic data as defined
under section 13.02.
new text endNotwithstanding section 13.46, subdivision 1, paragraph (a), data under
this paragraph that are inactive investigative data on an individual who is a vendor of services
are private data on individuals, as defined in section 13.02. The identity of the reporter may
only be disclosed as provided in paragraph (c).

Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.

(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02.
Upon completion of the investigation, the data are classified as provided in clauses (1) to
(3) and paragraph (c).

(1) The investigation memorandum must contain the following data, which are public:

(i) the name of the facility investigated;

(ii) a statement of the nature of the alleged maltreatment;

(iii) pertinent information obtained from medical or other records reviewed;

(iv) the identity of the investigator;

(v) a summary of the investigation's findings;

(vi) statement of whether the report was found to be substantiated, inconclusive, false,
or that no determination will be made;

(vii) a statement of any action taken by the facility;

(viii) a statement of any action taken by the lead investigative agency; and

(ix) when a lead investigative agency's determination has substantiated maltreatment, a
statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.

The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data listed in clause (2).

(2) Data on individuals collected and maintained in the investigation memorandum are
private data, including:

(i) the name of the vulnerable adult;

(ii) the identity of the individual alleged to be the perpetrator;

(iii) the identity of the individual substantiated as the perpetrator; and

(iv) the identity of all individuals interviewed as part of the investigation.

(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.

(c) deleted text beginAfter the assessment or investigation is completed,deleted text end The name of the reporter must
be confidential. The subject of the report may compel disclosure of the name of the reporter
only with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. This subdivision does not
alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
that where the identity of the reporter is relevant to a criminal prosecution, the district court
shall do an in-camera review prior to determining whether to order disclosure of the identity
of the reporter.

(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:

(1) data from reports determined to be false, maintained for three years after the finding
was made;

(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;

(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and

(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.

(e) The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations. On a biennial basis, the commissioners of health
and human services shall jointly report the following information to the legislature and the
governor:

(1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;

(2) trends about types of substantiated maltreatment found in the reporting period;

(3) if there are upward trends for types of maltreatment substantiated, recommendations
for addressing and responding to them;

(4) efforts undertaken or recommended to improve the protection of vulnerable adults;

(5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;

(6) recommended changes to statutes affecting the protection of vulnerable adults; and

(7) any other information that is relevant to the report trends and findings.

(f) Each lead investigative agency must have a record retention policy.

(g) Lead investigative agencies,new text begin county agencies responsible for adult protective services,new text end
prosecuting authorities, and law enforcement agencies may exchange not public data, as
defined in section 13.02,new text begin with a tribal agency, facility, service provider, vulnerable adult,
primary support person for a vulnerable adult, state licensing board, federal or state agency,
the ombudsman for long-term care, or the ombudsman for mental health and developmental
disabilities,
new text end if the agency or authority deleted text beginrequestingdeleted text endnew text begin providingnew text end the data determines that the data
are pertinent and necessary deleted text beginto the requesting agency in initiating, furthering, or completingdeleted text endnew text begin
to prevent further maltreatment of a vulnerable adult, to safeguard a vulnerable adult, or for
new text end
an investigation under this section. Data collected under this section must be made available
to prosecuting authorities and law enforcement officials, local county agencies, and licensing
agencies investigating the alleged maltreatment under this section. The lead investigative
agency shall exchange not public data with the vulnerable adult maltreatment review panel
established in section 256.021 if the data are pertinent and necessary for a review requested
under that section. Notwithstanding section 138.17, upon completion of the review, not
public data received by the review panel must be destroyed.

(h) Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.

(i) A lead investigative agency may notify other affected parties and their authorized
representative if the lead investigative agency has reason to believe maltreatment has occurred
and determines the information will safeguard the well-being of the affected parties or dispel
widespread rumor or unrest in the affected facility.

(j) Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.

Sec. 45.

Minnesota Statutes 2020, section 626.5571, subdivision 1, is amended to read:


Subdivision 1.

Establishment of team.

A county may establish a multidisciplinary adult
protection team comprised of the director of the local welfare agency or designees, the
county attorney or designees, the county sheriff or designees, and representatives of health
care. In addition, representatives of mental health or other appropriate human service
agencies, representatives from local tribal governments, deleted text beginanddeleted text end adult advocate groupsnew text begin, and any
other organization with relevant expertise
new text end may be added to the adult protection team.

Sec. 46.

Minnesota Statutes 2020, section 626.5571, subdivision 2, is amended to read:


Subd. 2.

Duties of team.

A multidisciplinary adult protection team may provide public
and professional education, develop resources for prevention, intervention, and treatment,
and provide case consultation to the local welfare agency to better enable the agency to
carry out its deleted text beginadult protectiondeleted text end functions under section 626.557 and to meet the community's
needs deleted text beginfor adult protection servicesdeleted text end. Case consultation may be performed by a committee of
the team composed of the team members representing social services, law enforcement, the
county attorney, health care, and persons directly involved in an individual case as determined
by the case consultation committee. Case consultation deleted text beginisdeleted text endnew text begin includesnew text end a case review process that
results in recommendations about services to be provided to the identified adult and family.

Sec. 47.

Minnesota Statutes 2020, section 626.5572, subdivision 2, is amended to read:


Subd. 2.

Abuse.

"Abuse" means:

(a) An act against a vulnerable adult that constitutes a violation of, an attempt to violate,
or aiding and abetting a violation of:

(1) assault in the first through fifth degrees as defined in sections 609.221 to 609.224;

(2) the use of drugs to injure or facilitate crime as defined in section 609.235;

(3) the solicitation, inducement, and promotion of prostitution as defined in section
609.322; and

(4) criminal sexual conduct in the first through fifth degrees as defined in sections
609.342 to 609.3451.

A violation includes any action that meets the elements of the crime, regardless of
whether there is a criminal proceeding or conviction.

(b) Conduct which is not an accident or therapeutic conduct as defined in this section,
which produces or could reasonably be expected to produce physical pain or injury or
emotional distress including, but not limited to, the following:

(1) hitting, slapping, kicking, pinching, biting, or corporal punishment of a vulnerable
adult;

(2) use of repeated or malicious oral, written, or gestured language toward a vulnerable
adult or the treatment of a vulnerable adult which would be considered by a reasonable
person to be disparaging, derogatory, humiliating, harassing, or threatening;new text begin or
new text end

(3) use of any aversive or deprivation procedure, unreasonable confinement, or
involuntary seclusion, including the forced separation of the vulnerable adult from other
persons against the will of the vulnerable adult or the legal representative of the vulnerable
adultdeleted text begin; anddeleted text endnew text begin unless authorized under applicable licensing requirements or Minnesota Rules,
chapter 9544.
new text end

deleted text begin (4) use of any aversive or deprivation procedures for persons with developmental
disabilities or related conditions not authorized under section 245.825.
deleted text end

(c) Any sexual contact or penetration as defined in section 609.341, between a facility
staff person or a person providing services in the facility and a resident, patient, or client
of that facility.

(d) The act of forcing, compelling, coercing, or enticing a vulnerable adult against the
vulnerable adult's will to perform services for the advantage of another.

(e) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C or 252A, or section
253B.03 or 524.5-313, refuses consent or withdraws consent, consistent with that authority
and within the boundary of reasonable medical practice, to any therapeutic conduct, including
any care, service, or procedure to diagnose, maintain, or treat the physical or mental condition
of the vulnerable adult or, where permitted under law, to provide nutrition and hydration
parenterally or through intubation. This paragraph does not enlarge or diminish rights
otherwise held under law by:

(1) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or

(2) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct.

(f) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, a person with authority to make health care decisions for the vulnerable
adult, or a caregiver in good faith selects and depends upon spiritual means or prayer for
treatment or care of disease or remedial care of the vulnerable adult in lieu of medical care,
provided that this is consistent with the prior practice or belief of the vulnerable adult or
with the expressed intentions of the vulnerable adult.

(g) For purposes of this section, a vulnerable adult is not abused for the sole reason that
the vulnerable adult, who is not impaired in judgment or capacity by mental or emotional
dysfunction or undue influence, engages in consensual sexual contact with:

(1) a person, including a facility staff person, when a consensual sexual personal
relationship existed prior to the caregiving relationship; or

(2) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship.

Sec. 48.

Minnesota Statutes 2020, section 626.5572, subdivision 4, is amended to read:


Subd. 4.

Caregiver.

"Caregiver" means an individual or facility who has responsibility
for new text beginall or a portion ofnew text end the care of a vulnerable adult deleted text beginas a result of a family relationship, or
who has assumed responsibility for all or a portion of the care of a vulnerable adult
deleted text end
voluntarily, by contract, or by agreement.new text begin Caregiver does not include an unpaid caregiver
who provides incidental care.
new text end

Sec. 49.

Minnesota Statutes 2020, section 626.5572, subdivision 17, is amended to read:


Subd. 17.

Neglect.

deleted text begin "Neglect" means: deleted text end new text begin Neglect means neglect by a caregiver or self-neglect.
new text end

(a)new text begin "Caregiver neglect" meansnew text end the failure or omission by a caregiver to supply a vulnerable
adult with care or services, including but not limited to, food, clothing, shelter, health care,
or supervision which is:

(1) reasonable and necessary to obtain or maintain the vulnerable adult's physical or
mental health or safety, considering the physical and mental capacity or dysfunction of the
vulnerable adult; and

(2) which is not the result of an accident or therapeutic conduct.

(b) deleted text beginThe absence or likelihood of absence of care or services, including but not limited
to, food, clothing, shelter, health care, or supervision necessary to maintain the physical
and mental health of the vulnerable adult
deleted text endnew text begin "Self-neglect" means neglect by a vulnerable adult
of the vulnerable adult's own food, clothing, shelter, health care, or other services that are
not the responsibility of a caregiver
new text end which a reasonable person would deem essential to
obtain or maintain the vulnerable adult's health, safety, or comfort deleted text beginconsidering the physical
or mental capacity or dysfunction of the vulnerable adult
deleted text end.

(c) For purposes of this section, a vulnerable adult is not neglected for the sole reason
that:

(1) the vulnerable adult or a person with authority to make health care decisions for the
vulnerable adult under sections 144.651, 144A.44, chapter 145B, 145C, or 252A, or sections
253B.03 or 524.5-101 to 524.5-502, refuses consent or withdraws consent, consistent with
that authority and within the boundary of reasonable medical practice, to any therapeutic
conduct, including any care, service, or procedure to diagnose, maintain, or treat the physical
or mental condition of the vulnerable adult, or, where permitted under law, to provide
nutrition and hydration parenterally or through intubation; this paragraph does not enlarge
or diminish rights otherwise held under law by:

(i) a vulnerable adult or a person acting on behalf of a vulnerable adult, including an
involved family member, to consent to or refuse consent for therapeutic conduct; or

(ii) a caregiver to offer or provide or refuse to offer or provide therapeutic conduct; or

(2) the vulnerable adult, a person with authority to make health care decisions for the
vulnerable adult, or a caregiver in good faith selects and depends upon spiritual means or
prayer for treatment or care of disease or remedial care of the vulnerable adult in lieu of
medical care, provided that this is consistent with the prior practice or belief of the vulnerable
adult or with the expressed intentions of the vulnerable adult;

(3) the vulnerable adult, who is not impaired in judgment or capacity by mental or
emotional dysfunction or undue influence, engages in consensual sexual contact with:

(i) a person including a facility staff person when a consensual sexual personal
relationship existed prior to the caregiving relationship; or

(ii) a personal care attendant, regardless of whether the consensual sexual personal
relationship existed prior to the caregiving relationship; or

(4) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult which does not result in injury or harm which reasonably requires medical or mental
health care; or

(5) an individual makes an error in the provision of therapeutic conduct to a vulnerable
adult that results in injury or harm, which reasonably requires the care of a physician, and:

(i) the necessary care is provided in a timely fashion as dictated by the condition of the
vulnerable adult;

(ii) if after receiving care, the health status of the vulnerable adult can be reasonably
expected, as determined by the attending physician, to be restored to the vulnerable adult's
preexisting condition;

(iii) the error is not part of a pattern of errors by the individual;

(iv) if in a facility, the error is immediately reported as required under section 626.557,
and recorded internally in the facility;

(v) if in a facility, the facility identifies and takes corrective action and implements
measures designed to reduce the risk of further occurrence of this error and similar errors;
and

(vi) if in a facility, the actions required under items (iv) and (v) are sufficiently
documented for review and evaluation by the facility and any applicable licensing,
certification, and ombudsman agency.

(d) Nothing in this definition requires a caregiver, if regulated, to provide services in
excess of those required by the caregiver's license, certification, registration, or other
regulation.

(e) If the findings of an investigation by a lead investigative agency result in a
determination of substantiated maltreatment for the sole reason that the actions required of
a facility under paragraph (c), clause (5), item (iv), (v), or (vi), were not taken, then the
facility is subject to a correction order. An individual will not be found to have neglected
or maltreated the vulnerable adult based solely on the facility's not having taken the actions
required under paragraph (c), clause (5), item (iv), (v), or (vi). This must not alter the lead
investigative agency's determination of mitigating factors under section 626.557, subdivision
9c
, paragraph deleted text begin(c)deleted text endnew text begin (f)new text end.

Sec. 50.

Laws 2021, First Special Session chapter 7, article 10, section 1, the effective
date, is amended to read:


EFFECTIVE DATE.

This section is effective June 1, deleted text begin2022deleted text endnew text begin 2023new text end.

Sec. 51.

Laws 2021, First Special Session chapter 7, article 10, section 3, is amended to
read:


Sec. 3. LEGISLATIVE TASK FORCE; CHILD PROTECTION.

(a) A legislative task force is created todeleted text begin:
deleted text end

deleted text begin (1) review the efforts being made to implement the recommendations of the Governor's
Task Force on the Protection of Children;
deleted text end

deleted text begin (2) expand the efforts into related areas of the child welfare system;
deleted text end

deleted text begin (3) work with the commissioner of human services and community partners to establish
and evaluate child protection grants to address disparities in child welfare pursuant to
Minnesota Statutes, section 256E.28;
deleted text end

deleted text begin (4) review and recommend alternatives to law enforcement responding to a maltreatment
report by removing the child and evaluate situations in which it may be appropriate for a
social worker or other child protection worker to remove the child from the home;
deleted text end

deleted text begin (5) evaluate current statutes governing mandatory reporters, consider the modification
of mandatory reporting requirements for private or public youth recreation programs, and,
if necessary, introduce legislation by February 15, 2022, to implement appropriate
modifications;
deleted text end

deleted text begin (6) evaluate and consider the intersection of educational neglect and the child protection
system; and
deleted text end

deleted text begin (7)deleted text end identify deleted text beginadditionaldeleted text end areas within the child welfare system that need to be addressed
by the legislature.

(b) Members of the legislative task force shall include:

(1) six members from the house of representatives appointed by the speaker of the house,
including three from the majority party and three from the minority party; and

(2) six members from the senate, including three members appointed by the senate
majority leader and three members appointed by the senate minority leader.

(c) Members of the task force shall serve a term that expires on December 31 of the
deleted text begin even-numbereddeleted text endnew text begin odd-numberednew text end year following the year they are appointed. The speaker of
the house and the majority leader of the senate shall each appoint a chair and vice-chair
from the membership of the task force. The chair shall rotate after each meeting. The task
force must meet at least quarterly.

(d) Initial appointments to the task force shall be made by July 15, deleted text begin2021deleted text endnew text begin 2022new text end. The chair
shall convene the first meeting of the task force by August 15, deleted text begin2021deleted text endnew text begin 2022new text end.

(e) The task force may provide oversight and monitoring of:

(1) the efforts by the Department of Human Services, counties, and Tribes to implement
laws related to child protection;

(2) efforts by the Department of Human Services, counties, and Tribes to implement the
recommendations of the Governor's Task Force on the Protection of Children;

(3) efforts by agencies including but not limited to the Department of Education, the
Housing Finance Agency, the Department of Corrections, and the Department of Public
Safety, to work with the Department of Human Services to assure safety and well-being for
children at risk of harm or children in the child welfare system; and

(4) efforts by the Department of Human Services, other agencies, counties, and Tribes
to implement best practices to ensure every child is protected from maltreatment and neglect
and to ensure every child has the opportunity for healthy development.

deleted text begin (f) The task force, in cooperation with the commissioner of human services, shall issue
a report to the legislature and governor by February 1, 2024. The report must contain
information on the progress toward implementation of changes to the child protection system,
recommendations for additional legislative changes and procedures affecting child protection
and child welfare, and funding needs to implement recommended changes.
deleted text end

deleted text begin (g)deleted text endnew text begin (f)new text end This section expires December 31, deleted text begin2024deleted text endnew text begin 2025new text end.

ARTICLE 9

ECONOMIC ASSISTANCE

Section 1.

Minnesota Statutes 2020, section 256D.0515, is amended to read:


256D.0515 ASSET LIMITATIONS FOR SUPPLEMENTAL NUTRITION
ASSISTANCE PROGRAM HOUSEHOLDS.

All Supplemental Nutrition Assistance Program (SNAP) households must be determined
eligible for the benefit discussed under section 256.029. SNAP households must demonstrate
that their gross income is equal to or less than deleted text begin165deleted text endnew text begin 200new text end percent of the federal poverty
guidelines for the same family size.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective September 1, 2022.
new text end

Sec. 2.

Minnesota Statutes 2020, section 256E.36, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Commissioner" means the commissioner of human services.

(c) "Eligible organization" means a local governmental unitnew text begin, federally recognized Tribal
Nation,
new text end or nonprofit organization providing or seeking to provide emergency services for
homeless persons.

(d) "Emergency services" means:

(1) providing emergency shelter for homeless persons; and

(2) assisting homeless persons in obtaining essential services, including:

(i) access to permanent housing;

(ii) medical and psychological help;

(iii) employment counseling and job placement;

(iv) substance abuse treatment;

(v) financial assistance available from other programs;

(vi) emergency child care;

(vii) transportation; and

(viii) other services needed to stabilize housing.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 3.

Minnesota Statutes 2020, section 256P.04, subdivision 11, is amended to read:


Subd. 11.

Participant's completion of household report form.

(a) When a participant
is required to complete a household report form, the following paragraphs apply.

(b) If the agency receives an incomplete household report form, the agency must
immediately deleted text beginreturn the incomplete form and clearly state what the participant must do for
the form to be complete
deleted text endnew text begin contact the participant by phone or in writing to acquire the necessary
information to complete the form
new text end.

(c) The automated eligibility system must send a notice of proposed termination of
assistance to the participant if a complete household report form is not received by the
agency. The automated notice must be mailed to the participant by approximately the 16th
of the month. When a participant submits an incomplete form on or after the date a notice
of proposed termination has been sent, the termination is valid unless the participant submits
a complete form before the end of the month.

(d) The submission of a household report form is considered to have continued the
participant's application for assistance if a complete household report form is received within
a calendar month after the month in which the form was due. Assistance shall be paid for
the period beginning with the first day of that calendar month.

(e) An agency must allow good cause exemptions for a participant required to complete
a household report form when any of the following factors cause a participant to fail to
submit a completed household report form before the end of the month in which the form
is due:

(1) an employer delays completion of employment verification;

(2) the agency does not help a participant complete the household report form when the
participant asks for help;

(3) a participant does not receive a household report form due to a mistake on the part
of the department or the agency or a reported change in address;

(4) a participant is ill or physically or mentally incapacitated; or

(5) some other circumstance occurs that a participant could not avoid with reasonable
care which prevents the participant from providing a completed household report form
before the end of the month in which the form is due.

Sec. 4.

Minnesota Statutes 2021 Supplement, section 256P.06, subdivision 3, is amended
to read:


Subd. 3.

Income inclusions.

The following must be included in determining the income
of an assistance unit:

(1) earned income; and

(2) unearned income, which includes:

(i) interest and dividends from investments and savings;

(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;

(iii) proceeds from rent and contract for deed payments in excess of the principal and
interest portion owed on property;

(iv) income from trusts, excluding special needs and supplemental needs trusts;

(v) interest income from loans made by the participant or household;

(vi) cash prizes and winnings;

(vii) unemployment insurance income that is received by an adult member of the
assistance unit unless the individual receiving unemployment insurance income is:

(A) 18 years of age and enrolled in a secondary school; or

(B) 18 or 19 years of age, a caregiver, and is enrolled in school at least half-time;

(viii) retirement, survivors, and disability insurance payments;

(ix) nonrecurring income over $60 per quarter unless the nonrecurring income is: (A)
from tax refunds, tax rebates, or tax credits; (B) a reimbursement, rebate, award, grant, or
refund of personal or real property or costs or losses incurred when these payments are
made by: a public agency; a court; solicitations through public appeal; a federal, state, or
local unit of government; or a disaster assistance organization; (C) provided as an in-kind
benefit; or (D) earmarked and used for the purpose for which it was intended, subject to
verification requirements under section 256P.04;

(x) retirement benefits;

(xi) cash assistance benefits, as defined by each program in chapters 119B, 256D, 256I,
and 256J;

(xii) Tribal per capita payments unless excluded by federal and state law;

deleted text begin (xiii) income and payments from service and rehabilitation programs that meet or exceed
the state's minimum wage rate;
deleted text end

deleted text begin (xiv)deleted text endnew text begin (xiii)new text end income from members of the United States armed forces unless excluded
from income taxes according to federal or state law;

deleted text begin (xv)deleted text endnew text begin (xiv)new text end all child support payments for programs under chapters 119B, 256D, and 256I;

deleted text begin (xvi)deleted text endnew text begin (xv)new text end the amount of child support received that exceeds $100 for assistance units
with one child and $200 for assistance units with two or more children for programs under
chapter 256J;

deleted text begin (xvii)deleted text endnew text begin (xvi)new text end spousal support; and

deleted text begin (xviii)deleted text endnew text begin (xvii)new text end workers' compensation.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective November 1, 2022.
new text end

Sec. 5.

Minnesota Statutes 2020, section 268.19, subdivision 1, is amended to read:


Subdivision 1.

Use of data.

(a) Except as provided by this section, data gathered from
any person under the administration of the Minnesota Unemployment Insurance Law are
private data on individuals or nonpublic data not on individuals as defined in section 13.02,
subdivisions 9 and 12, and may not be disclosed except according to a district court order
or section 13.05. A subpoena is not considered a district court order. These data may be
disseminated to and used by the following agencies without the consent of the subject of
the data:

(1) state and federal agencies specifically authorized access to the data by state or federal
law;

(2) any agency of any other state or any federal agency charged with the administration
of an unemployment insurance program;

(3) any agency responsible for the maintenance of a system of public employment offices
for the purpose of assisting individuals in obtaining employment;

(4) the public authority responsible for child support in Minnesota or any other state in
accordance with section 256.978;

(5) human rights agencies within Minnesota that have enforcement powers;

(6) the Department of Revenue to the extent necessary for its duties under Minnesota
laws;

(7) public and private agencies responsible for administering publicly financed assistance
programs for the purpose of monitoring the eligibility of the program's recipients;

(8) the Department of Labor and Industry and the Commerce Fraud Bureau in the
Department of Commerce for uses consistent with the administration of their duties under
Minnesota law;

(9) the Department of Human Services and the Office of Inspector General and its agents
within the Department of Human Services, including county fraud investigators, for
investigations related to recipient or provider fraud and employees of providers when the
provider is suspected of committing public assistance fraud;

(10) local and state welfare agencies for monitoring the eligibility of the data subject
for assistance programs, or for any employment or training program administered by those
agencies, whether alone, in combination with another welfare agency, or in conjunction
with the department or to monitor and evaluate the statewide Minnesota family investment
program new text beginand other cash assistance programs, the Supplemental Nutrition Assistance Program,
and the Supplemental Nutrition Assistance Program Employment and Training program
new text endby
providing data on recipients and former recipients of Supplemental Nutrition Assistance
Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child
care assistance under chapter 119B, or medical programs under chapter 256B or 256L or
formerly codified under chapter 256D;

(11) local and state welfare agencies for the purpose of identifying employment, wages,
and other information to assist in the collection of an overpayment debt in an assistance
program;

(12) local, state, and federal law enforcement agencies for the purpose of ascertaining
the last known address and employment location of an individual who is the subject of a
criminal investigation;

(13) the United States Immigration and Customs Enforcement has access to data on
specific individuals and specific employers provided the specific individual or specific
employer is the subject of an investigation by that agency;

(14) the Department of Health for the purposes of epidemiologic investigations;

(15) the Department of Corrections for the purposes of case planning and internal research
for preprobation, probation, and postprobation employment tracking of offenders sentenced
to probation and preconfinement and postconfinement employment tracking of committed
offenders;

(16) the state auditor to the extent necessary to conduct audits of job opportunity building
zones as required under section 469.3201; and

(17) the Office of Higher Education for purposes of supporting program improvement,
system evaluation, and research initiatives including the Statewide Longitudinal Education
Data System.

(b) Data on individuals and employers that are collected, maintained, or used by the
department in an investigation under section 268.182 are confidential as to data on individuals
and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3
and 13, and must not be disclosed except under statute or district court order or to a party
named in a criminal proceeding, administrative or judicial, for preparation of a defense.

(c) Data gathered by the department in the administration of the Minnesota unemployment
insurance program must not be made the subject or the basis for any suit in any civil
proceedings, administrative or judicial, unless the action is initiated by the department.

Sec. 6. new text beginDIRECTION TO COMMISSIONER; SNAP VERIFICATION OF FEDERAL
WORK REQUIREMENTS.
new text end

new text begin No later than December 1, 2022, the commissioner of human services shall issue guidance
to local agencies that administer the Supplemental Nutrition Assistance Program (SNAP)
regarding local agency responsibilities for verification of federal work requirements for
SNAP recipients.
new text end

Sec. 7. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber each section of Minnesota Statutes listed in column
A with the number listed in column B. The revisor shall also make necessary grammatical
and cross-reference changes consistent with the renumbering.
new text end

new text begin Column A
new text end
new text begin Column B
new text end
new text begin 256D.051, subdivision 20
new text end
new text begin 256D.60, subdivision 1
new text end
new text begin 256D.051, subdivision 21
new text end
new text begin 256D.60, subdivision 2
new text end
new text begin 256D.051, subdivision 22
new text end
new text begin 256D.60, subdivision 3
new text end
new text begin 256D.051, subdivision 23
new text end
new text begin 256D.60, subdivision 4
new text end
new text begin 256D.051, subdivision 24
new text end
new text begin 256D.60, subdivision 5
new text end
new text begin 256D.0512
new text end
new text begin 256D.61
new text end
new text begin 256D.0515
new text end
new text begin 256D.62
new text end
new text begin 256D.0516
new text end
new text begin 256D.63
new text end
new text begin 256D.053
new text end
new text begin 256D.64
new text end

Sec. 8. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 256D.055, new text end new text begin is repealed.
new text end

ARTICLE 10

DIRECT CARE AND TREATMENT POLICY

Section 1.

Minnesota Statutes 2020, section 253B.18, subdivision 6, is amended to read:


Subd. 6.

Transfer.

(a) A patient who is a person who has a mental illness and is
dangerous to the public shall not be transferred out of a secure treatment facility unless it
appears to the satisfaction of the commissioner, after a hearing and favorable recommendation
by a majority of the special review board, that the transfer is appropriate. Transfer may be
to another state-operated treatment program. In those instances where a commitment also
exists to the Department of Corrections, transfer may be to a facility designated by the
commissioner of corrections.

(b) The following factors must be considered in determining whether a transfer is
appropriate:

(1) the person's clinical progress and present treatment needs;

(2) the need for security to accomplish continuing treatment;

(3) the need for continued institutionalization;

(4) which facility can best meet the person's needs; and

(5) whether transfer can be accomplished with a reasonable degree of safety for the
public.

new text begin (c) If a committed person has been transferred out of a secure treatment facility pursuant
to this subdivision, that committed person may voluntarily return to a secure treatment
facility for a period of up to 60 days with the consent of the head of the treatment facility.
new text end

new text begin (d) If the committed person is not returned to the original, nonsecure transfer facility
within 60 days of being readmitted to a secure treatment facility, the transfer is revoked and
the committed person must remain in a secure treatment facility. The committed person
must immediately be notified in writing of the revocation.
new text end

new text begin (e) Within 15 days of receiving notice of the revocation, the committed person may
petition the special review board for a review of the revocation. The special review board
shall review the circumstances of the revocation and shall recommend to the commissioner
whether or not the revocation should be upheld. The special review board may also
recommend a new transfer at the time of the revocation hearing.
new text end

new text begin (f) No action by the special review board is required if the transfer has not been revoked
and the committed person is returned to the original, nonsecure transfer facility with no
substantive change to the conditions of the transfer ordered under this subdivision.
new text end

new text begin (g) The head of the treatment facility may revoke a transfer made under this subdivision
and require a committed person to return to a secure treatment facility if:
new text end

new text begin (1) remaining in a nonsecure setting does not provide a reasonable degree of safety to
the committed person or others; or
new text end

new text begin (2) the committed person has regressed clinically and the facility to which the committed
person was transferred does not meet the committed person's needs.
new text end

new text begin (h) Upon the revocation of the transfer, the committed person must be immediately
returned to a secure treatment facility. A report documenting the reasons for revocation
must be issued by the head of the treatment facility within seven days after the committed
person is returned to the secure treatment facility. Advance notice to the committed person
of the revocation is not required.
new text end

new text begin (i) The committed person must be provided a copy of the revocation report and informed,
orally and in writing, of the rights of a committed person under this section. The revocation
report must be served upon the committed person, the committed person's counsel, and the
designated agency. The report must outline the specific reasons for the revocation, including
but not limited to the specific facts upon which the revocation is based.
new text end

new text begin (j) If a committed person's transfer is revoked, the committed person may re-petition for
transfer according to subdivision 5.
new text end

new text begin (k) A committed person aggrieved by a transfer revocation decision may petition the
special review board within seven business days after receipt of the revocation report for a
review of the revocation. The matter must be scheduled within 30 days. The special review
board shall review the circumstances leading to the revocation and, after considering the
factors in paragraph (b), shall recommend to the commissioner whether or not the revocation
shall be upheld. The special review board may also recommend a new transfer out of a
secure treatment facility at the time of the revocation hearing.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 256.01, subdivision 42, is amended
to read:


Subd. 42.

Expiration of report mandates.

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

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

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

(d)new text begin By January 15 of each year,new text end the commissioner shall submit a list deleted text beginto the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services by February 15 of each year, beginning February 15, 2022,
deleted text end of all reports set to
expire during the following calendar year deleted text beginin accordance with this sectiondeleted text endnew text begin to the chairs and
ranking minority members of the legislative committees with jurisdiction over human
services. Notwithstanding paragraph (c), this paragraph does not expire
new text end.

Sec. 3.

Laws 2009, chapter 79, article 13, section 3, subdivision 10, as amended by Laws
2009, chapter 173, article 2, section 1, is amended to read:


Subd. 10.

State-Operated Services

The amounts that may be spent from the
appropriation for each purpose are as follows:

Transfer Authority Related to
State-Operated Services.
Money
appropriated to finance state-operated services
may be transferred between the fiscal years of
the biennium with the approval of the
commissioner of finance.

County Past Due Receivables. The
commissioner is authorized to withhold county
federal administrative reimbursement when
the county of financial responsibility for
cost-of-care payments due the state under
Minnesota Statutes, section 246.54 or
253B.045, is 90 days past due. The
commissioner shall deposit the withheld
federal administrative earnings for the county
into the general fund to settle the claims with
the county of financial responsibility. The
process for withholding funds is governed by
Minnesota Statutes, section 256.017.

deleted text begin Forecast and Census Data. The
commissioner shall include census data and
fiscal projections for state-operated services
and Minnesota sex offender services with the
November and February budget forecasts.
Notwithstanding any contrary provision in this
article, this paragraph shall not expire
deleted text end.

(a) Adult Mental Health Services
106,702,000
107,201,000

Appropriation Limitation. No part of the
appropriation in this article to the
commissioner for mental health treatment
services provided by state-operated services
shall be used for the Minnesota sex offender
program.

Community Behavioral Health Hospitals.
Under Minnesota Statutes, section 246.51,
subdivision 1, a determination order for the
clients served in a community behavioral
health hospital operated by the commissioner
of human services is only required when a
client's third-party coverage has been
exhausted.

Base Adjustment. The general fund base is
decreased by $500,000 for fiscal year 2012
and by $500,000 for fiscal year 2013.

(b) Minnesota Sex Offender Services
Appropriations by Fund
General
38,348,000
67,503,000
Federal Fund
26,495,000
0

Use of Federal Stabilization Funds. Of this
appropriation, $26,495,000 in fiscal year 2010
is from the fiscal stabilization account in the
federal fund to the commissioner. This
appropriation must not be used for any activity
or service for which federal reimbursement is
claimed. This is a onetime appropriation.

(c) Minnesota Security Hospital and METO
Services
Appropriations by Fund
General
230,000
83,735,000
Federal Fund
83,505,000
0

Minnesota Security Hospital. For the
purposes of enhancing the safety of the public,
improving supervision, and enhancing
community-based mental health treatment,
state-operated services may establish
additional community capacity for providing
treatment and supervision of clients who have
been ordered into a less restrictive alternative
of care from the state-operated services
transitional services program consistent with
Minnesota Statutes, section 246.014.

Use of Federal Stabilization Funds.
$83,505,000 in fiscal year 2010 is appropriated
from the fiscal stabilization account in the
federal fund to the commissioner. This
appropriation must not be used for any activity
or service for which federal reimbursement is
claimed. This is a onetime appropriation.

Sec. 4. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, sections 246.0136; 252.025, subdivision 7; and 252.035, new text end new text begin are
repealed.
new text end

ARTICLE 11

PREVENTING HOMELESSNESS

Section 1.

Minnesota Statutes 2020, section 256E.33, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Transitional housing" means housing designed for independent living and provided
to a homeless person or family at a rental rate of at least 25 percent of the family income
for a period of up to deleted text begin24deleted text endnew text begin 36new text end months. If a transitional housing program is associated with a
licensed facility or shelter, it must be located in a separate facility or a specified section of
the main facility where residents can be responsible for their own meals and other daily
needs.

(c) "Support services" means an assessment service that identifies the needs of individuals
for independent living and arranges or provides for the appropriate educational, social, legal,
advocacy, child care, employment, financial, health care, or information and referral services
to meet these needs.

Sec. 2.

Minnesota Statutes 2020, section 256E.33, subdivision 2, is amended to read:


Subd. 2.

Establishment and administration.

A transitional housing program is
established to be administered by the commissioner. The commissioner may make grants
to eligible recipients or enter into agreements with community action agencies or other
public or private nonprofit agencies to make grants to eligible recipients to initiate, maintain,
or expand programs to provide transitional housing and support services for persons in need
of transitional housing, which may include up to six months of follow-up support services
for persons who complete transitional housing as they stabilize in permanent housing. The
commissioner must ensure that money appropriated to implement this section is distributed
as soon as practicable. The commissioner may make grants directly to eligible recipients.
The commissioner may new text beginextend new text enduse deleted text beginup to ten percent of the appropriation available fordeleted text endnew text begin ofnew text end
this program for persons needing assistance longer than deleted text begin24deleted text endnew text begin 36new text end months.

Sec. 3.

Minnesota Statutes 2020, section 256K.45, subdivision 6, is amended to read:


Subd. 6.

Funding.

Funds appropriated for this section may be expended on programs
described under subdivisions 3 to 5new text begin and 7new text end, technical assistance, and capacity building to
meet the greatest need on a statewide basis. The commissioner will provide outreach,
technical assistance, and program development support to increase capacity to new and
existing service providers to better meet needs statewide, particularly in areas where services
for homeless youth have not been established, especially in greater Minnesota.

Sec. 4.

Minnesota Statutes 2020, section 256K.45, is amended by adding a subdivision to
read:


new text begin Subd. 7. new text end

new text begin Provider repair or improvement grants. new text end

new text begin (a) Providers that serve homeless
youth under this section may apply for a grant of up to $200,000 under this subdivision to
make minor or mechanical repairs or improvements to a facility providing services to
homeless youth or youth at risk of homelessness.
new text end

new text begin (b) Grant applications under this subdivision must include a description of the repairs
or improvements and the estimated cost of the repairs or improvements.
new text end

new text begin (c) Grantees under this subdivision cannot receive grant funds under this subdivision
for two consecutive years.
new text end

Sec. 5.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 24,
is amended to read:


Subd. 24.

Grant Programs; Children and
Economic Support Grants

29,740,000
29,740,000

new text begin (a) new text endMinnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2022 do not
cancel but are available in fiscal year 2023.

new text begin (b) Base Level Adjustment; Provider Repair
Grants.
The general fund base includes
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 for provider repair or
improvement grants under Minnesota Statutes,
section 256K.45, subdivision 7.
new text end

Sec. 6.

Laws 2021, First Special Session chapter 8, article 6, section 1, subdivision 7, is
amended to read:


Subd. 7.

Report.

(a) No later than February 1, 2022, the task force shall submit an initial
report to the chairs and ranking minority members of the house of representatives and senate
committees and divisions with jurisdiction over housing and preventing homelessness on
its findings and recommendations.

(b) No later than deleted text beginAugust 31deleted text endnew text begin December 15new text end, 2022, the task force shall submit a final report
to the chairs and ranking minority members of the house of representatives and senate
committees and divisions with jurisdiction over housing and preventing homelessness on
its findings and recommendations.

ARTICLE 12

DEPARTMENT OF HUMAN SERVICES
LICENSING AND OPERATIONS POLICY

Section 1.

Minnesota Statutes 2020, section 245A.02, subdivision 5a, is amended to read:


Subd. 5a.

Controlling individual.

(a) "Controlling individual" means an owner of a
program or service provider licensed under this chapter and the following individuals, if
applicable:

(1) each officer of the organization, including the chief executive officer and chief
financial officer;

(2) the individual designated as the authorized agent under section 245A.04, subdivision
1, paragraph (b);

(3) the individual designated as the compliance officer under section 256B.04, subdivision
21, paragraph (g); deleted text beginand
deleted text end

(4) each managerial official whose responsibilities include the direction of the
management or policies of a programdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (5) the individual designated as the primary provider of care for a special family child
care program under section 245A.14, subdivision 4, paragraph (i).
new text end

(b) Controlling individual does not include:

(1) a bank, savings bank, trust company, savings association, credit union, industrial
loan and thrift company, investment banking firm, or insurance company unless the entity
operates a program directly or through a subsidiary;

(2) an individual who is a state or federal official, or 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 programs, unless the individual is also an officer,
owner, or managerial official of the program, receives remuneration from the program, or
owns any of the beneficial interests not excluded in this subdivision;

(3) an individual who owns less than five percent of the outstanding common shares of
a corporation:

(i) whose securities are exempt under section 80A.45, clause (6); or

(ii) whose transactions are exempt under section 80A.46, clause (2);

(4) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the program
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or

(5) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual according to paragraph (a).

(c) For purposes of this subdivision, "managerial official" means an individual who has
the decision-making authority related to the operation of the program, and the responsibility
for the ongoing management of or direction of the policies, services, or employees of the
program. A site director who has no ownership interest in the program is not considered to
be a managerial official for purposes of this definition.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 2.

Minnesota Statutes 2021 Supplement, section 245A.14, subdivision 4, is amended
to read:


Subd. 4.

Special family child care homes.

Nonresidential child care programs serving
14 or fewer children that are conducted at a location other than the license holder's own
residence shall be licensed under this section and the rules governing family child care or
group family child care if:

(a) the license holder is the primary provider of care and the nonresidential child care
program is conducted in a dwelling that is located on a residential lot;

(b) the license holder is an employer who may or may not be the primary provider of
care, and the purpose for the child care program is to provide child care services to children
of the license holder's employees;

(c) the license holder is a church or religious organization;

(d) the license holder is a community collaborative child care provider. For purposes of
this subdivision, a community collaborative child care provider is a provider participating
in a cooperative agreement with a community action agency as defined in section 256E.31;

(e) the license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this paragraph to exceed the licensed capacity of 14 children by no more than five
children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:

(1) the program does not exceed a capacity of 14 children more than a cumulative total
of four hours per day;

(2) the program meets a one to seven staff-to-child ratio during the variance period;

(3) all employees receive at least an extra four hours of training per year than required
in the rules governing family child care each year;

(4) the facility has square footage required per child under Minnesota Rules, part
9502.0425;

(5) the program is in compliance with local zoning regulations;

(6) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015,
Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided in the Minnesota State Fire Code 2015,
Section 202, unless the rooms in which the children are cared for are located on a level of
exit discharge and each of these child care rooms has an exit door directly to the exterior,
then the applicable fire code is Group E occupancies, as provided in the Minnesota State
Fire Code 2015, Section 202; and

(7) any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the license; or

(f) the license holder is the primary provider of care and has located the licensed child
care program in a commercial space, if the license holder meets the following requirements:

(1) the program is in compliance with local zoning regulations;

(2) the program is in compliance with the applicable fire code as follows:

(i) if the program serves more than five children older than 2-1/2 years of age, but no
more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code 2015,
Section 202; or

(ii) if the program serves more than five children 2-1/2 years of age or less, the applicable
fire code is Group I-4 Occupancies, as provided under the Minnesota State Fire Code 2015,
Section 202;

(3) any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and

(4) the license holder prominently displays the license issued by the commissioner which
contains the statement "This special family child care provider is not licensed as a child
care center."

(g) Notwithstanding Minnesota Rules, part 9502.0335, subpart 12, the commissioner
may issue up to four licenses to an organization licensed under paragraph (b), (c), or (e).
Each license must have its own primary provider of care as required under paragraph (i).
Each license must operate as a distinct and separate program in compliance with all applicable
laws and regulations.

(h) For licenses issued under paragraph (b), (c), (d), (e), or (f), the commissioner may
approve up to four licenses at the same location or under one contiguous roof if each license
holder is able to demonstrate compliance with all applicable rules and laws. Each licensed
program must operate as a distinct program and within the capacity, age, and ratio
distributions of each license.

(i) For a license issued under paragraph (b), (c), or (e), the license holder must designate
a person to be the primary provider of care at the licensed location on a form and in a manner
prescribed by the commissioner. The license holder shall notify the commissioner in writing
before there is a change of the person designated to be the primary provider of care. The
primary provider of care:

(1) must be the person who will be the provider of care at the program and present during
the hours of operation;

(2) must operate the program in compliance with applicable laws and regulations under
chapter 245A and Minnesota Rules, chapter 9502;

(3) is considered a child care background study subject as defined in section 245C.02,
subdivision 6a, and must comply with background study requirements in chapter 245C; deleted text beginand
deleted text end

(4) must complete the training that is required of license holders in section 245A.50deleted text begin.deleted text endnew text begin;
and
new text end

new text begin (5) is authorized to communicate with the county licensing agency and the department
on matters related to licensing.
new text end

(j) For any license issued under this subdivision, the license holder must ensure that any
other caregiver, substitute, or helper who assists in the care of children meets the training
requirements in section 245A.50 and background study requirements under chapter 245C.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 3.

Minnesota Statutes 2020, section 245A.1443, is amended to read:


245A.1443 deleted text beginCHEMICAL DEPENDENCYdeleted text endnew text begin SUBSTANCE USE DISORDER
TREATMENT LICENSED
new text end PROGRAMS THAT SERVE PARENTS WITH THEIR
CHILDREN.

Subdivision 1.

Application.

This section applies to deleted text beginchemical dependencydeleted text endnew text begin residential
substance use disorder
new text end treatment facilities that are licensed under this chapter and deleted text beginMinnesota
Rules,
deleted text end chapter deleted text begin9530,deleted text endnew text begin 245Gnew text end and that provide services in accordance with section 245G.19.

Subd. 2.

Requirements for providing education.

(a) On or before the date of a child's
initial physical presence at the facility, the license holder must provide education to the
child's parent related to safe bathing and reducing the risk of sudden unexpected infant death
and abusive head trauma from shaking infants and young children. new text beginThe license holder must
use the educational material developed by the commissioner to comply with this requirement.
new text end At a minimum, the education must address:

(1) instruction that a child or infant should never be left unattended around water, a tub
should be filled with only two to four inches of water for infants, and an infant should never
be put into a tub when the water is running; and

(2) the risk factors related to sudden unexpected infant death and abusive head trauma
from shaking infants and young children, and means of reducing the risks, including the
safety precautions identified in section 245A.1435 and the deleted text begindangersdeleted text endnew text begin risksnew text end of co-sleeping.

(b) The license holder must document the parent's receipt of the education and keep the
documentation in the parent's file. The documentation must indicate whether the parent
agrees to comply with the safeguards. If the parent refuses to comply, program staff must
provide additional education to the parent deleted text beginat appropriate intervals, at least weeklydeleted text endnew text begin as described
in the parental supervision plan. The parental supervision plan must include the intervention,
frequency, and staff responsible
new text end for the duration of the parent's participation in the program
or until the parent agrees to comply with the safeguards.

Subd. 3.

Parental supervision of children.

(a) On or before the date of a child's initial
physical presence at the facility, the license holder must deleted text begincomplete anddeleted text end document deleted text beginan
assessment of
deleted text end the parent's capacity to meet the health and safety needs of the child while
on the facility premisesdeleted text begin, including identifying circumstances when the parent may be unable
to adequately care for their child due to
deleted text endnew text begin considering the following factorsnew text end:

(1) the parent's physical deleted text beginordeleted text endnew text begin andnew text end mental health;

(2) the parent being under the influence of drugs, alcohol, medications, or other chemicals;

deleted text begin (3) the parent being unable to provide appropriate supervision for the child; or
deleted text end

new text begin (3) the child's physical and mental health; and
new text end

(4) any other information available to the license holder that indicates the parent may
not be able to adequately care for the child.

(b) The license holder must have written procedures specifying the actions to be taken
by staff if a parent is or becomes unable to adequately care for the parent's child.

new text begin (c) If the parent refuses to comply with the safeguards described in subdivision 2 or is
unable to adequately care for the child, the license holder must develop a parental supervision
plan in conjunction with the client. The plan must account for any factors in paragraph (a)
that contribute to the parent's inability to adequately care for the child. The plan must be
dated and signed by the staff person who completed the plan.
new text end

Subd. 4.

Alternative supervision arrangements.

The license holder must have written
procedures addressing whether the program permits a parent to arrange for supervision of
the parent's child by another client in the program. If permitted, the facility must have a
procedure that requires staff approval of the supervision arrangement before the supervision
by the nonparental client occurs. The procedure for approval must include an assessment
of the nonparental client's capacity to assume the supervisory responsibilities using the
criteria in subdivision 3. The license holder must document the license holder's approval of
the supervisory arrangement and the assessment of the nonparental client's capacity to
supervise the child, and must keep this documentation in the file of the parent of the child
being supervised.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 4.

Minnesota Statutes 2020, section 245F.15, subdivision 1, is amended to read:


Subdivision 1.

Qualifications for all staff who have direct patient contact.

deleted text begin(a)deleted text end All
staff who have direct patient contact must be at least 18 years of age deleted text beginand must, at the time
of hiring, document that they meet the requirements in paragraph (b), (c), or (d)
deleted text end.

deleted text begin (b) Program directors, supervisors, nurses, and alcohol and drug counselors must be free
of substance use problems for at least two years immediately preceding their hiring and
must sign a statement attesting to that fact.
deleted text end

deleted text begin (c) Recovery peers must be free of substance use problems for at least one year
immediately preceding their hiring and must sign a statement attesting to that fact.
deleted text end

deleted text begin (d) Technicians and other support staff must be free of substance use problems for at
least six months immediately preceding their hiring and must sign a statement attesting to
that fact.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 5.

Minnesota Statutes 2020, section 245F.16, subdivision 1, is amended to read:


Subdivision 1.

Policy requirements.

A license holder must have written personnel
policies and must make them available to staff members at all times. The personnel policies
must:

(1) ensure that a staff member's retention, promotion, job assignment, or pay are not
affected by a good-faith communication between the staff member and the Department of
Human Services, Department of Health, Ombudsman for Mental Health and Developmental
Disabilities, law enforcement, or local agencies that investigate complaints regarding patient
rights, health, or safety;

(2) include a job description for each position that specifies job responsibilities, degree
of authority to execute job responsibilities, standards of job performance related to specified
job responsibilities, and qualifications;

(3) provide for written job performance evaluations for staff members of the license
holder at least annually;

(4) describe deleted text beginbehavior that constitutes groundsdeleted text endnew text begin the processnew text end for disciplinary action,
suspension, or dismissaldeleted text begin, including policies that address substance use problems and meet
the requirements of section 245F.15, subdivisions 1 and 2. The policies and procedures
must list behaviors or incidents that are considered substance use problems. The list must
include:
deleted text endnew text begin of a staff person for violating the drug and alcohol policy described in section
245A.04, subdivision 1, paragraph (c);
new text end

deleted text begin (i) receiving treatment for substance use disorder within the period specified for the
position in the staff qualification requirements;
deleted text end

deleted text begin (ii) substance use that has a negative impact on the staff member's job performance;
deleted text end

deleted text begin (iii) substance use that affects the credibility of treatment services with patients, referral
sources, or other members of the community; and
deleted text end

deleted text begin (iv) symptoms of intoxication or withdrawal on the job;
deleted text end

(5) include policies prohibiting personal involvement with patients and policies
prohibiting patient maltreatment as specified under sections 245A.65, 626.557, and 626.5572
and chapters 260E and 604;

(6) include a chart or description of organizational structure indicating the lines of
authority and responsibilities;

(7) include a written plan for new staff member orientation that, at a minimum, includes
training related to the specific job functions for which the staff member was hired, program
policies and procedures, patient needs, and the areas identified in subdivision 2, paragraphs
(b) to (e); and

(8) include a policy on the confidentiality of patient information.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 6.

Minnesota Statutes 2020, section 245G.01, subdivision 4, is amended to read:


Subd. 4.

Alcohol and drug counselor.

"Alcohol and drug counselor" deleted text beginhas the meaning
given in section 148F.01, subdivision 5
deleted text endnew text begin means a person who is qualified according to section
245G.11, subdivision 5
new text end.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2020, section 245G.01, subdivision 17, is amended to read:


Subd. 17.

Licensed professional in private practice.

new text begin(a) new text end"Licensed professional in
private practice" means an individual who:

(1) is licensed under chapter 148F, or is exempt from licensure under that chapter but
is otherwise licensed to provide alcohol and drug counseling services;

(2) practices solely within the permissible scope of the individual's license as defined
in the law authorizing licensure; and

(3) does not affiliate with other licensed or unlicensed professionals to provide alcohol
and drug counseling services. deleted text beginAffiliation does not include conferring with another
professional or making a client referral.
deleted text end

new text begin (b) For purposes of this subdivision, affiliate includes but is not limited to:
new text end

new text begin (1) using the same electronic record system as another professional, except when the
system prohibits each professional from accessing the records of another professional;
new text end

new text begin (2) advertising the services of more than one professional together;
new text end

new text begin (3) accepting client referrals made to a group of professionals;
new text end

new text begin (4) providing services to another professional's clients when that professional is absent;
or
new text end

new text begin (5) appearing in any way to be a group practice or program.
new text end

new text begin (c) For purposes of this subdivision, affiliate does not include:
new text end

new text begin (1) conferring with another professional;
new text end

new text begin (2) making a client referral to another professional;
new text end

new text begin (3) contracting with the same agency as another professional for billing services;
new text end

new text begin (4) using the same waiting area for clients in an office as another professional; or
new text end

new text begin (5) using the same receptionist as another professional if the receptionist supports each
professional independently.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2020, section 245G.06, is amended by adding a subdivision to
read:


new text begin Subd. 2a. new text end

new text begin Documentation of treatment services. new text end

new text begin The license holder must ensure that
the staff member who provides the treatment service documents in the client record the
date, type, and amount of each treatment service provided to a client and the client's response
to each treatment service within seven days of providing the treatment service.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 9.

Minnesota Statutes 2020, section 245G.06, is amended by adding a subdivision to
read:


new text begin Subd. 2b. new text end

new text begin Client record documentation requirements. new text end

new text begin (a) The license holder must
document in the client record any significant event that occurs at the program on the day
the event occurs. A significant event is an event that impacts the client's relationship with
other clients, staff, or the client's family, or the client's treatment plan.
new text end

new text begin (b) A residential treatment program must document in the client record the following
items on the day that each occurs:
new text end

new text begin (1) medical and other appointments the client attended;
new text end

new text begin (2) concerns related to medications that are not documented in the medication
administration record; and
new text end

new text begin (3) concerns related to attendance for treatment services, including the reason for any
client absence from a treatment service.
new text end

new text begin (c) Each entry in a client's record must be accurate, legible, signed, dated, and include
the job title or position of the staff person that made the entry. A late entry must be clearly
labeled "late entry." A correction to an entry must be made in a way in which the original
entry can still be read.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 10.

Minnesota Statutes 2020, section 245G.06, subdivision 3, is amended to read:


Subd. 3.

deleted text beginDocumentation of treatment services;deleted text end Treatment plan review.

deleted text begin (a) A review
of all treatment services must be documented weekly and include a review of:
deleted text end

deleted text begin (1) care coordination activities;
deleted text end

deleted text begin (2) medical and other appointments the client attended;
deleted text end

deleted text begin (3) issues related to medications that are not documented in the medication administration
record; and
deleted text end

deleted text begin (4) issues related to attendance for treatment services, including the reason for any client
absence from a treatment service.
deleted text end

deleted text begin (b) A note must be entered immediately following any significant event. A significant
event is an event that impacts the client's relationship with other clients, staff, the client's
family, or the client's treatment plan.
deleted text end

deleted text begin (c)deleted text end A treatment plan review must be entered in a client's file weekly or after each treatment
service, whichever is less frequent, by the deleted text beginstaff member providing the servicedeleted text endnew text begin alcohol and
drug counselor responsible for the client's treatment plan
new text end. The review must indicate the span
of time covered by the review and each of the six dimensions listed in section 245G.05,
subdivision 2
, paragraph (c). The review must:

deleted text begin (1) indicate the date, type, and amount of each treatment service provided and the client's
response to each service;
deleted text end

deleted text begin (2)deleted text endnew text begin (1)new text end address each goal in the treatment plan and whether the methods to address the
goals are effective;

deleted text begin (3)deleted text endnew text begin (2)new text end include monitoring of any physical and mental health problems;

deleted text begin (4)deleted text endnew text begin (3)new text end document the participation of others;

deleted text begin (5)deleted text endnew text begin (4)new text end document staff recommendations for changes in the methods identified in the
treatment plan and whether the client agrees with the change; and

deleted text begin (6)deleted text endnew text begin (5)new text end include a review and evaluation of the individual abuse prevention plan according
to section 245A.65.

deleted text begin (d) Each entry in a client's record must be accurate, legible, signed, and dated. A late
entry must be clearly labeled "late entry." A correction to an entry must be made in a way
in which the original entry can still be read.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 11.

Minnesota Statutes 2020, section 245G.08, subdivision 5, is amended to read:


Subd. 5.

Administration of medication and assistance with self-medication.

(a) A
license holder must meet the requirements in this subdivision if a service provided includes
the administration of medication.

(b) A staff member, other than a licensed practitioner or nurse, who is delegated by a
licensed practitioner or a registered nurse the task of administration of medication or assisting
with self-medication, must:

(1) successfully complete a medication administration training program for unlicensed
personnel through an accredited Minnesota postsecondary educational institution. A staff
member's completion of the course must be documented in writing and placed in the staff
member's personnel file;

(2) be trained according to a formalized training program that is taught by a registered
nurse and offered by the license holder. The training must include the process for
administration of naloxone, if naloxone is kept on site. A staff member's completion of the
training must be documented in writing and placed in the staff member's personnel records;
or

(3) demonstrate to a registered nurse competency to perform the delegated activity. A
registered nurse must be employed or contracted to develop the policies and procedures for
administration of medication or assisting with self-administration of medication, or both.

(c) A registered nurse must provide supervision as defined in section 148.171, subdivision
23. The registered nurse's supervision must include, at a minimum, monthly on-site
supervision or more often if warranted by a client's health needs. The policies and procedures
must include:

(1) a provision that a delegation of administration of medication is new text beginlimited to a method
a staff member has been trained to administer and
new text endlimited to deleted text beginthe administration ofdeleted text endnew text begin:
new text end

new text begin (i)new text end a medication that is administered orally, topically, or as a suppository, an eye drop,
an ear drop, deleted text beginordeleted text end an inhalantnew text begin, or an intranasalnew text end;new text begin and
new text end

new text begin (ii) an intramuscular injection of naloxone or epinephrine;
new text end

(2) a provision that each client's file must include documentation indicating whether
staff must conduct the administration of medication or the client must self-administer
medication, or both;

(3) a provision that a client may carry emergency medication such as nitroglycerin as
instructed by the client's physician or advanced practice registered nurse;

(4) a provision for the client to self-administer medication when a client is scheduled to
be away from the facility;

(5) a provision that if a client self-administers medication when the client is present in
the facility, the client must self-administer medication under the observation of a trained
staff member;

(6) a provision that when a license holder serves a client who is a parent with a child,
the parent may only administer medication to the child under a staff member's supervision;

(7) requirements for recording the client's use of medication, including staff signatures
with date and time;

(8) guidelines for when to inform a nurse of problems with self-administration of
medication, including a client's failure to administer, refusal of a medication, adverse
reaction, or error; and

(9) procedures for acceptance, documentation, and implementation of a prescription,
whether written, verbal, telephonic, or electronic.

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 2020, section 245G.09, subdivision 3, is amended to read:


Subd. 3.

Contents.

Client records must contain the following:

(1) documentation that the client was given information on client rights and
responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
an orientation to the program abuse prevention plan required under section 245A.65,
subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record
must contain documentation that the client was provided educational information according
to section 245G.05, subdivision 1, paragraph (b);

(2) an initial services plan completed according to section 245G.04;

(3) a comprehensive assessment completed according to section 245G.05;

(4) an assessment summary completed according to section 245G.05, subdivision 2;

(5) an individual abuse prevention plan according to sections 245A.65, subdivision 2,
and 626.557, subdivision 14, when applicable;

(6) an individual treatment plan according to section 245G.06, subdivisions 1 and 2;

(7) documentation of treatment servicesnew text begin, significant events, appointments, concerns,new text end and
treatment plan deleted text beginreviewdeleted text endnew text begin reviewsnew text end according to section 245G.06, deleted text beginsubdivisiondeleted text endnew text begin subdivisions 2a,
2b, and
new text end 3; and

(8) a summary at the time of service termination according to section 245G.06,
subdivision 4.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022.
new text end

Sec. 13.

Minnesota Statutes 2020, section 245G.11, subdivision 1, is amended to read:


Subdivision 1.

General qualifications.

(a) All staff members who have direct contact
must be 18 years of age or older. deleted text beginAt the time of employment, each staff member must meet
the qualifications in this subdivision. For purposes of this subdivision, "problematic substance
use" means a behavior or incident listed by the license holder in the personnel policies and
procedures according to section 245G.13, subdivision 1, clause (5).
deleted text end

deleted text begin (b) A treatment director, supervisor, nurse, counselor, student intern, or other professional
must be free of problematic substance use for at least the two years immediately preceding
employment and must sign a statement attesting to that fact.
deleted text end

deleted text begin (c) A paraprofessional, recovery peer, or any other staff member with direct contact
must be free of problematic substance use for at least one year immediately preceding
employment and must sign a statement attesting to that fact.
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 14.

Minnesota Statutes 2020, section 245G.11, subdivision 10, is amended to read:


Subd. 10.

Student interns.

A qualified staff member must supervise and be responsible
for a treatment service performed by a student intern and must review and sign each
assessment, deleted text beginprogress note, anddeleted text end individual treatment plannew text begin, and treatment plan reviewnew text end prepared
by a student intern. A student intern must receive the orientation and training required in
section 245G.13, subdivisions 1, clause (7), and 2. No more than 50 percent of the treatment
staff may be students or licensing candidates with time documented to be directly related
to the provision of treatment services for which the staff are authorized.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 15.

Minnesota Statutes 2020, section 245G.13, subdivision 1, is amended to read:


Subdivision 1.

Personnel policy requirements.

A license holder must have written
personnel policies that are available to each staff member. The personnel policies must:

(1) ensure that staff member retention, promotion, job assignment, or pay are not affected
by a good faith communication between a staff member and the department, the Department
of Health, the ombudsman for mental health and developmental disabilities, law enforcement,
or a local agency for the investigation of a complaint regarding a client's rights, health, or
safety;

(2) contain a job description for each staff member position specifying responsibilities,
degree of authority to execute job responsibilities, and qualification requirements;

(3) provide for a job performance evaluation based on standards of job performance
conducted on a regular and continuing basis, including a written annual review;

(4) describe behavior that constitutes grounds for disciplinary action, suspension, or
dismissal, including deleted text beginpolicies that address staff member problematic substance use and the
requirements of section 245G.11, subdivision 1,
deleted text end policies prohibiting personal involvement
with a client in violation of chapter 604, and policies prohibiting client abuse described in
sections 245A.65, 626.557, and 626.5572, and chapter 260E;

deleted text begin (5) identify how the program will identify whether behaviors or incidents are problematic
substance use, including a description of how the facility must address:
deleted text end

deleted text begin (i) receiving treatment for substance use within the period specified for the position in
the staff qualification requirements, including medication-assisted treatment;
deleted text end

deleted text begin (ii) substance use that negatively impacts the staff member's job performance;
deleted text end

deleted text begin (iii) substance use that affects the credibility of treatment services with a client, referral
source, or other member of the community;
deleted text end

deleted text begin (iv) symptoms of intoxication or withdrawal on the job; and
deleted text end

deleted text begin (v) the circumstances under which an individual who participates in monitoring by the
health professional services program for a substance use or mental health disorder is able
to provide services to the program's clients;
deleted text end

new text begin (5) describe the process for disciplinary action, suspension, or dismissal of a staff person
for violating the drug and alcohol policy described in section 245A.04, subdivision 1,
paragraph (c);
new text end

(6) include a chart or description of the organizational structure indicating lines of
authority and responsibilities;

(7) include orientation within 24 working hours of starting for each new staff member
based on a written plan that, at a minimum, must provide training related to the staff member's
specific job responsibilities, policies and procedures, client confidentiality, HIV minimum
standards, and client needs; and

(8) include policies outlining the license holder's response to a staff member with a
behavior problem that interferes with the provision of treatment service.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 16.

Minnesota Statutes 2020, section 245G.20, is amended to read:


245G.20 LICENSE HOLDERS SERVING PERSONS WITH CO-OCCURRING
DISORDERS.

A license holder specializing in the treatment of a person with co-occurring disorders
must:

(1) demonstrate that staff levels are appropriate for treating a client with a co-occurring
disorder, and that there are adequate staff members with mental health training;

(2) have continuing access to a medical provider with appropriate expertise in prescribing
psychotropic medication;

(3) have a mental health professional available for staff member supervision and
consultation;

(4) determine group size, structure, and content considering the special needs of a client
with a co-occurring disorder;

(5) have documentation of active interventions to stabilize mental health symptoms
present in the individual treatment plans and deleted text beginprogress notesdeleted text endnew text begin treatment plan reviewsnew text end;

(6) have continuing documentation of collaboration with continuing care mental health
providers, and involvement of the providers in treatment planning meetings;

(7) have available program materials adapted to a client with a mental health problem;

(8) have policies that provide flexibility for a client who may lapse in treatment or may
have difficulty adhering to established treatment rules as a result of a mental illness, with
the goal of helping a client successfully complete treatment; and

(9) have individual psychotherapy and case management available during treatment
service.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2023.
new text end

Sec. 17.

Minnesota Statutes 2020, section 245G.22, subdivision 7, is amended to read:


Subd. 7.

Restrictions for unsupervised use of methadone hydrochloride.

(a) If a
medical director or prescribing practitioner assesses and determines that a client meets the
criteria in subdivision 6 and may be dispensed a medication used for the treatment of opioid
addiction, the restrictions in this subdivision must be followed when the medication to be
dispensed is methadone hydrochloride. The results of the assessment must be contained in
the client file.new text begin The number of unsupervised use medication doses per week in paragraphs
(b) to (d) is in addition to the number of unsupervised use medication doses a client may
receive for days the clinic is closed for business as allowed by subdivision 6, paragraph (a).
new text end

(b) During the first 90 days of treatment, the unsupervised use medication supply must
be limited to a maximum of a single dose each week and the client shall ingest all other
doses under direct supervision.

(c) In the second 90 days of treatment, the unsupervised use medication supply must be
limited to two doses per week.

(d) In the third 90 days of treatment, the unsupervised use medication supply must not
exceed three doses per week.

(e) In the remaining months of the first year, a client may be given a maximum six-day
unsupervised use medication supply.

(f) After one year of continuous treatment, a client may be given a maximum two-week
unsupervised use medication supply.

(g) After two years of continuous treatment, a client may be given a maximum one-month
unsupervised use medication supply, but must make monthly visits to the program.

new text begin EFFECTIVE DATE. new text end

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

Sec. 18.

Laws 2020, First Special Session chapter 7, section 1, subdivision 5, as amended
by Laws 2021, First Special Session chapter 7, article 2, section 73, is amended to read:


Subd. 5.

Waivers and modifications; extension deleted text beginfor 365 daysdeleted text end.

new text begin(a) new text endWhen the peacetime
emergency declared by the governor in response to the COVID-19 outbreak expires, is
terminated, or is rescinded by the proper authority, waiver CV23: modifying background
study requirements, issued by the commissioner of human services pursuant to Executive
Orders 20-11 and 20-12, including any amendments to the modification issued before the
peacetime emergency expires, shall remain in effect deleted text beginfor 365 days after the peacetime
emergency ends
deleted text endnew text begin until January 1, 2023new text end.

new text begin (b) Under the extension of the waiver in paragraph (a), mandatory direct contact
supervision requirements are waived to allow the commissioner to permit an individual to
work without supervision while that individual's background study is being processed, on
a case-by-case basis and as permitted under federal law and regulation, while providers
transition from name and date of birth background studies of only Minnesota records to
fingerprint-based background studies.
new text end

new text begin (c) The commissioner shall conduct a name and date of birth background study of only
Minnesota records for an individual who has direct contact with persons served in any
program licensed by the commissioner that is not authorized to conduct fingerprint-based
national criminal history record checks, until federal approval is obtained for
fingerprint-based national criminal history record checks and necessary NETStudy 2.0
system changes following federal approval have been completed. A name and date of birth
background study of only Minnesota records conducted under this paragraph shall remain
valid until three months after the commissioner begins conducting fingerprint-based national
criminal history record checks.
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. 19. new text beginCHILD CARE REGULATION MODERNIZATION; PILOT PROJECTS.
new text end

new text begin The commissioner of human services may conduct and administer pilot projects to test
methods and procedures for the projects to modernize regulation of child care centers and
family child care allowed under Laws 2021, First Special Session chapter 7, article 2, sections
75 and 81. To carry out the pilot projects, the commissioner of human services may, by
issuing a commissioner's order, waive enforcement of existing specific statutory program
requirements, rules, and standards in one or more counties. The commissioner's order
establishing the waiver must provide alternative methods and procedures of administration
and must not be in conflict with the basic purposes, coverage, or benefits provided by law.
Pilot projects must comply with the requirements of the child care and development fund
plan.
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. 20. new text beginDIRECTION TO COMMISSIONER OF HUMAN SERVICES; AMENDING
CHILDREN'S RESIDENTIAL FACILITY AND DETOXIFICATION PROGRAM
RULES.
new text end

new text begin (a) The commissioner of human services must amend Minnesota Rules, part 2960.0460,
to remove all references to repealed Minnesota Rules, part 2960.0460, subpart 2.
new text end

new text begin (b) The commissioner must amend Minnesota Rules, part 2960.0470, to require license
holders to have written personnel policies that describe the process for disciplinary action,
suspension, or dismissal of a staff person for violating the drug and alcohol policy described
in Minnesota Statutes, section 245A.04, subdivision 1, paragraph (c), and Minnesota Rules,
part 2960.0030, subpart 9.
new text end

new text begin (c) The commissioner must amend Minnesota Rules, part 9530.6565, subpart 1, to
remove items A and B and the documentation requirement that references these items.
new text end

new text begin (d) The commissioner must amend Minnesota Rules, part 9530.6570, subpart 1, item
D, to remove the existing language and insert language to require license holders to have
written personnel policies that describe the process for disciplinary action, suspension, or
dismissal of a staff person for violating the drug and alcohol policy described in Minnesota
Statutes, section 245A.04, subdivision 1, paragraph (c).
new text end

new text begin (e) For purposes of this section, the commissioner may use the good cause exempt
process under Minnesota Statutes, section 14.388, subdivision 1, clause (3), and Minnesota
Statutes, section 14.386, does not apply.
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. 21. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 245F.15, subdivision 2; and 245G.11, subdivision
2,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Minnesota Rules, parts 2960.0460, subpart 2; and 9530.6565, subpart 2, 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 January 1, 2023.
new text end

ARTICLE 13

MISCELLANEOUS

Section 1.

Minnesota Statutes 2020, section 34A.01, subdivision 4, is amended to read:


Subd. 4.

Food.

"Food" means every ingredient used for, entering into the consumption
of, or used or intended for use in the preparation of food, drink, confectionery, or condiment
for humans or other animals, whether simple, mixed, or compound; and articles used as
components of these ingredientsnew text begin, except that edible cannabinoid products, as defined in
section 151.72, subdivision 1, paragraph (c), are not food
new text end.

Sec. 2.

Minnesota Statutes 2020, section 137.68, is amended to read:


137.68 new text beginMINNESOTA RARE DISEASE new text endADVISORY COUNCIL deleted text beginON RARE
DISEASES
deleted text end.

Subdivision 1.

Establishment.

deleted text beginThe University of Minnesota is requested to establishdeleted text endnew text begin
There is established
new text end an advisory council on rare diseases to provide advice onnew text begin policies,
access, equity,
new text end research, diagnosis, treatment, and education related to rare diseases.new text begin The
advisory council is established in honor of Chloe Barnes and her experiences in the health
care system.
new text end For purposes of this section, "rare disease" has the meaning given in United
States Code, title 21, section 360bb. The council shall be called the deleted text beginChloe Barnes Advisory
Council on Rare Diseases
deleted text endnew text begin Minnesota Rare Disease Advisory Councilnew text end.new text begin The Council on
Disability shall provide meeting and office space and administrative support to the advisory
council but does not have authority over the work of the advisory council.
new text end

Subd. 2.

Membership.

(a) The advisory council deleted text beginmaydeleted text endnew text begin shallnew text end consist of new text beginat least 17 new text endpublic
members new text beginwho reflect statewide representation. Except for initial members, members are
new text end appointed by deleted text beginthe Board of Regents or a designeedeleted text endnew text begin the governornew text end according to paragraph (b)
deleted text begin anddeleted text endnew text begin.new text end Four members of the legislature new text beginare new text endappointed according to paragraph (c).

(b) deleted text beginThe Board of Regents or a designee is requested todeleted text endnew text begin The governor shallnew text end appoint new text beginat
least
new text endthe following public membersnew text begin according to section 15.0597new text end:

(1) three physicians licensed and practicing in the state with experience researching,
diagnosing, or treating rare diseases, including one specializing in pediatrics;

(2) one registered nurse or advanced practice registered nurse licensed and practicing
in the state with experience treating rare diseases;

(3) at least two hospital administrators, or their designees, from hospitals in the state
that provide care to persons diagnosed with a rare disease. One administrator or designee
appointed under this clause must represent a hospital in which the scope of service focuses
on rare diseases of pediatric patients;

(4) three persons age 18 or older who either have a rare disease or are a caregiver of a
person with a rare diseasenew text begin. One person appointed under this clause must reside in rural
Minnesota
new text end;

(5) a representative of a rare disease patient organization that operates in the state;

(6) a social worker with experience providing services to persons diagnosed with a rare
disease;

(7) a pharmacist with experience with drugs used to treat rare diseases;

(8) a dentist licensed and practicing in the state with experience treating rare diseases;

(9) a representative of the biotechnology industry;

(10) a representative of health plan companies;

(11) a medical researcher with experience conducting research on rare diseases; deleted text beginand
deleted text end

(12) a genetic counselor with experience providing services to persons diagnosed with
a rare disease or caregivers of those personsdeleted text begin.deleted text endnew text begin; and
new text end

new text begin (13) representatives with other areas of expertise as identified by the advisory council.
new text end

(c) The advisory council shall include two members of the senate, one appointed by the
majority leader and one appointed by the minority leader; and two members of the house
of representatives, one appointed by the speaker of the house and one appointed by the
minority leader. new text beginMembers appointed under this paragraph serve until their successors are
appointed.
new text end

(d) The commissioner of health or a designee, a representative of Mayo Medical School,
and a representative of the University of Minnesota Medical School shall serve as ex officio,
nonvoting members of the advisory council.

(e) deleted text beginInitial appointments to the advisory council shall be made no later than September
1, 2019.
deleted text end Members appointed according to paragraph (b) shall serve for a term of three years,
except deleted text beginthatdeleted text end the initial members appointed according to paragraph (b) deleted text beginshall have an initial
term of two, three, or four years determined by lot by the chairperson
deleted text end. Members appointed
according to paragraph (b) shall serve until their successors have been appointed.

new text begin (f) Members may be reappointed for up to two full additional terms according to the
advisory council's operating procedures.
new text end

new text begin (g) Members may be removed as provided in section 15.059, subdivision 4.
new text end

new text begin (h) Public members serve without compensation, but may have expenses reimbursed as
provided in section 15.059, subdivision 3. Legislative members may receive per diem
according to the rules of their respective bodies.
new text end

Subd. 3.

Meetings.

deleted text beginThe Board of Regents or a designee is requested to convene the first
meeting of the advisory council no later than October 1, 2019.
deleted text end The advisory council shall
meet at the call of the chairperson or at the request of a majority of advisory council members.new text begin
Meetings of the advisory council are subject to section 13D.01, and notice of its meetings
is governed by section 13D.04.
new text end

new text begin Subd. 3a. new text end

new text begin Chairperson; executive director; staff; executive committee. new text end

new text begin (a) The
advisory council shall elect a chairperson and other officers as it deems necessary and in
accordance with the advisory council's operating procedures.
new text end

new text begin (b) The advisory council shall be governed by an executive committee elected by the
members of the advisory council. One member of the executive committee must be the
advisory council chairperson.
new text end

new text begin (c) The advisory council shall appoint an executive director. The executive director
serves as an ex officio nonvoting member of the executive committee. The advisory council
may delegate to the executive director any powers and duties under this section that do not
require advisory council approval. The executive director serves in the unclassified service
and may be removed at any time by a majority vote of the advisory council. The executive
director may employ and direct staff necessary to carry out advisory council mandates,
policies, activities, and objectives.
new text end

new text begin (d) The executive committee may appoint additional subcommittees and work groups
as necessary to fulfill the duties of the advisory council.
new text end

Subd. 4.

Duties.

(a) The advisory council's duties may include, but are not limited to:

(1) in conjunction with the state's medical schools, the state's schools of public health,
and hospitals in the state that provide care to persons diagnosed with a rare disease,
developing resources or recommendations relating to quality of and access to treatment and
services in the state for persons with a rare disease, including but not limited to:

(i) a list of existing, publicly accessible resources on research, diagnosis, treatment, and
education relating to rare diseases;

(ii) identifying best practices for rare disease care implemented in other states, at the
national level, and at the international level that will improve rare disease care in the state
and seeking opportunities to partner with similar organizations in other states and countries;

(iii) identifyingnew text begin and addressingnew text end problems faced by patients with a rare disease when
changing health plans, including recommendations on how to remove obstacles faced by
these patients to finding a new health plan and how to improve the ease and speed of finding
a new health plan that meets the needs of patients with a rare disease; deleted text beginand
deleted text end

new text begin (iv) identifying and addressing barriers faced by patients with a rare disease to obtaining
care, caused by prior authorization requirements in private and public health plans; and
new text end

deleted text begin (iv)deleted text endnew text begin (v)new text end identifyingnew text begin, recommending, and implementingnew text end best practices to ensure health
care providers are adequately informed of the most effective strategies for recognizing and
treating rare diseases; deleted text beginand
deleted text end

(2) advising, consulting, and cooperating with the Department of Health,new text begin includingnew text end the
Advisory Committee on Heritable and Congenital Disordersdeleted text begin,deleted text endnew text begin; the Department of Human
Services, including the Drug Utilization Review Board and the Drug Formulary Committee;
new text end
and other agencies of state government in developing new text beginrecommendations, new text endinformationnew text begin,new text end and
programs for the public and the health care community relating to diagnosis, treatment, and
awareness of rare diseasesdeleted text begin.deleted text endnew text begin;
new text end

new text begin (3) advising on policy issues and advancing policy initiatives at the state and federal
levels; and
new text end

new text begin (4) receiving funds and issuing grants.
new text end

(b) The advisory council shall collect additional topic areas for study and evaluation
from the general public. In order for the advisory council to study and evaluate a topic, the
topic must be approved for study and evaluation by the advisory council.

new text begin (c) Legislative members may not deliberate about or vote on decisions related to the
issuance of grants of state money.
new text end

Subd. 5.

Conflict of interest.

Advisory council members are subject to the deleted text beginBoard of
Regents policy on conflicts
deleted text endnew text begin advisory council's conflictnew text end of interestnew text begin policy as outlined in the
advisory council's operating procedures
new text end.

Subd. 6.

Annual report.

By January 1 of each year, beginning January 1, 2020, the
advisory council shall report to the chairs and ranking minority members of the legislative
committees with jurisdiction over higher education and health care policy on the advisory
council's activities under subdivision 4 and other issues on which the advisory council may
choose to report.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 3.

Minnesota Statutes 2020, section 151.72, subdivision 1, is amended to read:


Subdivision 1.

Definitions.

(a) For the purposes of this section, the following terms have
the meanings given.

new text begin (b) "Certified hemp" means hemp plants that have been tested and found to meet the
requirements of chapter 18K and the rules adopted thereunder.
new text end

new text begin (c) "Edible cannabinoid product" means any product that is intended to be eaten or
consumed as a beverage by humans, contains a cannabinoid in combination with food
ingredients, and is not a drug.
new text end

deleted text begin (b)deleted text endnew text begin (d)new text end "Hemp" has the meaning given to "industrial hemp" in section 18K.02, subdivision
3.

new text begin (e) "Label" has the meaning given in section 151.01, subdivision 18.
new text end

deleted text begin (c)deleted text endnew text begin (f)new text end "Labeling" means all labels and other written, printed, or graphic matter that are:

(1) affixed to the immediate container in which a product regulated under this section
is sold; deleted text beginor
deleted text end

(2) provided, in any manner, with the immediate container, including but not limited to
outer containers, wrappers, package inserts, brochures, or pamphletsdeleted text begin.deleted text endnew text begin; or
new text end

new text begin (3) provided on that portion of a manufacturer's website that is linked by a scannable
barcode or matrix barcode.
new text end

new text begin (g) "Matrix barcode" means a code that stores data in a two-dimensional array of
geometrically shaped dark and light cells capable of being read by the camera on a
smartphone or other mobile device.
new text end

new text begin (h) "Nonintoxicating cannabinoid" means substances extracted from certified hemp
plants that do not produce intoxicating effects when consumed by any route of administration.
new text end

Sec. 4.

Minnesota Statutes 2020, section 151.72, subdivision 2, is amended to read:


Subd. 2.

Scope.

(a) This section applies to the sale of any product that contains
deleted text begin nonintoxicatingdeleted text end cannabinoids extracted from hemp deleted text beginother than fooddeleted text endnew text begin andnew text end that isnew text begin an edible
cannabinoid product or is
new text end intended for human or animal consumption by any route of
administration.

(b) This section does not apply to any product dispensed by a registered medical cannabis
manufacturer pursuant to sections 152.22 to 152.37.

new text begin (c) The board must have no authority over food products, as defined in section 34A.01,
subdivision 4, that do not contain cannabinoids extracted or derived from hemp.
new text end

Sec. 5.

Minnesota Statutes 2020, section 151.72, subdivision 3, is amended to read:


Subd. 3.

Sale of cannabinoids derived from hemp.

new text begin(a) new text endNotwithstanding any other
section of this chapter, a product containing nonintoxicating cannabinoidsnew text begin, including an
edible cannabinoid product,
new text end may be sold for human or animal consumption new text beginonly new text endif all of
the requirements of this section are metnew text begin, provided that a product sold for human or animal
consumption does not contain more than 0.3 percent of any tetrahydrocannabinol and an
edible cannabinoid product does not contain an amount of any tetrahydrocannabinol that
exceeds the limits established in subdivision 5a, paragraph (f)
new text end.

new text begin (b) No other substance extracted or otherwise derived from hemp may be sold for human
consumption if the substance is intended:
new text end

new text begin (1) for external or internal use in the diagnosis, cure, mitigation, treatment, or prevention
of disease in humans or other animals; or
new text end

new text begin (2) to affect the structure or any function of the bodies of humans or other animals.
new text end

new text begin (c) No product containing any cannabinoid or tetrahydrocannabinol extracted or otherwise
derived from hemp may be sold to any individual who is under the age of 21.
new text end

new text begin (d) Products that meet the requirements of this section are not controlled substances
under section 152.02.
new text end

Sec. 6.

Minnesota Statutes 2020, section 151.72, subdivision 4, is amended to read:


Subd. 4.

Testing requirements.

(a) A manufacturer of a product regulated under this
section must submit representative samples of the product to an independent, accredited
laboratory in order to certify that the product complies with the standards adopted by the
board. Testing must be consistent with generally accepted industry standards for herbal and
botanical substances, and, at a minimum, the testing must confirm that the product:

(1) contains the amount or percentage of cannabinoids that is stated on the label of the
product;

(2) does not contain more than trace amounts of any new text beginmold, residual solvents, new text endpesticides,
fertilizers, or heavy metals; and

(3) does not contain deleted text begina delta-9 tetrahydrocannabinol concentration that exceeds the
concentration permitted for industrial hemp as defined in section 18K.02, subdivision 3
deleted text endnew text begin
more than 0.3 percent of any tetrahydrocannabinol
new text end.

(b) Upon the request of the board, the manufacturer of the product must provide the
board with the results of the testing required in this section.

new text begin (c) Testing of the hemp from which the nonintoxicating cannabinoid was derived, or
possession of a certificate of analysis for such hemp, does not meet the testing requirements
of this section.
new text end

Sec. 7.

Minnesota Statutes 2021 Supplement, section 151.72, subdivision 5, is amended
to read:


Subd. 5.

Labeling requirements.

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

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

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

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

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

new text begin (b) The information in paragraph (a) may be provided on an outer package if the
immediate container that holds the product is too small to contain all of the information.
new text end

new text begin (c) The information required in paragraph (a) may be provided through the use of a
scannable barcode or matrix barcode that links to a page on the manufacturer's website if
that page contains all of the information required by this subdivision.
new text end

new text begin (d) new text endThe label must also include a statement stating that deleted text beginthisdeleted text endnew text begin thenew text end product does not claim
to diagnose, treat, cure, or prevent any disease and has not been evaluated or approved by
the United States Food and Drug Administration (FDA) unless the product has been so
approved.

deleted text begin (b)deleted text endnew text begin (e)new text end The information required deleted text beginto be on the labeldeleted text endnew text begin by this subdivisionnew text end must be prominently
and conspicuously placed deleted text beginanddeleted text endnew text begin on the label or displayed on the websitenew text end in terms that can be
easily read and understood by the consumer.

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

Sec. 8.

Minnesota Statutes 2020, section 151.72, is amended by adding a subdivision to
read:


new text begin Subd. 5a. new text end

new text begin Additional requirements for edible cannabinoid products. new text end

new text begin (a) In addition
to the testing and labeling requirements under subdivisions 4 and 5, an edible cannabinoid
must meet the requirements of this subdivision.
new text end

new text begin (b) An edible cannabinoid product must not:
new text end

new text begin (1) bear the likeness or contain cartoon-like characteristics of a real or fictional person,
animal, or fruit that appeals to children;
new text end

new text begin (2) be modeled after a brand of products primarily consumed by or marketed to children;
new text end

new text begin (3) be made by applying an extracted or concentrated hemp-derived cannabinoid to a
commercially available candy or snack food item;
new text end

new text begin (4) contain an ingredient, other than a hemp-derived cannabinoid, that is not approved
by the United States Food and Drug Administration for use in food;
new text end

new text begin (5) be packaged in a way that resembles the trademarked, characteristic, or
product-specialized packaging of any commercially available food product; or
new text end

new text begin (6) be packaged in a container that includes a statement, artwork, or design that could
reasonably mislead any person to believe that the package contains anything other than an
edible cannabinoid product.
new text end

new text begin (c) An edible cannabinoid product must be prepackaged in packaging or a container that
is child-resistant, tamper-evident, and opaque or placed in packaging or a container that is
child-resistant, tamper-evident, and opaque at the final point of sale to a customer. The
requirement that packaging be child-resistant does not apply to an edible cannabinoid product
that is intended to be consumed as a beverage and which contains no more than a trace
amount of any tetrahydrocannabinol.
new text end

new text begin (d) If an edible cannabinoid product is intended for more than a single use or contains
multiple servings, each serving must be indicated by scoring, wrapping, or other indicators
designating the individual serving size.
new text end

new text begin (e) A label containing at least the following information must be affixed to the packaging
or container of all edible cannabinoid products sold to consumers:
new text end

new text begin (1) the serving size;
new text end

new text begin (2) the cannabinoid profile per serving and in total;
new text end

new text begin (3) a list of ingredients, including identification of any major food allergens declared
by name; and
new text end

new text begin (4) the following statement: "Keep this product out of reach of children."
new text end

new text begin (f) An edible cannabinoid product must not contain more than five milligrams of any
tetrahydrocannabinol in a single serving, or more than a total of 50 milligrams of any
tetrahydrocannabinol per package.
new text end

Sec. 9.

Minnesota Statutes 2020, section 151.72, subdivision 6, is amended to read:


Subd. 6.

Enforcement.

(a) A product deleted text beginsolddeleted text endnew text begin regulatednew text end under this sectionnew text begin, including an
edible cannabinoid product,
new text end shall be considered an adulterated drug if:

(1) it consists, in whole or in part, of any filthy, putrid, or decomposed substance;

(2) it has been produced, prepared, packed, or held under unsanitary conditions where
it may have been rendered injurious to health, or where it may have been contaminated with
filth;

(3) its container is composed, in whole or in part, of any poisonous or deleterious
substance that may render the contents injurious to health;

(4) it contains any new text beginfood additives, new text endcolor additivesnew text begin,new text end or excipients that have been found by
the FDA to be unsafe for human or animal consumption; deleted text beginor
deleted text end

(5) it contains an amount or percentage of new text beginnonintoxicating new text endcannabinoids that is different
than the amount or percentage stated on the labeldeleted text begin.deleted text endnew text begin;
new text end

new text begin (6) it contains more than 0.3 percent of any tetrahydrocannabinol or, if the product is
an edible cannabinoid product, an amount of tetrahydrocannabinol that exceeds the limits
established in subdivision 5a, paragraph (f); or
new text end

new text begin (7) it contains more than trace amounts of mold, residual solvents, pesticides, fertilizers,
or heavy metals.
new text end

(b) A product deleted text beginsolddeleted text end new text beginregulatednew text end under this section shall be considered a misbranded drug
if the product's labeling is false or misleading in any manner or in violation of the
requirements of this section.

(c) The board's authority to issue cease and desist orders under section 151.06; to embargo
adulterated and misbranded drugs under section 151.38; and to seek injunctive relief under
section 214.11, extends to any violation of this section.

Sec. 10.

Minnesota Statutes 2020, section 152.02, subdivision 2, is amended to read:


Subd. 2.

Schedule I.

(a) Schedule I consists of the substances listed in this subdivision.

(b) Opiates. Unless specifically excepted or unless listed in another schedule, any of the
following substances, including their analogs, isomers, esters, ethers, salts, and salts of
isomers, esters, and ethers, whenever the existence of the analogs, isomers, esters, ethers,
and salts is possible:

(1) acetylmethadol;

(2) allylprodine;

(3) alphacetylmethadol (except levo-alphacetylmethadol, also known as levomethadyl
acetate);

(4) alphameprodine;

(5) alphamethadol;

(6) alpha-methylfentanyl benzethidine;

(7) betacetylmethadol;

(8) betameprodine;

(9) betamethadol;

(10) betaprodine;

(11) clonitazene;

(12) dextromoramide;

(13) diampromide;

(14) diethyliambutene;

(15) difenoxin;

(16) dimenoxadol;

(17) dimepheptanol;

(18) dimethyliambutene;

(19) dioxaphetyl butyrate;

(20) dipipanone;

(21) ethylmethylthiambutene;

(22) etonitazene;

(23) etoxeridine;

(24) furethidine;

(25) hydroxypethidine;

(26) ketobemidone;

(27) levomoramide;

(28) levophenacylmorphan;

(29) 3-methylfentanyl;

(30) acetyl-alpha-methylfentanyl;

(31) alpha-methylthiofentanyl;

(32) benzylfentanyl beta-hydroxyfentanyl;

(33) beta-hydroxy-3-methylfentanyl;

(34) 3-methylthiofentanyl;

(35) thenylfentanyl;

(36) thiofentanyl;

(37) para-fluorofentanyl;

(38) morpheridine;

(39) 1-methyl-4-phenyl-4-propionoxypiperidine;

(40) noracymethadol;

(41) norlevorphanol;

(42) normethadone;

(43) norpipanone;

(44) 1-(2-phenylethyl)-4-phenyl-4-acetoxypiperidine (PEPAP);

(45) phenadoxone;

(46) phenampromide;

(47) phenomorphan;

(48) phenoperidine;

(49) piritramide;

(50) proheptazine;

(51) properidine;

(52) propiram;

(53) racemoramide;

(54) tilidine;

(55) trimeperidine;

(56) N-(1-Phenethylpiperidin-4-yl)-N-phenylacetamide (acetyl fentanyl);

(57) 3,4-dichloro-N-[(1R,2R)-2-(dimethylamino)cyclohexyl]-N-
methylbenzamide(U47700);

(58) N-phenyl-N-[1-(2-phenylethyl)piperidin-4-yl]furan-2-carboxamide(furanylfentanyl);

(59) 4-(4-bromophenyl)-4-dimethylamino-1-phenethylcyclohexanol (bromadol);

(60) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopropanecarboxamide (Cyclopropryl
fentanyl);

(61) N-(1-phenethylpiperidin-4-yl)-N-phenylbutanamide) (butyryl fentanyl);

(62) 1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) (MT-45);

(63) N-(1-phenethylpiperidin-4-yl)-N-phenylcyclopentanecarboxamide (cyclopentyl
fentanyl);

(64) N-(1-phenethylpiperidin-4-yl)-N-phenylisobutyramide (isobutyryl fentanyl);

(65) N-(1-phenethylpiperidin-4-yl)-N-phenylpentanamide (valeryl fentanyl);

(66) N-(4-chlorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide
(para-chloroisobutyryl fentanyl);

(67) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)butyramide (para-fluorobutyryl
fentanyl);

(68) N-(4-methoxyphenyl)-N-(1-phenethylpiperidin-4-yl)butyramide
(para-methoxybutyryl fentanyl);

(69) N-(2-fluorophenyl)-2-methoxy-N-(1-phenethylpiperidin-4-yl)acetamide (ocfentanil);

(70) N-(4-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)isobutyramide (4-fluoroisobutyryl
fentanyl or para-fluoroisobutyryl fentanyl);

(71) N-(1-phenethylpiperidin-4-yl)-N-phenylacrylamide (acryl fentanyl or
acryloylfentanyl);

(72) 2-methoxy-N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide (methoxyacetyl
fentanyl);

(73) N-(2-fluorophenyl)-N-(1-phenethylpiperidin-4-yl)propionamide (ortho-fluorofentanyl
or 2-fluorofentanyl);

(74) N-(1-phenethylpiperidin-4-yl)-N-phenyltetrahydrofuran-2-carboxamide
(tetrahydrofuranyl fentanyl); and

(75) Fentanyl-related substances, their isomers, esters, ethers, salts and salts of isomers,
esters and ethers, meaning any substance not otherwise listed under another federal
Administration Controlled Substance Code Number or not otherwise listed in this section,
and for which no exemption or approval is in effect under section 505 of the Federal Food,
Drug, and Cosmetic Act, United States Code , title 21, section 355, that is structurally related
to fentanyl by one or more of the following modifications:

(i) replacement of the phenyl portion of the phenethyl group by any monocycle, whether
or not further substituted in or on the monocycle;

(ii) substitution in or on the phenethyl group with alkyl, alkenyl, alkoxyl, hydroxyl, halo,
haloalkyl, amino, or nitro groups;

(iii) substitution in or on the piperidine ring with alkyl, alkenyl, alkoxyl, ester, ether,
hydroxyl, halo, haloalkyl, amino, or nitro groups;

(iv) replacement of the aniline ring with any aromatic monocycle whether or not further
substituted in or on the aromatic monocycle; or

(v) replacement of the N-propionyl group by another acyl group.

(c) Opium derivatives. Any of the following substances, their analogs, salts, isomers,
and salts of isomers, unless specifically excepted or unless listed in another schedule,
whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:

(1) acetorphine;

(2) acetyldihydrocodeine;

(3) benzylmorphine;

(4) codeine methylbromide;

(5) codeine-n-oxide;

(6) cyprenorphine;

(7) desomorphine;

(8) dihydromorphine;

(9) drotebanol;

(10) etorphine;

(11) heroin;

(12) hydromorphinol;

(13) methyldesorphine;

(14) methyldihydromorphine;

(15) morphine methylbromide;

(16) morphine methylsulfonate;

(17) morphine-n-oxide;

(18) myrophine;

(19) nicocodeine;

(20) nicomorphine;

(21) normorphine;

(22) pholcodine; and

(23) thebacon.

(d) Hallucinogens. Any material, compound, mixture or preparation which contains any
quantity of the following substances, their analogs, salts, isomers (whether optical, positional,
or geometric), and salts of isomers, unless specifically excepted or unless listed in another
schedule, whenever the existence of the analogs, salts, isomers, and salts of isomers is
possible:

(1) methylenedioxy amphetamine;

(2) methylenedioxymethamphetamine;

(3) methylenedioxy-N-ethylamphetamine (MDEA);

(4) n-hydroxy-methylenedioxyamphetamine;

(5) 4-bromo-2,5-dimethoxyamphetamine (DOB);

(6) 2,5-dimethoxyamphetamine (2,5-DMA);

(7) 4-methoxyamphetamine;

(8) 5-methoxy-3, 4-methylenedioxyamphetamine;

(9) alpha-ethyltryptamine;

(10) bufotenine;

(11) diethyltryptamine;

(12) dimethyltryptamine;

(13) 3,4,5-trimethoxyamphetamine;

(14) 4-methyl-2, 5-dimethoxyamphetamine (DOM);

(15) ibogaine;

(16) lysergic acid diethylamide (LSD);

(17) mescaline;

(18) parahexyl;

(19) N-ethyl-3-piperidyl benzilate;

(20) N-methyl-3-piperidyl benzilate;

(21) psilocybin;

(22) psilocyn;

(23) tenocyclidine (TPCP or TCP);

(24) N-ethyl-1-phenyl-cyclohexylamine (PCE);

(25) 1-(1-phenylcyclohexyl) pyrrolidine (PCPy);

(26) 1-[1-(2-thienyl)cyclohexyl]-pyrrolidine (TCPy);

(27) 4-chloro-2,5-dimethoxyamphetamine (DOC);

(28) 4-ethyl-2,5-dimethoxyamphetamine (DOET);

(29) 4-iodo-2,5-dimethoxyamphetamine (DOI);

(30) 4-bromo-2,5-dimethoxyphenethylamine (2C-B);

(31) 4-chloro-2,5-dimethoxyphenethylamine (2C-C);

(32) 4-methyl-2,5-dimethoxyphenethylamine (2C-D);

(33) 4-ethyl-2,5-dimethoxyphenethylamine (2C-E);

(34) 4-iodo-2,5-dimethoxyphenethylamine (2C-I);

(35) 4-propyl-2,5-dimethoxyphenethylamine (2C-P);

(36) 4-isopropylthio-2,5-dimethoxyphenethylamine (2C-T-4);

(37) 4-propylthio-2,5-dimethoxyphenethylamine (2C-T-7);

(38) 2-(8-bromo-2,3,6,7-tetrahydrofuro [2,3-f][1]benzofuran-4-yl)ethanamine
(2-CB-FLY);

(39) bromo-benzodifuranyl-isopropylamine (Bromo-DragonFLY);

(40) alpha-methyltryptamine (AMT);

(41) N,N-diisopropyltryptamine (DiPT);

(42) 4-acetoxy-N,N-dimethyltryptamine (4-AcO-DMT);

(43) 4-acetoxy-N,N-diethyltryptamine (4-AcO-DET);

(44) 4-hydroxy-N-methyl-N-propyltryptamine (4-HO-MPT);

(45) 4-hydroxy-N,N-dipropyltryptamine (4-HO-DPT);

(46) 4-hydroxy-N,N-diallyltryptamine (4-HO-DALT);

(47) 4-hydroxy-N,N-diisopropyltryptamine (4-HO-DiPT);

(48) 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT);

(49) 5-methoxy-α-methyltryptamine (5-MeO-AMT);

(50) 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT);

(51) 5-methylthio-N,N-dimethyltryptamine (5-MeS-DMT);

(52) 5-methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT);

(53) 5-methoxy-α-ethyltryptamine (5-MeO-AET);

(54) 5-methoxy-N,N-dipropyltryptamine (5-MeO-DPT);

(55) 5-methoxy-N,N-diethyltryptamine (5-MeO-DET);

(56) 5-methoxy-N,N-diallyltryptamine (5-MeO-DALT);

(57) methoxetamine (MXE);

(58) 5-iodo-2-aminoindane (5-IAI);

(59) 5,6-methylenedioxy-2-aminoindane (MDAI);

(60) 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25B-NBOMe);

(61) 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25C-NBOMe);

(62) 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe);

(63) 2-(2,5-Dimethoxyphenyl)ethanamine (2C-H);

(64) 2-(4-Ethylthio-2,5-dimethoxyphenyl)ethanamine (2C-T-2);

(65) N,N-Dipropyltryptamine (DPT);

(66) 3-[1-(Piperidin-1-yl)cyclohexyl]phenol (3-HO-PCP);

(67) N-ethyl-1-(3-methoxyphenyl)cyclohexanamine (3-MeO-PCE);

(68) 4-[1-(3-methoxyphenyl)cyclohexyl]morpholine (3-MeO-PCMo);

(69) 1-[1-(4-methoxyphenyl)cyclohexyl]-piperidine (methoxydine, 4-MeO-PCP);

(70) 2-(2-Chlorophenyl)-2-(ethylamino)cyclohexan-1-one (N-Ethylnorketamine,
ethketamine, NENK);

(71) methylenedioxy-N,N-dimethylamphetamine (MDDMA);

(72) 3-(2-Ethyl(methyl)aminoethyl)-1H-indol-4-yl (4-AcO-MET); and

(73) 2-Phenyl-2-(methylamino)cyclohexanone (deschloroketamine).

(e) Peyote. All parts of the plant presently classified botanically as Lophophora williamsii
Lemaire, whether growing or not, the seeds thereof, any extract from any part of the plant,
and every compound, manufacture, salts, derivative, mixture, or preparation of the plant,
its seeds or extracts. The listing of peyote as a controlled substance in Schedule I does not
apply to the nondrug use of peyote in bona fide religious ceremonies of the American Indian
Church, and members of the American Indian Church are exempt from registration. Any
person who manufactures peyote for or distributes peyote to the American Indian Church,
however, is required to obtain federal registration annually and to comply with all other
requirements of law.

(f) Central nervous system depressants. Unless specifically excepted or unless listed in
another schedule, any material compound, mixture, or preparation which contains any
quantity of the following substances, their analogs, salts, isomers, and salts of isomers
whenever the existence of the analogs, salts, isomers, and salts of isomers is possible:

(1) mecloqualone;

(2) methaqualone;

(3) gamma-hydroxybutyric acid (GHB), including its esters and ethers;

(4) flunitrazepam;

(5) 2-(2-Methoxyphenyl)-2-(methylamino)cyclohexanone (2-MeO-2-deschloroketamine,
methoxyketamine);

(6) tianeptine;

(7) clonazolam;

(8) etizolam;

(9) flubromazolam; and

(10) flubromazepam.

(g) Stimulants. Unless specifically excepted or unless listed in another schedule, any
material compound, mixture, or preparation which contains any quantity of the following
substances, their analogs, salts, isomers, and salts of isomers whenever the existence of the
analogs, salts, isomers, and salts of isomers is possible:

(1) aminorex;

(2) cathinone;

(3) fenethylline;

(4) methcathinone;

(5) methylaminorex;

(6) N,N-dimethylamphetamine;

(7) N-benzylpiperazine (BZP);

(8) methylmethcathinone (mephedrone);

(9) 3,4-methylenedioxy-N-methylcathinone (methylone);

(10) methoxymethcathinone (methedrone);

(11) methylenedioxypyrovalerone (MDPV);

(12) 3-fluoro-N-methylcathinone (3-FMC);

(13) methylethcathinone (MEC);

(14) 1-benzofuran-6-ylpropan-2-amine (6-APB);

(15) dimethylmethcathinone (DMMC);

(16) fluoroamphetamine;

(17) fluoromethamphetamine;

(18) α-methylaminobutyrophenone (MABP or buphedrone);

(19) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)butan-1-one (butylone);

(20) 2-(methylamino)-1-(4-methylphenyl)butan-1-one (4-MEMABP or BZ-6378);

(21) 1-(naphthalen-2-yl)-2-(pyrrolidin-1-yl) pentan-1-one (naphthylpyrovalerone or
naphyrone);

(22) (alpha-pyrrolidinopentiophenone (alpha-PVP);

(23) (RS)-1-(4-methylphenyl)-2-(1-pyrrolidinyl)-1-hexanone (4-Me-PHP or MPHP);

(24) 2-(1-pyrrolidinyl)-hexanophenone (Alpha-PHP);

(25) 4-methyl-N-ethylcathinone (4-MEC);

(26) 4-methyl-alpha-pyrrolidinopropiophenone (4-MePPP);

(27) 2-(methylamino)-1-phenylpentan-1-one (pentedrone);

(28) 1-(1,3-benzodioxol-5-yl)-2-(methylamino)pentan-1-one (pentylone);

(29) 4-fluoro-N-methylcathinone (4-FMC);

(30) 3,4-methylenedioxy-N-ethylcathinone (ethylone);

(31) alpha-pyrrolidinobutiophenone (α-PBP);

(32) 5-(2-Aminopropyl)-2,3-dihydrobenzofuran (5-APDB);

(33) 1-phenyl-2-(1-pyrrolidinyl)-1-heptanone (PV8);

(34) 6-(2-Aminopropyl)-2,3-dihydrobenzofuran (6-APDB);

(35) 4-methyl-alpha-ethylaminopentiophenone (4-MEAPP);

(36) 4'-chloro-alpha-pyrrolidinopropiophenone (4'-chloro-PPP);

(37) 1-(1,3-Benzodioxol-5-yl)-2-(dimethylamino)butan-1-one (dibutylone, bk-DMBDB);

(38) 1-(3-chlorophenyl) piperazine (meta-chlorophenylpiperazine or mCPP);

(39) 1-(1,3-benzodioxol-5-yl)-2-(ethylamino)-pentan-1-one (N-ethylpentylone, ephylone);
and

(40) any other substance, except bupropion or compounds listed under a different
schedule, that is structurally derived from 2-aminopropan-1-one by substitution at the
1-position with either phenyl, naphthyl, or thiophene ring systems, whether or not the
compound is further modified in any of the following ways:

(i) by substitution in the ring system to any extent with alkyl, alkylenedioxy, alkoxy,
haloalkyl, hydroxyl, or halide substituents, whether or not further substituted in the ring
system by one or more other univalent substituents;

(ii) by substitution at the 3-position with an acyclic alkyl substituent;

(iii) by substitution at the 2-amino nitrogen atom with alkyl, dialkyl, benzyl, or
methoxybenzyl groups; or

(iv) by inclusion of the 2-amino nitrogen atom in a cyclic structure.

(h) Marijuana, tetrahydrocannabinols, and synthetic cannabinoids. Unless specifically
excepted or unless listed in another schedule, any natural or synthetic material, compound,
mixture, or preparation that contains any quantity of the following substances, their analogs,
isomers, esters, ethers, salts, and salts of isomers, esters, and ethers, whenever the existence
of the isomers, esters, ethers, or salts is possible:

(1) marijuana;

(2) tetrahydrocannabinols naturally contained in a plant of the genus Cannabis,new text begin except
that tetrahydrocannabinols do not include any material, compound, mixture, or preparation
that qualifies as industrial hemp as defined in section 18K.02, subdivision 3;
new text end synthetic
equivalents of the substances contained in the cannabis plant or in the resinous extractives
of the plantdeleted text begin,deleted text endnew text begin;new text end or synthetic substances with similar chemical structure and pharmacological
activity to those substances contained in the plant or resinous extract, including, but not
limited to, 1 cis or trans tetrahydrocannabinol, 6 cis or trans tetrahydrocannabinol, and 3,4
cis or trans tetrahydrocannabinol;

(3) synthetic cannabinoids, including the following substances:

(i) Naphthoylindoles, which are any compounds containing a 3-(1-napthoyl)indole
structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group, whether or not further substituted in the indole ring to any
extent and whether or not substituted in the naphthyl ring to any extent. Examples of
naphthoylindoles include, but are not limited to:

(A) 1-Pentyl-3-(1-naphthoyl)indole (JWH-018 and AM-678);

(B) 1-Butyl-3-(1-naphthoyl)indole (JWH-073);

(C) 1-Pentyl-3-(4-methoxy-1-naphthoyl)indole (JWH-081);

(D) 1-[2-(4-morpholinyl)ethyl]-3-(1-naphthoyl)indole (JWH-200);

(E) 1-Propyl-2-methyl-3-(1-naphthoyl)indole (JWH-015);

(F) 1-Hexyl-3-(1-naphthoyl)indole (JWH-019);

(G) 1-Pentyl-3-(4-methyl-1-naphthoyl)indole (JWH-122);

(H) 1-Pentyl-3-(4-ethyl-1-naphthoyl)indole (JWH-210);

(I) 1-Pentyl-3-(4-chloro-1-naphthoyl)indole (JWH-398);

(J) 1-(5-fluoropentyl)-3-(1-naphthoyl)indole (AM-2201).

(ii) Napthylmethylindoles, which are any compounds containing a
1H-indol-3-yl-(1-naphthyl)methane structure with substitution at the nitrogen atom of the
indole ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group, whether or not further
substituted in the indole ring to any extent and whether or not substituted in the naphthyl
ring to any extent. Examples of naphthylmethylindoles include, but are not limited to:

(A) 1-Pentyl-1H-indol-3-yl-(1-naphthyl)methane (JWH-175);

(B) 1-Pentyl-1H-indol-3-yl-(4-methyl-1-naphthyl)methane (JWH-184).

(iii) Naphthoylpyrroles, which are any compounds containing a 3-(1-naphthoyl)pyrrole
structure with substitution at the nitrogen atom of the pyrrole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the pyrrole ring to any
extent, whether or not substituted in the naphthyl ring to any extent. Examples of
naphthoylpyrroles include, but are not limited to,
(5-(2-fluorophenyl)-1-pentylpyrrol-3-yl)-naphthalen-1-ylmethanone (JWH-307).

(iv) Naphthylmethylindenes, which are any compounds containing a naphthylideneindene
structure with substitution at the 3-position of the indene ring by an alkyl, haloalkyl, alkenyl,
cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indene ring to any
extent, whether or not substituted in the naphthyl ring to any extent. Examples of
naphthylemethylindenes include, but are not limited to,
E-1-[1-(1-naphthalenylmethylene)-1H-inden-3-yl]pentane (JWH-176).

(v) Phenylacetylindoles, which are any compounds containing a 3-phenylacetylindole
structure with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl,
alkenyl, cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
extent, whether or not substituted in the phenyl ring to any extent. Examples of
phenylacetylindoles include, but are not limited to:

(A) 1-(2-cyclohexylethyl)-3-(2-methoxyphenylacetyl)indole (RCS-8);

(B) 1-pentyl-3-(2-methoxyphenylacetyl)indole (JWH-250);

(C) 1-pentyl-3-(2-methylphenylacetyl)indole (JWH-251);

(D) 1-pentyl-3-(2-chlorophenylacetyl)indole (JWH-203).

(vi) Cyclohexylphenols, which are compounds containing a
2-(3-hydroxycyclohexyl)phenol structure with substitution at the 5-position of the phenolic
ring by an alkyl, haloalkyl, alkenyl, cycloalkylmethyl, cycloalkylethyl,
1-(N-methyl-2-piperidinyl)methyl or 2-(4-morpholinyl)ethyl group whether or not substituted
in the cyclohexyl ring to any extent. Examples of cyclohexylphenols include, but are not
limited to:

(A) 5-(1,1-dimethylheptyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol (CP 47,497);

(B) 5-(1,1-dimethyloctyl)-2-[(1R,3S)-3-hydroxycyclohexyl]-phenol
(Cannabicyclohexanol or CP 47,497 C8 homologue);

(C) 5-(1,1-dimethylheptyl)-2-[(1R,2R)-5-hydroxy-2-(3-hydroxypropyl)cyclohexyl]
-phenol (CP 55,940).

(vii) Benzoylindoles, which are any compounds containing a 3-(benzoyl)indole structure
with substitution at the nitrogen atom of the indole ring by an alkyl, haloalkyl, alkenyl,
cycloalkylmethyl, cycloalkylethyl, 1-(N-methyl-2-piperidinyl)methyl or
2-(4-morpholinyl)ethyl group whether or not further substituted in the indole ring to any
extent and whether or not substituted in the phenyl ring to any extent. Examples of
benzoylindoles include, but are not limited to:

(A) 1-Pentyl-3-(4-methoxybenzoyl)indole (RCS-4);

(B) 1-(5-fluoropentyl)-3-(2-iodobenzoyl)indole (AM-694);

(C) (4-methoxyphenyl-[2-methyl-1-(2-(4-morpholinyl)ethyl)indol-3-yl]methanone (WIN
48,098 or Pravadoline).

(viii) Others specifically named:

(A) (6aR,10aR)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (HU-210);

(B) (6aS,10aS)-9-(hydroxymethyl)-6,6-dimethyl-3-(2-methyloctan-2-yl)
-6a,7,10,10a-tetrahydrobenzo[c]chromen-1-ol (Dexanabinol or HU-211);

(C) 2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]
-1,4-benzoxazin-6-yl-1-naphthalenylmethanone (WIN 55,212-2);

(D) (1-pentylindol-3-yl)-(2,2,3,3-tetramethylcyclopropyl)methanone (UR-144);

(E) (1-(5-fluoropentyl)-1H-indol-3-yl)(2,2,3,3-tetramethylcyclopropyl)methanone
(XLR-11);

(F) 1-pentyl-N-tricyclo[3.3.1.13,7]dec-1-yl-1H-indazole-3-carboxamide
(AKB-48(APINACA));

(G) N-((3s,5s,7s)-adamantan-1-yl)-1-(5-fluoropentyl)-1H-indazole-3-carboxamide
(5-Fluoro-AKB-48);

(H) 1-pentyl-8-quinolinyl ester-1H-indole-3-carboxylic acid (PB-22);

(I) 8-quinolinyl ester-1-(5-fluoropentyl)-1H-indole-3-carboxylic acid (5-Fluoro PB-22);

(J) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-pentyl-1H-indazole- 3-carboxamide
(AB-PINACA);

(K) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-[(4-fluorophenyl)methyl]-
1H-indazole-3-carboxamide (AB-FUBINACA);

(L) N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H-
indazole-3-carboxamide(AB-CHMINACA);

(M) (S)-methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3- methylbutanoate
(5-fluoro-AMB);

(N) [1-(5-fluoropentyl)-1H-indazol-3-yl](naphthalen-1-yl) methanone (THJ-2201);

(O) (1-(5-fluoropentyl)-1H-benzo[d]imidazol-2-yl)(naphthalen-1-yl)methanone)
(FUBIMINA);

(P) (7-methoxy-1-(2-morpholinoethyl)-N-((1S,2S,4R)-1,3,3-trimethylbicyclo
[2.2.1]heptan-2-yl)-1H-indole-3-carboxamide (MN-25 or UR-12);

(Q) (S)-N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)
-1H-indole-3-carboxamide (5-fluoro-ABICA);

(R) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
-1H-indole-3-carboxamide;

(S) N-(1-amino-3-phenyl-1-oxopropan-2-yl)-1-(5-fluoropentyl)
-1H-indazole-3-carboxamide;

(T) methyl 2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido) -3,3-dimethylbutanoate;

(U) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1(cyclohexylmethyl)-1
H-indazole-3-carboxamide (MAB-CHMINACA);

(V) N-(1-Amino-3,3-dimethyl-1-oxo-2-butanyl)-1-pentyl-1H-indazole-3-carboxamide
(ADB-PINACA);

(W) methyl (1-(4-fluorobenzyl)-1H-indazole-3-carbonyl)-L-valinate (FUB-AMB);

(X) N-[(1S)-2-amino-2-oxo-1-(phenylmethyl)ethyl]-1-(cyclohexylmethyl)-1H-Indazole-
3-carboxamide. (APP-CHMINACA);

(Y) quinolin-8-yl 1-(4-fluorobenzyl)-1H-indole-3-carboxylate (FUB-PB-22); and

(Z) methyl N-[1-(cyclohexylmethyl)-1H-indole-3-carbonyl]valinate (MMB-CHMICA).

(ix) Additional substances specifically named:

(A) 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1
H-pyrrolo[2,3-B]pyridine-3-carboxamide (5F-CUMYL-P7AICA);

(B) 1-(4-cyanobutyl)-N-(2- phenylpropan-2-yl)-1 H-indazole-3-carboxamide
(4-CN-Cumyl-Butinaca);

(C) naphthalen-1-yl-1-(5-fluoropentyl)-1-H-indole-3-carboxylate (NM2201; CBL2201);

(D) N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(5-fluoropentyl)-1
H-indazole-3-carboxamide (5F-ABPINACA);

(E) methyl-2-(1-(cyclohexylmethyl)-1H-indole-3-carboxamido)-3,3-dimethylbutanoate
(MDMB CHMICA);

(F) methyl 2-(1-(5-fluoropentyl)-1H-indazole-3-carboxamido)-3,3-dimethylbutanoate
(5F-ADB; 5F-MDMB-PINACA); and

(G) N-(1-amino-3,3-dimethyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)
1H-indazole-3-carboxamide (ADB-FUBINACA).

(i) A controlled substance analog, to the extent that it is implicitly or explicitly intended
for human consumption.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective August 1, 2022, and applies to crimes
committed on or after that date.
new text end

Sec. 11.

Minnesota Statutes 2021 Supplement, section 363A.50, is amended to read:


363A.50 NONDISCRIMINATION IN ACCESS TO TRANSPLANTS.

Subdivision 1.

Definitions.

(a) For purposes of this section, the following terms have
the meanings given unless the context clearly requires otherwise.

(b) "Anatomical gift" has the meaning given in section 525A.02, subdivision 4.

(c) "Auxiliary aids and services" include, but are not limited to:

(1) qualified interpreters or other effective methods of making aurally delivered materials
available to individuals with hearing impairmentsnew text begin and to non-English-speaking individualsnew text end;

(2) qualified readers, taped texts, texts in accessible electronic format, or other effective
methods of making visually delivered materials available to individuals with visual
impairments;

(3) the provision of information in a format that is accessible for individuals with
cognitive, neurological, developmental, intellectual, or physical disabilities;

(4) the provision of supported decision-making services; and

(5) the acquisition or modification of equipment or devices.

(d) "Covered entity" means:

(1) any licensed provider of health care services, including licensed health care
practitioners, hospitals, nursing facilities, laboratories, intermediate care facilities, psychiatric
residential treatment facilities, institutions for individuals with intellectual or developmental
disabilities, and prison health centers; or

(2) any entity responsible for matching anatomical gift donors to potential recipients.

(e) "Disability" has the meaning given in section 363A.03, subdivision 12.

(f) "Organ transplant" means the transplantation or infusion of a part of a human body
into the body of another for the purpose of treating or curing a medical condition.

(g) "Qualified individual" means an individual who, with or without available support
networks, the provision of auxiliary aids and services, or reasonable modifications to policies
or practices, meets the essential eligibility requirements for the receipt of an anatomical
gift.

(h) "Reasonable modifications" include, but are not limited to:

(1) communication with individuals responsible for supporting an individual with
postsurgical and post-transplantation care, including medication; and

(2) consideration of support networks available to the individual, including family,
friends, and home and community-based services, including home and community-based
services funded through Medicaid, Medicare, another health plan in which the individual
is enrolled, or any program or source of funding available to the individual, in determining
whether the individual is able to comply with post-transplant medical requirements.

(i) "Supported decision making" has the meaning given in section 524.5-102, subdivision
16a.

Subd. 2.

Prohibition of discrimination.

(a) A covered entity may not, on the basis of
a qualified individual'snew text begin race, ethnicity,new text end mental new text begindisability, new text endor physical disability:

(1) deem an individual ineligible to receive an anatomical gift or organ transplant;

(2) deny medical or related organ transplantation services, including evaluation, surgery,
counseling, and postoperative treatment and care;

(3) refuse to refer the individual to a transplant center or other related specialist for the
purpose of evaluation or receipt of an anatomical gift or organ transplant;

(4) refuse to place an individual on an organ transplant waiting list or place the individual
at a lower-priority position on the list than the position at which the individual would have
been placed if not for the individual's new text beginrace, ethnicity, or new text enddisability; or

(5) decline insurance coverage for any procedure associated with the receipt of the
anatomical gift or organ transplant, including post-transplantation and postinfusion care.

(b) Notwithstanding paragraph (a), a covered entity may take an individual's disability
into account when making treatment or coverage recommendations or decisions, solely to
the extent that the physical or mental disability has been found by a physician, following
an individualized evaluation of the potential recipient to be medically significant to the
provision of the anatomical gift or organ transplant. The provisions of this section may not
be deemed to require referrals or recommendations for, or the performance of, organ
transplants that are not medically appropriate given the individual's overall health condition.

(c) If an individual has the necessary support system to assist the individual in complying
with post-transplant medical requirements, an individual's inability to independently comply
with those requirements may not be deemed to be medically significant for the purposes of
paragraph (b).

(d) A covered entity must make reasonable modifications to policies, practices, or
procedures, when such modifications are necessary to make services such as
transplantation-related counseling, information, coverage, or treatment available to qualified
individuals with disabilities, unless the entity can demonstrate that making such modifications
would fundamentally alter the nature of such services.

(e) A covered entity must take such steps as may be necessary to ensure that no qualified
individual with a disability is denied services such as transplantation-related counseling,
information, coverage, or treatment because of the absence of auxiliary aids and services,
unless the entity can demonstrate that taking such steps would fundamentally alter the nature
of the services being offered or result in an undue burden. A covered entity is not required
to provide supported decision-making services.

(f) A covered entity must otherwise comply with the requirements of Titles II and III of
the Americans with Disabilities Act of 1990, the Americans with Disabilities Act
Amendments Act of 2008, and the Minnesota Human Rights Act.

(g) The provisions of this section apply to each part of the organ transplant process.

Subd. 3.

Remedies.

In addition to all other remedies available under this chapter, any
individual who has been subjected to discrimination in violation of this section may initiate
a civil action in a court of competent jurisdiction to enjoin violations of this section.

Sec. 12. new text beginINITIAL MEMBERS AND FIRST MEETING; MINNESOTA RARE
DISEASE ADVISORY COUNCIL.
new text end

new text begin Public members serving on the University of Minnesota's Advisory Council on Rare
Diseases on June 30, 2022, are the initial public members of the Minnesota Rare Disease
Advisory Council. The terms of the members begin on July 1, 2022. The governor must
designate six members to serve a two-year term; six members to serve a three-year term;
and five members to serve a four-year term. The governor may appoint additional members
under Minnesota Statutes, section 137.68, subdivision 2, paragraph (b), clause (13), and
must set their terms so that roughly one-third of the members' terms expire after two years,
one-third after three years, and one-third after four years. Legislative members of the
University of Minnesota's Advisory Council on Rare Disease serve on the Minnesota Rare
Disease Advisory Council until appointing authorities appoint successors. The person serving
as chair of the executive subcommittee of the University of Minnesota's Advisory Council
on Rare Diseases shall convene the first meeting of the Minnesota Rare Disease Advisory
Council by September 1, 2022.
new text end

Sec. 13. new text beginAPPROPRIATIONS.
new text end

new text begin In accordance with Minnesota Statutes, section 15.039, subdivision 6, the unexpended
balance of money appropriated from the general fund to the Board of Regents of the
University of Minnesota for purposes of the advisory council on rare diseases under
Minnesota Statutes, section 137.68, shall be under the control of the Minnesota Rare Disease
Advisory Council and the Council on Disability.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2022.
new text end

Sec. 14. new text beginREVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber as Minnesota Statutes, section 256.4835, the
Minnesota Rare Disease Advisory Council that is currently coded as Minnesota Statutes,
section 137.68. 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, 2022.
new text end

ARTICLE 14

MANDATED REPORTS

Section 1.

Minnesota Statutes 2020, section 62J.692, subdivision 5, is amended to read:


Subd. 5.

Report.

(a) Sponsoring institutions receiving funds under this section must
sign and submit a medical education grant verification report (GVR) to verify that the correct
grant amount was forwarded to each eligible training site. If the sponsoring institution fails
to submit the GVR by the stated deadline, or to request and meet the deadline for an
extension, the sponsoring institution is required to return the full amount of funds received
to the commissioner within 30 days of receiving notice from the commissioner. The
commissioner shall distribute returned funds to the appropriate training sites in accordance
with the commissioner's approval letter.

(b) The reports must provide verification of the distribution of the funds and must include:

(1) the total number of eligible trainee FTEs in each clinical medical education program;

(2) the name of each funded program and, for each program, the dollar amount distributed
to each training site and a training site expenditure report;

(3) documentation of any discrepancies between the initial grant distribution notice
included in the commissioner's approval letter and the actual distribution;

(4) a statement by the sponsoring institution stating that the completed grant verification
report is valid and accurate; and

(5) other information the commissioner deems appropriate to evaluate the effectiveness
of the use of funds for medical education.

(c) Each year, the commissioner shall provide an annual summary report to the legislature
on the implementation of this section.new text begin This report is exempt from section 144.05, subdivision
7.
new text end

Sec. 2.

Minnesota Statutes 2020, section 62Q.37, subdivision 7, is amended to read:


Subd. 7.

Human services.

deleted text begin(a)deleted text end The commissioner of human services shall implement
this section in a manner that is consistent with applicable federal laws and regulations and
that avoids the duplication of review activities performed by a nationally recognized
independent organization.

deleted text begin (b) By December 31 of each year, the commissioner shall submit to the legislature a
written report identifying the number of audits performed by a nationally recognized
independent organization that were accepted, partially accepted, or rejected by the
commissioner under this section. The commissioner shall provide the rationale for partial
acceptance or rejection. If the rationale for the partial acceptance or rejection was based on
the commissioner's determination that the standards used in the audit were not equivalent
to state law, regulation, or contract requirement, the report must document the variances
deleted text end deleted text begin between the audit standards and the applicable state requirements.
deleted text end

Sec. 3.

Minnesota Statutes 2020, section 144.193, is amended to read:


144.193 INVENTORY OF BIOLOGICAL AND HEALTH DATA.

By February 1, 2014, and annually after that date, the commissioner shall prepare an
inventory of biological specimens, registries, and health data and databases collected or
maintained by the commissioner. In addition to the inventory, the commissioner shall provide
the schedules for storage of health data and biological specimens. The inventories must be
listed in reverse chronological order beginning with the year 2012. The commissioner shall
make the inventory and schedules available on the department's website deleted text beginand submit the
inventory and schedules to the chairs and ranking minority members of the committees of
the legislature with jurisdiction over health policy and data practices issues
deleted text end.

Sec. 4.

Minnesota Statutes 2020, section 144.4199, subdivision 8, is amended to read:


Subd. 8.

Report.

By January 15 of each year, the commissioner shall submit a report to
the chairs and ranking minority members of the house of representatives Ways and Means
Committee, the senate Finance Committee, and the house of representatives and senate
committees with jurisdiction over health and human services finance, detailing expenditures
made in the previous calendar year from the public health response contingency account.new text begin
This report is exempt from section 144.05, subdivision 7.
new text end

Sec. 5.

Minnesota Statutes 2020, section 144A.10, subdivision 17, is amended to read:


Subd. 17.

Agency quality improvement program; annual report on survey
process.

(a) The commissioner shall establish a quality improvement program for the nursing
facility survey and complaint processes. The commissioner must regularly consult with
consumers, consumer advocates, and representatives of the nursing home industry and
representatives of nursing home employees in implementing the program. The commissioner,
through the quality improvement program, shall submit to the legislature an annual survey
and certification quality improvement report, beginning December 15, 2004, and each
December 15 thereafter.new text begin This report is exempt from section 144.05, subdivision 7.
new text end

(b) The report must include, but is not limited to, an analysis of:

(1) the number, scope, and severity of citations by region within the state;

(2) cross-referencing of citations by region within the state and between states within
the Centers for Medicare and Medicaid Services region in which Minnesota is located;

(3) the number and outcomes of independent dispute resolutions;

(4) the number and outcomes of appeals;

(5) compliance with timelines for survey revisits and complaint investigations;

(6) techniques of surveyors in investigations, communication, and documentation to
identify and support citations;

(7) compliance with timelines for providing facilities with completed statements of
deficiencies; and

(8) other survey statistics relevant to improving the survey process.

(c) The report must also identify and explain inconsistencies and patterns across regions
of the state; include analyses and recommendations for quality improvement areas identified
by the commissioner, consumers, consumer advocates, and representatives of the nursing
home industry and nursing home employees; and provide action plans to address problems
that are identified.

Sec. 6.

Minnesota Statutes 2020, section 144A.351, subdivision 1, is amended to read:


Subdivision 1.

Report requirements.

new text begin(a) new text endThe commissioners of health and human
services, with the cooperation of counties and in consultation with stakeholders, including
persons who need or are using long-term care services and supports, lead agencies, regional
entities, senior, disability, and mental health organization representatives, service providers,
and community members shall deleted text beginprepare a report to the legislature by August 15, 2013, and
biennially thereafter,
deleted text endnew text begin compile datanew text end regarding the status of the full range of long-term care
services and supports for the elderly and children and adults with disabilities and mental
illnesses in Minnesota. deleted text beginAny amounts appropriated for this report are available in either year
of the biennium.
deleted text end The deleted text beginreport shall addressdeleted text endnew text begin compiled data shall includenew text end:

(1) demographics and need for long-term care services and supports in Minnesota;

(2) summary of county and regional reports on long-term care gaps, surpluses, imbalances,
and corrective action plans;

(3) status of long-term care services and related mental health services, housing options,
and supports by county and region including:

(i) changes in availability of the range of long-term care services and housing options;

(ii) access problems, including access to the least restrictive and most integrated services
and settings, regarding long-term care services; and

(iii) comparative measures of long-term care services availability, including serving
people in their home areas near family, and changes over time; and

(4) recommendations regarding goals for the future of long-term care services and
supports, policy and fiscal changes, and resource development and transition needs.

new text begin (b) The commissioners of health and human services shall make the compiled data
available on at least one of the department's websites.
new text end

Sec. 7.

Minnesota Statutes 2020, section 144A.483, subdivision 1, is amended to read:


Subdivision 1.

Annual legislative report on home care licensing.

The commissioner
shall establish a quality improvement program for the home care survey and home care
complaint investigation processes. The commissioner shall submit to the legislature an
annual report, beginning October 1, 2015, and each October 1 thereafternew text begin, until October 1,
2027
new text end. Each report will review the previous state fiscal year of home care licensing and
regulatory activities. The report must include, but is not limited to, an analysis of:

(1) the number of FTEs in the Division of Compliance Monitoring, including the Office
of Health Facility Complaints units assigned to home care licensing, survey, investigation,
and enforcement process;

(2) numbers of and descriptive information about licenses issued, complaints received
and investigated, including allegations made and correction orders issued, surveys completed
and timelines, and correction order reconsiderations and results;

(3) descriptions of emerging trends in home care provision and areas of concern identified
by the department in its regulation of home care providers;

(4) information and data regarding performance improvement projects underway and
planned by the commissioner in the area of home care surveys; and

(5) work of the Department of Health Home Care Advisory Council.

Sec. 8.

Minnesota Statutes 2020, section 145.4134, is amended to read:


145.4134 COMMISSIONER'S PUBLIC REPORT.

(a) By July 1 of each year, except for 1998 and 1999 information, the commissioner
shall issue a public report providing statistics for the previous calendar year compiled from
the data submitted under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249.
For 1998 and 1999 information, the report shall be issued October 1, 2000. Each report
shall provide the statistics for all previous calendar years, adjusted to reflect any additional
information from late or corrected reports. The commissioner shall ensure that none of the
information included in the public reports can reasonably lead to identification of an
individual having performed or having had an abortion. All data included on the forms
under sections 145.4131 to 145.4133 and sections 145.4241 to 145.4249 must be included
in the public report, except that the commissioner shall maintain as confidential, data which
alone or in combination may constitute information from which an individual having
performed or having had an abortion may be identified using epidemiologic principles. deleted text beginThe
commissioner shall submit the report to the senate Health and Family Security Committee
and the house of representatives Health and Human Services Committee.
deleted text end

(b) The commissioner may, by rules adopted under chapter 14, alter the submission
dates established under sections 145.4131 to 145.4133 for administrative convenience, fiscal
savings, or other valid reason, provided that physicians or facilities and the commissioner
of human services submit the required information once each year and the commissioner
issues a report once each year.

Sec. 9.

Minnesota Statutes 2020, section 145.928, subdivision 13, is amended to read:


Subd. 13.

Reports.

(a) The commissioner shall submit a biennial report to the legislature
on the local community projects, tribal government, and community health board prevention
activities funded under this section. These reports must include information on grant
recipients, activities that were conducted using grant funds, evaluation data, and outcome
measures, if available. These reports are due by January 15 of every other year, beginning
in the year 2003.

(b) The commissioner shall release an annual report to the public deleted text beginand submit the annual
report to the chairs and ranking minority members of the house of representatives and senate
committees with jurisdiction over public health
deleted text end on grants made under subdivision 7 to
decrease racial and ethnic disparities in infant mortality rates. The report must provide
specific information on the amount of each grant awarded to each agency or organization,
an itemized list submitted to the commissioner by each agency or organization awarded a
grant specifying all uses of grant funds and the amount expended for each use, the population
served by each agency or organization, outcomes of the programs funded by each grant,
and the amount of the appropriation retained by the commissioner for administrative and
associated expenses. The commissioner shall issue a report each January 15 for the previous
fiscal year beginning January 15, 2016.

Sec. 10.

Minnesota Statutes 2020, section 245.4661, subdivision 10, is amended to read:


Subd. 10.

Commissioner duty to report on use of grant funds biennially.

new text begin(a) new text endBy
November 1, 2016, and biennially thereafter, the commissioner of human services shall
provide sufficient information to the members of the legislative committees having
jurisdiction over mental health funding and policy issues to evaluate the use of funds
appropriated under this section of law. The commissioner shall provide, at a minimum, the
following information:

(1) the amount of funding to mental health initiatives, what programs and services were
funded in the previous two years, gaps in services that each initiative brought to the attention
of the commissioner, and outcome data for the programs and services that were funded; and

(2) the amount of funding for other targeted services and the location of services.

new text begin (b) This subdivision expires January 1, 2032.
new text end

Sec. 11.

Minnesota Statutes 2020, section 245.4889, subdivision 3, is amended to read:


Subd. 3.

Commissioner duty to report on use of grant funds biennially.

new text begin(a) new text endBy
November 1, 2016, and biennially thereafter, the commissioner of human services shall
provide sufficient information to the members of the legislative committees having
jurisdiction over mental health funding and policy issues to evaluate the use of funds
appropriated under this section. The commissioner shall provide, at a minimum, the following
information:

(1) the amount of funding for children's mental health grants, what programs and services
were funded in the previous two years, and outcome data for the programs and services that
were funded; and

(2) the amount of funding for other targeted services and the location of services.

new text begin (b) This subdivision expires January 1, 2032.
new text end

Sec. 12.

Minnesota Statutes 2021 Supplement, section 245A.03, subdivision 7, is amended
to read:


Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a family child foster care home or family adult foster care home
license is issued during this moratorium, and the license holder changes the license holder's
primary residence away from the physical location of the foster care license, the
commissioner shall revoke the license according to section 245A.07. The commissioner
shall not issue an initial license for a community residential setting licensed under chapter
245D. When approving an exception under this paragraph, the commissioner shall consider
the resource need determination process in paragraph (h), the availability of foster care
licensed beds in the geographic area in which the licensee seeks to operate, the results of a
person's choices during their annual assessment and service plan review, and the
recommendation of the local county board. The determination by the commissioner is final
and not subject to appeal. Exceptions to the moratorium include:

(1) foster care settings where at least 80 percent of the residents are 55 years of age or
older;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital level care;

(5) new foster care licenses or community residential setting licenses for people receiving
services under chapter 245D and residing in an unlicensed setting before May 1, 2017, and
for which a license is required. This exception does not apply to people living in their own
home. For purposes of this clause, there is a presumption that a foster care or community
residential setting license is required for services provided to three or more people in a
dwelling unit when the setting is controlled by the provider. A license holder subject to this
exception may rebut the presumption that a license is required by seeking a reconsideration
of the commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until June 30, 2018. This exception is available when:

(i) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and

(ii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the unlicensed
setting as determined by the lead agency; or

(6) new foster care licenses or community residential setting licenses for people receiving
customized living or 24-hour customized living services under the brain injury or community
access for disability inclusion waiver plans under section 256B.49 and residing in the
customized living setting before July 1, 2022, for which a license is required. A customized
living service provider subject to this exception may rebut the presumption that a license
is required by seeking a reconsideration of the commissioner's determination. The
commissioner's disposition of a request for reconsideration is final and not subject to appeal
under chapter 14. The exception is available until June 30, 2023. This exception is available
when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people under the brain injury or community access for disability
inclusion waiver plans under section 256B.49 in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

(ii) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and

(iii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the customized
living setting as determined by the lead agency.

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
deleted text begin reportsdeleted text endnew text begin datanew text end required by section 144A.351, and other data and information shall be used to
determine where the reduced capacity determined under section 256B.493 will be
implemented. The commissioner shall consult with the stakeholders described in section
144A.351, and employ a variety of methods to improve the state's capacity to meet the
informed decisions of those people who want to move out of corporate foster care or
community residential settings, long-term service needs within budgetary limits, including
seeking proposals from service providers or lead agencies to change service type, capacity,
or location to improve services, increase the independence of residents, and better meet
needs identified by the long-term services and supports reports and statewide data and
information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493. deleted text beginAnnually, by August 1, the commissioner shall provide
information and data on capacity of licensed long-term services and supports, actions taken
under the subdivision to manage statewide long-term services and supports resources, and
any recommendations for change to the legislative committees with jurisdiction over the
health and human services budget.
deleted text end

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

Sec. 13.

Minnesota Statutes 2020, section 256.01, subdivision 29, is amended to read:


Subd. 29.

State medical review team.

(a) To ensure the timely processing of
determinations of disability by the commissioner's state medical review team under sections
256B.055, subdivisions 7, paragraph (b), and 12, and 256B.057, subdivision 9, the
commissioner shall review all medical evidence and seek information from providers,
applicants, and enrollees to support the determination of disability where necessary. Disability
shall be determined according to the rules of title XVI and title XIX of the Social Security
Act and pertinent rules and policies of the Social Security Administration.

(b) Prior to a denial or withdrawal of a requested determination of disability due to
insufficient evidence, the commissioner shall (1) ensure that the missing evidence is necessary
and appropriate to a determination of disability, and (2) assist applicants and enrollees to
obtain the evidence, including, but not limited to, medical examinations and electronic
medical records.

deleted text begin (c) The commissioner shall provide the chairs of the legislative committees with
jurisdiction over health and human services finance and budget the following information
on the activities of the state medical review team by February 1 of each year:
deleted text end

deleted text begin (1) the number of applications to the state medical review team that were denied,
approved, or withdrawn;
deleted text end

deleted text begin (2) the average length of time from receipt of the application to a decision;
deleted text end

deleted text begin (3) the number of appeals, appeal results, and the length of time taken from the date the
person involved requested an appeal for a written decision to be made on each appeal;
deleted text end

deleted text begin (4) for applicants, their age, health coverage at the time of application, hospitalization
history within three months of application, and whether an application for Social Security
or Supplemental Security Income benefits is pending; and
deleted text end

deleted text begin (5) specific information on the medical certification, licensure, or other credentials of
the person or persons performing the medical review determinations and length of time in
that position.
deleted text end

deleted text begin (d)deleted text endnew text begin (c)new text end Any appeal made under section 256.045, subdivision 3, of a disability
determination made by the state medical review team must be decided according to the
timelines under section 256.0451, subdivision 22, paragraph (a). If a written decision is not
issued within the timelines under section 256.0451, subdivision 22, paragraph (a), the appeal
must be immediately reviewed by the chief human services judge.

Sec. 14.

Minnesota Statutes 2020, section 256.021, subdivision 3, is amended to read:


Subd. 3.

Report.

new text begin(a) new text endBy January 15 of each year, the panel shall submit a report to the
committees of the legislature with jurisdiction over section 626.557 regarding the number
of requests for review it receives under this section, the number of cases where the panel
requires the lead investigative agency to reconsider its final disposition, and the number of
cases where the final disposition is changed, and any recommendations to improve the
review or investigative process.

new text begin (b) This subdivision expires January 1, 2024.
new text end

Sec. 15.

Minnesota Statutes 2021 Supplement, section 256.042, subdivision 4, as amended
by Laws 2022, chapter 53, section 5, is amended to read:


Subd. 4.

Grants.

(a) The commissioner of human services shall submit a report of the
grants proposed by the advisory council to be awarded for the upcoming calendar year to
the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services policy and finance, by December 1 of each year, beginning
deleted text begin March 1, 2020deleted text endnew text begin December 1, 2022. This paragraph expires upon the expiration of the advisory
council
new text end.

(b) The grants shall be awarded to proposals selected by the advisory council that address
the priorities in subdivision 1, paragraph (a), clauses (1) to (4), unless otherwise appropriated
by the legislature. The advisory council shall determine grant awards and funding amounts
based on the funds appropriated to the commissioner under section 256.043, subdivision 3,
paragraph (h), and subdivision 3a, paragraph (d). The commissioner shall award the grants
from the opiate epidemic response fund and administer the grants in compliance with section
16B.97. No more than ten percent of the grant amount may be used by a grantee for
administration.

Sec. 16.

Minnesota Statutes 2020, section 256.042, subdivision 5, as amended by Laws
2022, chapter 53, section 6, is amended to read:


Subd. 5.

Reports.

(a) The advisory council shall report annually to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance by January 31 of each year. The report shall include information
about the individual projects that receive grants, the municipality projects funded by direct
payments received as part of a statewide opioid settlement agreement, and the overall role
of the project in addressing the opioid addiction and overdose epidemic in Minnesota. The
report must describe the grantees and municipalities and the activities implemented, along
with measurable outcomes as determined by the council in consultation with the
commissioner of human services and the commissioner of management and budget. At a
minimum, the report must include information about the number of individuals who received
information or treatment, the outcomes the individuals achieved, and demographic
information about the individuals participating in the project; an assessment of the progress
toward achieving statewide access to qualified providers and comprehensive treatment and
recovery services; and an update on the evaluations implemented by the commissioner of
management and budget for the promising practices and theory-based projects that receive
funding.

(b) The commissioner of management and budget, in consultation with the Opiate
Epidemic Response Advisory Council, shall report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance when an evaluation study described in subdivision 1, paragraph (c), is
complete on the promising practices or theory-based projects that are selected for evaluation
activities. The report shall include demographic information; outcome information for the
individuals in the program; the results for the program in promoting recovery, employment,
family reunification, and reducing involvement with the criminal justice system; and other
relevant outcomes determined by the commissioner of management and budget that are
specific to the projects that are evaluated. The report shall include information about the
ability of grant programs to be scaled to achieve the statewide results that the grant project
demonstrated.

(c) The advisory council, in its annual report to the legislature under paragraph (a) due
by January 31, 2024, shall include recommendations on whether the appropriations to the
specified entities under Laws 2019, chapter 63, should be continued, adjusted, or
discontinued; whether funding should be appropriated for other purposes related to opioid
abuse prevention, education, and treatment; and on the appropriate level of funding for
existing and new uses.

(d) Municipalities receiving direct payments from a statewide opioid settlement agreement
must report annually to the commissioner of human services on how the payments were
used on opioid remediation. The report must be submitted in a format prescribed by the
commissioner. The report must include data and measurable outcomes on expenditures
funded with direct payments from a statewide opioid settlement agreement, including details
on services listed in the categories of approved uses, as identified in agreements between
the state of Minnesota, the Association of Minnesota Counties, and the League of Minnesota
Cities. Reporting requirements must include, at a minimum:

(1) contact information;

(2) information on funded services and programs; and

(3) target populations for each funded service and program.

(e) In reporting data and outcomes under paragraph (d), municipalities must include, to
the extent feasible, information on the use of evidence-based and culturally relevant services.

(f) For municipal projects using $25,000 or more of statewide opioid settlement agreement
payments in a calendar year, municipalities must also include in the report required under
paragraph (d):

(1) a brief qualitative description of successes or challenges; and

(2) results using process and quality measures.

new text begin (g) This subdivision expires upon the expiration of the advisory council.
new text end

Sec. 17.

Minnesota Statutes 2020, section 256.9657, subdivision 8, is amended to read:


Subd. 8.

Commissioner's duties.

new text begin(a) Beginning October 1, 2023, new text endthe commissioner of
human services shallnew text begin annuallynew text end report to the deleted text beginlegislature quarterly on the first day of January,
April, July, and October
deleted text endnew text begin chairs and ranking minority members of the legislative committees
with jurisdiction over health care policy and finance
new text end regarding the provider surcharge
program. The report shall include information on total billings, total collections, and
administrative expendituresnew text begin for the previous fiscal yearnew text end. deleted text beginThe report on January 1, 1993,
shall include information on all surcharge billings, collections, federal matching payments
received, efforts to collect unpaid amounts, and administrative costs pertaining to the
surcharge program in effect from July 1, 1991, to September 30, 1992
deleted text endnew text begin This paragraph expires
January 1, 2032
new text end.

new text begin (b) new text endThe surcharge shall be adjusted by inflationary and caseload changes in future
bienniums to maintain reimbursement of health care providers in accordance with the
requirements of the state and federal laws governing the medical assistance program,
including the requirements of the Medicaid moratorium amendments of 1991 found in
Public Law No. 102-234.

new text begin (c) new text endThe commissioner shall request the Minnesota congressional delegation to support
a change in federal law that would prohibit federal disallowances for any state that makes
a good faith effort to comply with Public Law 102-234 by enacting conforming legislation
prior to the issuance of federal implementing regulations.

Sec. 18.

Minnesota Statutes 2020, section 256.975, subdivision 11, is amended to read:


Subd. 11.

Regional and local dementia grants.

(a) The Minnesota Board on Aging
shall award competitive grants to eligible applicants for regional and local projects and
initiatives targeted to a designated community, which may consist of a specific geographic
area or population, to increase awareness of Alzheimer's disease and other dementias,
increase the rate of cognitive testing in the population at risk for dementias, promote the
benefits of early diagnosis of dementias, or connect caregivers of persons with dementia to
education and resources.

(b) The project areas for grants include:

(1) local or community-based initiatives to promote the benefits of physician or advanced
practice registered nurse consultations for all individuals who suspect a memory or cognitive
problem;

(2) local or community-based initiatives to promote the benefits of early diagnosis of
Alzheimer's disease and other dementias; and

(3) local or community-based initiatives to provide informational materials and other
resources to caregivers of persons with dementia.

(c) Eligible applicants for local and regional grants may include, but are not limited to,
community health boards, school districts, colleges and universities, community clinics,
tribal communities, nonprofit organizations, and other health care organizations.

(d) Applicants must:

(1) describe the proposed initiative, including the targeted community and how the
initiative meets the requirements of this subdivision; and

(2) identify the proposed outcomes of the initiative and the evaluation process to be used
to measure these outcomes.

(e) In awarding the regional and local dementia grants, the Minnesota Board on Aging
must give priority to applicants who demonstrate that the proposed project:

(1) is supported by and appropriately targeted to the community the applicant serves;

(2) is designed to coordinate with other community activities related to other health
initiatives, particularly those initiatives targeted at the elderly;

(3) is conducted by an applicant able to demonstrate expertise in the project areas;

(4) utilizes and enhances existing activities and resources or involves innovative
approaches to achieve success in the project areas; and

(5) strengthens community relationships and partnerships in order to achieve the project
areas.

(f) The board shall divide the state into specific geographic regions and allocate a
percentage of the money available for the local and regional dementia grants to projects or
initiatives aimed at each geographic region.

(g) The board shall award any available grants by January 1, 2016, and each July 1
thereafter.

(h) Each grant recipient shall report to the board on the progress of the initiative at least
once during the grant period, and within two months of the end of the grant period shall
submit a final report to the board that includes the outcome results.

(i) The Minnesota Board on Aging shalldeleted text begin:
deleted text end

deleted text begin (1)deleted text end develop the criteria and procedures to allocate the grants under this subdivision,
evaluate all applicants on a competitive basis and award the grants, and select qualified
providers to offer technical assistance to grant applicants and grantees. The selected provider
shall provide applicants and grantees assistance with project design, evaluation methods,
materials, and trainingdeleted text begin; anddeleted text endnew text begin.
new text end

deleted text begin (2) submit by January 15, 2017, and on each January 15 thereafter, a progress report on
the dementia grants programs under this subdivision to the chairs and ranking minority
members of the senate and house of representatives committees and divisions with jurisdiction
over health finance and policy. The report shall include:
deleted text end

deleted text begin (i) information on each grant recipient;
deleted text end

deleted text begin (ii) a summary of all projects or initiatives undertaken with each grant;
deleted text end

deleted text begin (iii) the measurable outcomes established by each grantee, an explanation of the
evaluation process used to determine whether the outcomes were met, and the results of the
evaluation; and
deleted text end

deleted text begin (iv) an accounting of how the grant funds were spent.
deleted text end

Sec. 19.

Minnesota Statutes 2020, section 256.975, subdivision 12, is amended to read:


Subd. 12.

Self-directed caregiver grants.

The Minnesota Board on Aging shall, in
consultation with area agencies on aging and other community caregiver stakeholders,
administer self-directed caregiver grants to support at-risk family caregivers of older adults
or others eligible under the Older Americans Act of 1965, United States Code, title 42,
chapter 35, sections 3001 to 3058ff, to sustain family caregivers in the caregivers' roles so
older adults can remain at home longer. deleted text beginThe board shall submit by January 15, 2022, and
each January 15 thereafter, a progress report on the self-directed caregiver grants program
to the chairs and ranking minority members of the senate and house of representatives
committees and divisions with jurisdiction over human services. The progress report must
include metrics on the use of the grant program.
deleted text end

Sec. 20.

Minnesota Statutes 2020, section 256B.0561, subdivision 4, is amended to read:


Subd. 4.

Report.

new text begin(a) new text endBy September 1, 2019, and each September 1 thereafter, the
commissioner shall submit a report to the chairs and ranking minority members of the house
and senate committees with jurisdiction over human services finance that includes the
number of cases affected by periodic data matching under this section, the number of
recipients identified as possibly ineligible as a result of a periodic data match, and the number
of recipients whose eligibility was terminated as a result of a periodic data match. The report
must also specify, for recipients whose eligibility was terminated, how many cases were
closed due to failure to cooperate.

new text begin (b) This subdivision expires January 1, 2027.
new text end

Sec. 21.

Minnesota Statutes 2020, section 256B.0911, subdivision 5, is amended to read:


Subd. 5.

Administrative activity.

(a) The commissioner shall streamline the processes,
including timelines for when assessments need to be completed, required to provide the
services in this section and shall implement integrated solutions to automate the business
processes to the extent necessary for community support plan approval, reimbursement,
program planning, evaluation, and policy development.

(b) The commissioner of human services shall work with lead agencies responsible for
conducting long-term consultation services to modify the MnCHOICES application and
assessment policies to create efficiencies while ensuring federal compliance with medical
assistance and long-term services and supports eligibility criteria.

(c) The commissioner shall work with lead agencies responsible for conducting long-term
consultation services to develop a set of measurable benchmarks sufficient to demonstrate
quarterly improvement in the average time per assessment and other mutually agreed upon
measures of increasing efficiency. The commissioner shall collect data on these benchmarks
and provide to the lead agencies deleted text beginand the chairs and ranking minority members of the
legislative committees with jurisdiction over human services
deleted text end an annual trend analysis of
the data in order to demonstrate the commissioner's compliance with the requirements of
this subdivision.

Sec. 22.

Minnesota Statutes 2020, section 256B.0949, subdivision 17, is amended to read:


Subd. 17.

Provider shortage; authority for exceptions.

(a) In consultation with the
Early Intensive Developmental and Behavioral Intervention Advisory Council and
stakeholders, including agencies, professionals, parents of people with ASD or a related
condition, and advocacy organizations, the commissioner shall determine if a shortage of
EIDBI providers exists. For the purposes of this subdivision, "shortage of EIDBI providers"
means a lack of availability of providers who meet the EIDBI provider qualification
requirements under subdivision 15 that results in the delay of access to timely services under
this section, or that significantly impairs the ability of a provider agency to have sufficient
providers to meet the requirements of this section. The commissioner shall consider
geographic factors when determining the prevalence of a shortage. The commissioner may
determine that a shortage exists only in a specific region of the state, multiple regions of
the state, or statewide. The commissioner shall also consider the availability of various types
of treatment modalities covered under this section.

(b) The commissioner, in consultation with the Early Intensive Developmental and
Behavioral Intervention Advisory Council and stakeholders, must establish processes and
criteria for granting an exception under this paragraph. The commissioner may grant an
exception only if the exception would not compromise a person's safety and not diminish
the effectiveness of the treatment. The commissioner may establish an expiration date for
an exception granted under this paragraph. The commissioner may grant an exception for
the following:

(1) EIDBI provider qualifications under this section;

(2) medical assistance provider enrollment requirements under section 256B.04,
subdivision 21; or

(3) EIDBI provider or agency standards or requirements.

(c) If the commissioner, in consultation with the Early Intensive Developmental and
Behavioral Intervention Advisory Council and stakeholders, determines that a shortage no
longer exists, the commissioner must submit a notice that a shortage no longer exists to the
chairs and ranking minority members of the senate and the house of representatives
committees with jurisdiction over health and human services. The commissioner must post
the notice for public comment for 30 days. The commissioner shall consider public comments
before submitting to the legislature a request to end the shortage declaration. deleted text beginThe
commissioner shall annually provide an update on the status of the provider shortage and
exceptions granted to the chairs and ranking minority members of the senate and house of
representatives committees with jurisdiction over health and human services.
deleted text end The
commissioner shall not declare the shortage of EIDBI providers ended without direction
from the legislature to declare it ended.

Sec. 23.

Minnesota Statutes 2020, section 256B.493, subdivision 2, is amended to read:


Subd. 2.

Planned closure process needs determination.

A resource need determination
process, managed at the state level, using available deleted text beginreportsdeleted text endnew text begin datanew text end required by section 144A.351
and other data and information shall be used by the commissioner to align capacity where
needed.

Sec. 24.

Minnesota Statutes 2020, section 256B.69, subdivision 9d, is amended to read:


Subd. 9d.

Financial and quality assurance audits.

(a) The commissioner shall require,
in the request for bids and resulting contracts with managed care plans and county-based
purchasing plans under this section and section 256B.692, that each managed care plan and
county-based purchasing plan submit to and fully cooperate with the independent third-party
financial audits by the legislative auditor under subdivision 9e of the information required
under subdivision 9c, paragraph (b). Each contract with a managed care plan or county-based
purchasing plan under this section or section 256B.692 must provide the commissioner, the
legislative auditor, and vendors contracting with the legislative auditor, access to all data
required to complete audits under subdivision 9e.

(b) Each managed care plan and county-based purchasing plan providing services under
this section shall provide to the commissioner biweekly encounter data and claims data for
state public health care programs and shall participate in a quality assurance program that
verifies the timeliness, completeness, accuracy, and consistency of the data provided. The
commissioner shall develop written protocols for the quality assurance program and shall
make the protocols publicly available. The commissioner shall contract for an independent
third-party audit to evaluate the quality assurance protocols as to the capacity of the protocols
to ensure complete and accurate data and to evaluate the commissioner's implementation
of the protocols.

(c) Upon completion of the evaluation under paragraph (b), the commissioner shall
provide copies of the report to the legislative auditor deleted text beginand the chairs and ranking minority
members of the legislative committees with jurisdiction over health care policy and financing
deleted text end.

(d) Any actuary under contract with the commissioner to provide actuarial services must
meet the independence requirements under the professional code for fellows in the Society
of Actuaries and must not have provided actuarial services to a managed care plan or
county-based purchasing plan that is under contract with the commissioner pursuant to this
section and section 256B.692 during the period in which the actuarial services are being
provided. An actuary or actuarial firm meeting the requirements of this paragraph must
certify and attest to the rates paid to the managed care plans and county-based purchasing
plans under this section and section 256B.692, and the certification and attestation must be
auditable.

(e) The commissioner, to the extent of available funding, shall conduct ad hoc audits of
state public health care program administrative and medical expenses reported by managed
care plans and county-based purchasing plans. This includes: financial and encounter data
reported to the commissioner under subdivision 9c, including payments to providers and
subcontractors; supporting documentation for expenditures; categorization of administrative
and medical expenses; and allocation methods used to attribute administrative expenses to
state public health care programs. These audits also must monitor compliance with data and
financial report certification requirements established by the commissioner for the purposes
of managed care capitation payment rate-setting. The managed care plans and county-based
purchasing plans shall fully cooperate with the audits in this subdivision.

deleted text begin The commissioner shall report to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance
by February 1, 2016, and each February 1 thereafter, the number of ad hoc audits conducted
in the past calendar year and the results of these audits.
deleted text end

(f) Nothing in this subdivision shall allow the release of information that is nonpublic
data pursuant to section 13.02.

Sec. 25.

Minnesota Statutes 2020, section 256E.28, subdivision 6, is amended to read:


Subd. 6.

Evaluation.

(a) Using the outcomes established according to subdivision 3,
the commissioner shall conduct a biennial evaluation of the grant program funded under
this section. Grant recipients shall cooperate with the commissioner in the evaluation and
shall provide the commissioner with the information needed to conduct the evaluation.

(b) The commissioner shall consult with the legislative task force on child protection
during the evaluation process deleted text beginanddeleted text endnew text begin.
new text end

new text begin (c) The commissioner new text endshall submit a biennial evaluation report to the task force and to
the chairs and ranking minority members of the house of representatives and senate
committees with jurisdiction over child protection funding.new text begin This paragraph expires January
1, 2032.
new text end

Sec. 26.

Minnesota Statutes 2020, section 256R.18, is amended to read:


256R.18 REPORT BY COMMISSIONER OF HUMAN SERVICES.

new text begin (a) new text endBeginning January 1, 2019, the commissioner shall provide to the house of
representatives and senate committees with jurisdiction over nursing facility payment rates
a biennial report on the effectiveness of the reimbursement system in improving quality,
restraining costs, and any other features of the system as determined by the commissioner.

new text begin (b) This section expires January 1, 2026.
new text end

Sec. 27.

Minnesota Statutes 2020, section 257.0725, is amended to read:


257.0725 ANNUAL REPORT.

new text begin (a) new text endThe commissioner of human services shall publish an annual report on child
maltreatment and on children in out-of-home placement. The commissioner shall confer
with counties, child welfare organizations, child advocacy organizations, the courts, and
other groups on how to improve the content and utility of the department's annual report.
In regard to child maltreatment, the report shall include the number and kinds of maltreatment
reports received and any other data that the commissioner determines is appropriate to
include in a report on child maltreatment. In regard to children in out-of-home placement,
the report shall include, by county and statewide, information on legal status, living
arrangement, age, sex, race, accumulated length of time in placement, reason for most recent
placement, race of family with whom placed, school enrollments within seven days of
placement pursuant to section 120A.21, and other information deemed appropriate on all
children in out-of-home placement. Out-of-home placement includes placement in any
facility by an authorized child-placing agency.

new text begin (b) This section expires January 1, 2032.
new text end

Sec. 28.

Minnesota Statutes 2020, section 260.775, is amended to read:


260.775 PLACEMENT RECORDS.

new text begin (a) new text endThe commissioner of human services shall publish annually an inventory of all Indian
children in residential facilities. The inventory shall include, by county and statewide,
information on legal status, living arrangement, age, sex, tribe in which the child is a member
or eligible for membership, accumulated length of time in foster care, and other demographic
information deemed appropriate concerning all Indian children in residential facilities. The
report must also state the extent to which authorized child-placing agencies comply with
the order of preference described in United States Code, title 25, section 1901, et seq.new text begin The
commissioner shall include the information required under this paragraph in the annual
report on child maltreatment and on children in out-of-home placement under section
257.0725.
new text end

new text begin (b) This section expires January 1, 2032.
new text end

Sec. 29.

Minnesota Statutes 2020, section 260E.24, subdivision 6, is amended to read:


Subd. 6.

Required referral to early intervention services.

new text begin(a) new text endA child under age three
who is involved in a substantiated case of maltreatment shall be referred for screening under
the Individuals with Disabilities Education Act, part C. Parents must be informed that the
evaluation and acceptance of services are voluntary. The commissioner of human services
shall monitor referral rates by county deleted text beginand annually report the information to the legislaturedeleted text end.
Refusal to have a child screened is not a basis for a child in need of protection or services
petition under chapter 260C.

new text begin (b) The commissioner of human services shall include the referral rates by county for
screening under the Individuals with Disabilities Education Act, part C in the annual report
on child maltreatment under section 257.0725. This paragraph expires January 1, 2032.
new text end

Sec. 30.

Minnesota Statutes 2020, section 260E.38, subdivision 3, is amended to read:


Subd. 3.

Report required.

new text begin(a) new text endThe commissioner shall produce an annual report of the
summary results of the reviews. The report must only contain aggregate data and may not
include any data that could be used to personally identify any subject whose data is included
in the report. The report is public information and must be provided to the chairs and ranking
minority members of the legislative committees having jurisdiction over child protection
issues.new text begin The commissioner shall include the information required under this paragraph in the
annual report on child maltreatment and on children in out-of-home placement under section
257.0725.
new text end

new text begin (b) This subdivision expires January 1, 2032.
new text end

Sec. 31.

Minnesota Statutes 2020, section 518A.77, is amended to read:


518A.77 GUIDELINES REVIEW.

new text begin (a) new text endNo later than 2006 and every four years after that, the Department of Human Services
must conduct a review of the child support guidelines.

new text begin (b) This section expires January 1, 2032.
new text end

Sec. 32.

Minnesota Statutes 2020, section 626.557, subdivision 12b, is amended to read:


Subd. 12b.

Data management.

(a) In performing any of the duties of this section as a
lead investigative agency, the county social service agency shall maintain appropriate
records. Data collected by the county social service agency under this section are welfare
data under section 13.46. Notwithstanding section 13.46, subdivision 1, paragraph (a), data
under this paragraph that are inactive investigative data on an individual who is a vendor
of services are private data on individuals, as defined in section 13.02. The identity of the
reporter may only be disclosed as provided in paragraph (c).

Data maintained by the common entry point are confidential data on individuals or
protected nonpublic data as defined in section 13.02. Notwithstanding section 138.163, the
common entry point shall maintain data for three calendar years after date of receipt and
then destroy the data unless otherwise directed by federal requirements.

(b) The commissioners of health and human services shall prepare an investigation
memorandum for each report alleging maltreatment investigated under this section. County
social service agencies must maintain private data on individuals but are not required to
prepare an investigation memorandum. During an investigation by the commissioner of
health or the commissioner of human services, data collected under this section are
confidential data on individuals or protected nonpublic data as defined in section 13.02.
Upon completion of the investigation, the data are classified as provided in clauses (1) to
(3) and paragraph (c).

(1) The investigation memorandum must contain the following data, which are public:

(i) the name of the facility investigated;

(ii) a statement of the nature of the alleged maltreatment;

(iii) pertinent information obtained from medical or other records reviewed;

(iv) the identity of the investigator;

(v) a summary of the investigation's findings;

(vi) statement of whether the report was found to be substantiated, inconclusive, false,
or that no determination will be made;

(vii) a statement of any action taken by the facility;

(viii) a statement of any action taken by the lead investigative agency; and

(ix) when a lead investigative agency's determination has substantiated maltreatment, a
statement of whether an individual, individuals, or a facility were responsible for the
substantiated maltreatment, if known.

The investigation memorandum must be written in a manner which protects the identity
of the reporter and of the vulnerable adult and may not contain the names or, to the extent
possible, data on individuals or private data listed in clause (2).

(2) Data on individuals collected and maintained in the investigation memorandum are
private data, including:

(i) the name of the vulnerable adult;

(ii) the identity of the individual alleged to be the perpetrator;

(iii) the identity of the individual substantiated as the perpetrator; and

(iv) the identity of all individuals interviewed as part of the investigation.

(3) Other data on individuals maintained as part of an investigation under this section
are private data on individuals upon completion of the investigation.

(c) After the assessment or investigation is completed, the name of the reporter must be
confidential. The subject of the report may compel disclosure of the name of the reporter
only with the consent of the reporter or upon a written finding by a court that the report was
false and there is evidence that the report was made in bad faith. This subdivision does not
alter disclosure responsibilities or obligations under the Rules of Criminal Procedure, except
that where the identity of the reporter is relevant to a criminal prosecution, the district court
shall do an in-camera review prior to determining whether to order disclosure of the identity
of the reporter.

(d) Notwithstanding section 138.163, data maintained under this section by the
commissioners of health and human services must be maintained under the following
schedule and then destroyed unless otherwise directed by federal requirements:

(1) data from reports determined to be false, maintained for three years after the finding
was made;

(2) data from reports determined to be inconclusive, maintained for four years after the
finding was made;

(3) data from reports determined to be substantiated, maintained for seven years after
the finding was made; and

(4) data from reports which were not investigated by a lead investigative agency and for
which there is no final disposition, maintained for three years from the date of the report.

(e) The commissioners of health and human services shall annually publish on their
websites the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigation under this section,
and the resolution of those investigations.

deleted text begin On a biennial basis, the commissioners of health and human services shall jointly report
the following information to the legislature and the governor:
deleted text end

deleted text begin (1) the number and type of reports of alleged maltreatment involving licensed facilities
reported under this section, the number of those requiring investigations under this section,
the resolution of those investigations, and which of the two lead agencies was responsible;
deleted text end

deleted text begin (2) trends about types of substantiated maltreatment found in the reporting period;
deleted text end

deleted text begin (3) if there are upward trends for types of maltreatment substantiated, recommendations
for addressing and responding to them;
deleted text end

deleted text begin (4) efforts undertaken or recommended to improve the protection of vulnerable adults;
deleted text end

deleted text begin (5) whether and where backlogs of cases result in a failure to conform with statutory
time frames and recommendations for reducing backlogs if applicable;
deleted text end

deleted text begin (6) recommended changes to statutes affecting the protection of vulnerable adults; and
deleted text end

deleted text begin (7) any other information that is relevant to the report trends and findings.
deleted text end

(f) Each lead investigative agency must have a record retention policy.

(g) Lead investigative agencies, prosecuting authorities, and law enforcement agencies
may exchange not public data, as defined in section 13.02, if the agency or authority
requesting the data determines that the data are pertinent and necessary to the requesting
agency in initiating, furthering, or completing an investigation under this section. Data
collected under this section must be made available to prosecuting authorities and law
enforcement officials, local county agencies, and licensing agencies investigating the alleged
maltreatment under this section. The lead investigative agency shall exchange not public
data with the vulnerable adult maltreatment review panel established in section 256.021 if
the data are pertinent and necessary for a review requested under that section.
Notwithstanding section 138.17, upon completion of the review, not public data received
by the review panel must be destroyed.

(h) Each lead investigative agency shall keep records of the length of time it takes to
complete its investigations.

(i) A lead investigative agency may notify other affected parties and their authorized
representative if the lead investigative agency has reason to believe maltreatment has occurred
and determines the information will safeguard the well-being of the affected parties or dispel
widespread rumor or unrest in the affected facility.

(j) Under any notification provision of this section, where federal law specifically
prohibits the disclosure of patient identifying information, a lead investigative agency may
not provide any notice unless the vulnerable adult has consented to disclosure in a manner
which conforms to federal requirements.

Sec. 33. new text beginREPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2020, sections 62U.10, subdivision 3; 144.1911, subdivision 10;
144.564, subdivision 3; 144A.483, subdivision 2; 245.981; 246.131; 246B.03, subdivision
2; 246B.035; 256.01, subdivision 31; and 256B.0638, subdivision 7,
new text end new text begin are repealed.
new text end

new text begin (b) new text end new text begin Laws 1998, chapter 382, article 1, section 23, new text end new text begin is repealed.
new text end

ARTICLE 15

FORECAST ADJUSTMENTS AND CARRY FORWARD AUTHORITY

Section 1. new text beginHUMAN SERVICES APPROPRIATION.
new text end

new text begin The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2021, First Special
Session chapter 7, article 16, from the general fund or any fund named to the Department
of Human Services for the purposes specified in this article, to be available for the fiscal
year indicated for each purpose. The figures "2022" and "2023" used in this article mean
that the appropriations listed under them are available for the fiscal years ending June 30,
2022, or June 30, 2023, respectively. "The first year" is fiscal year 2022. "The second year"
is fiscal year 2023. "The biennium" is fiscal years 2022 and 2023.
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 2022
new text end
new text begin 2023
new text end

Sec. 2. new text beginCOMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Total Appropriation
new text end

new text begin $
new text end
new text begin (585,901,000)
new text end
new text begin $
new text end
new text begin 182,791,000
new text end
new text begin Appropriations by Fund
new text end
new text begin General Fund
new text end
new text begin (406,629,000)
new text end
new text begin 185,395,000
new text end
new text begin Health Care Access
Fund
new text end
new text begin (86,146,000)
new text end
new text begin (11,799,000)
new text end
new text begin Federal TANF
new text end
new text begin (93,126,000)
new text end
new text begin 9,195,000
new text end

new text begin Subd. 2. new text end

new text begin Forecasted Programs
new text end

new text begin (a) MFIP/DWP
new text end
new text begin Appropriations by Fund
new text end
new text begin General Fund
new text end
new text begin 72,106,000
new text end
new text begin (14,397,000)
new text end
new text begin Federal TANF
new text end
new text begin (93,126,000)
new text end
new text begin 9,195,000
new text end
new text begin (b) MFIP Child Care Assistance
new text end
new text begin (103,347,000)
new text end
new text begin (73,738,000)
new text end
new text begin (c) General Assistance
new text end
new text begin (4,175,000)
new text end
new text begin (1,488,000)
new text end
new text begin (d) Minnesota Supplemental Aid
new text end
new text begin 318,000
new text end
new text begin 1,613,000
new text end
new text begin (e) Housing Support
new text end
new text begin (1,994,000)
new text end
new text begin 9,257,000
new text end
new text begin (f) Northstar Care for Children
new text end
new text begin (9,613,000)
new text end
new text begin (4,865,000)
new text end
new text begin (g) MinnesotaCare
new text end
new text begin (86,146,000)
new text end
new text begin (11,799,000)
new text end

new text begin These appropriations are from the health care
access fund.
new text end

new text begin (h) Medical Assistance
new text end
new text begin Appropriations by Fund
new text end
new text begin General Fund
new text end
new text begin (348,364,000)
new text end
new text begin 292,880,000
new text end
new text begin Health Care Access
Fund
new text end
new text begin -0-
new text end
new text begin -0-
new text end
new text begin (i) Alternative Care Program
new text end
new text begin -0-
new text end
new text begin -0-
new text end
new text begin (j) Behavioral Health Fund
new text end
new text begin (11,560,000)
new text end
new text begin (23,867,000)
new text end

new text begin Subd. 3. new text end

new text begin Technical Activities
new text end

new text begin -0-
new text end
new text begin -0-
new text end

new text begin These appropriations are from the federal
TANF 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. 3.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 23,
is amended to read:


Subd. 23.

Grant Programs; Children and
Community Service Grants

61,251,000
deleted text begin 61,856,000 deleted text end new text begin
60,856,000
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. 4.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 24,
is amended to read:


Subd. 24.

Grant Programs; Children and
Economic Support Grants

29,740,000
deleted text begin 29,740,000 deleted text end new text begin
30,740,000
new text end

Minnesota Food Assistance Program.
Unexpended funds for the Minnesota food
assistance program for fiscal year 2022 do not
cancel but are available in fiscal year 2023.

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.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 29,
is amended to read:


Subd. 29.

Grant Programs; Disabilities Grants

31,398,000
31,010,000

(a) Training Stipends for Direct Support
Services Providers.
$1,000,000 in fiscal year
2022 is from the general fund for stipends for
individual providers of direct support services
as defined in Minnesota Statutes, section
256B.0711, subdivision 1. deleted text beginThesedeleted text end new text beginThe new text endstipends
are available to individual providers who have
completed designated voluntary trainings
made available through the State-Provider
Cooperation Committee formed by the State
of Minnesota and the Service Employees
International Union Healthcare Minnesota.
Any unspent appropriation in fiscal year 2022
is available in fiscal year 2023. This is a
onetime appropriation. This appropriation is
available only if the labor agreement between
the state of Minnesota and the Service
Employees International Union Healthcare
Minnesota under Minnesota Statutes, section
179A.54, is approved under Minnesota
Statutes, section 3.855.

(b) Parent-to-Parent Peer Support. $125,000
in fiscal year 2022 and $125,000 in fiscal year
2023 are from the general fund for a grant to
an alliance member of Parent to Parent USA
to support the alliance member's
parent-to-parent peer support program for
families of children with a disability or special
health care need.

(c) Self-Advocacy Grants. (1) $143,000 in
fiscal year 2022 and $143,000 in fiscal year
2023 are from the general fund for a grant
under Minnesota Statutes, section 256.477,
subdivision 1
.

(2) $105,000 in fiscal year 2022 and $105,000
in fiscal year 2023 are from the general fund
for subgrants under Minnesota Statutes,
section 256.477, subdivision 2.

(d) Minnesota Inclusion Initiative Grants.
$150,000 in fiscal year 2022 and $150,000 in
fiscal year 2023 are from the general fund for
grants under Minnesota Statutes, section
256.4772.

(e) Grants to Expand Access to Child Care
for Children with Disabilities.
$250,000 in
fiscal year 2022 and $250,000 in fiscal year
2023 are from the general fund for grants to
expand access to child care for children with
disabilities.new text begin Any unexpended amount in fiscal
year 2022 is available through June 30, 2023.
new text end
This is a onetime appropriation.

(f) Parenting with a Disability Pilot Project.
The general fund base includes $1,000,000 in
fiscal year 2024 and $0 in fiscal year 2025 to
implement the parenting with a disability pilot
project.

(g) Base Level Adjustment. The general fund
base is $29,260,000 in fiscal year 2024 and
$22,260,000 in fiscal year 2025.

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.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 31,
is amended to read:


Subd. 31.

Grant Programs; Adult Mental Health
Grants

Appropriations by Fund
General
98,772,000
98,703,000
Opiate Epidemic
Response
2,000,000
2,000,000

(a) Culturally and Linguistically
Appropriate Services Implementation
Grants.
$2,275,000 in fiscal year 2022 and
$2,206,000 in fiscal year 2023 are from the
general fund for grants to disability services,
mental health, and substance use disorder
treatment providers to implement culturally
and linguistically appropriate services
standards, according to the implementation
and transition plan developed by the
commissioner.new text begin Any unexpended amount in
fiscal year 2022 is available through June 30,
2023.
new text end The general fund base for this
appropriation is $1,655,000 in fiscal year 2024
and $0 in fiscal year 2025.

(b) Base Level Adjustment. The general fund
base is $93,295,000 in fiscal year 2024 and
$83,324,000 in fiscal year 2025. The opiate
epidemic response fund base is $2,000,000 in
fiscal year 2024 and $0 in fiscal year 2025.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 32,
is amended to read:


Subd. 32.

Grant Programs; Child Mental Health
Grants

30,167,000
30,182,000

(a) Children's Residential Facilities.
$1,964,000 in fiscal year 2022 and $1,979,000
in fiscal year 2023 are to reimburse counties
and Tribal governments for a portion of the
costs of treatment in children's residential
facilities. The commissioner shall distribute
the appropriation deleted text beginon an annual basisdeleted text end to
counties and Tribal governments
proportionally based on a methodology
developed by the commissioner.new text begin The fiscal
year 2022 appropriation is available until June
30, 2023.
new text end

(b) Base Level Adjustment. The general fund
base is $29,580,000 in fiscal year 2024 and
$27,705,000 in fiscal year 2025.

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 33,
is amended to read:


Subd. 33.

Grant Programs; Chemical
Dependency Treatment Support Grants

Appropriations by Fund
General
4,273,000
4,274,000
Lottery Prize
1,733,000
1,733,000
Opiate Epidemic
Response
500,000
500,000

(a) Problem Gambling. $225,000 in fiscal
year 2022 and $225,000 in fiscal year 2023
are from the lottery prize fund for a grant to
the state affiliate recognized by the National
Council on Problem Gambling. The affiliate
must provide services to increase public
awareness of problem gambling, education,
training for individuals and organizations
providing effective treatment services to
problem gamblers and their families, and
research related to problem gambling.

(b) Recovery Community Organization
Grants.
$2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
general fund for grants to recovery community
organizations, as defined in Minnesota
Statutes, section 254B.01, subdivision 8, to
provide for costs and community-based peer
recovery support services that are not
otherwise eligible for reimbursement under
Minnesota Statutes, section 254B.05, as part
of the continuum of care for substance use
disorders.new text begin Any unexpended amount in fiscal
year 2022 is available through June 30, 2023.
new text end
The general fund base for this appropriation
is $2,000,000 in fiscal year 2024 and $0 in
fiscal year 2025

(c) Base Level Adjustment. The general fund
base is $4,636,000 in fiscal year 2024 and
$2,636,000 in fiscal year 2025. The opiate
epidemic response fund base is $500,000 in
fiscal year 2024 and $0 in fiscal year 2025.

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.

Laws 2021, First Special Session chapter 7, article 17, section 3, is amended to
read:


Sec. 3. GRANTS FOR TECHNOLOGY FOR HCBS RECIPIENTS.

(a) This act includes $500,000 in fiscal year 2022 and $2,000,000 in fiscal year 2023
for the commissioner of human services to issue competitive grants to home and
community-based service providers. Grants must be used to provide technology assistance,
including but not limited to Internet services, to older adults and people with disabilities
who do not have access to technology resources necessary to use remote service delivery
and telehealth.new text begin Any unexpended amount in fiscal year 2022 is available through June 30,
2023.
new text end The general fund base included in this act for this purpose is $1,500,000 in fiscal year
2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

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.

Laws 2021, First Special Session chapter 7, article 17, section 6, is amended to
read:


Sec. 6. TRANSITION TO COMMUNITY INITIATIVE.

(a) This act includes $5,500,000 in fiscal year 2022 and $5,500,000 in fiscal year 2023
for additional funding for grants awarded under the transition to community initiative
described in Minnesota Statutes, section 256.478.new text begin Any unexpended amount in fiscal year
2022 is available through June 30, 2023.
new text end The general fund base in this act for this purpose
is $4,125,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Laws 2021, First Special Session chapter 7, article 17, section 10, is amended to
read:


Sec. 10. PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED
COMMUNITIES.

(a) This act includes $6,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
for the commissioner to establish a grant program for small provider organizations that
provide services to rural or underserved communities with limited home and
community-based services provider capacity. The grants are available to build organizational
capacity to provide home and community-based services in Minnesota and to build new or
expanded infrastructure to access medical assistance reimbursement.new text begin Any unexpended
amount in fiscal year 2022 is available through June 30, 2023.
new text end The general fund base in this
act for this purpose is $8,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) The commissioner shall conduct community engagement, provide technical assistance,
and establish a collaborative learning community related to the grants available under this
section and work with the commissioner of management and budget and the commissioner
of the Department of Administration to mitigate barriers in accessing grant funds. Funding
awarded for the community engagement activities described in this paragraph is exempt
from state solicitation requirements under Minnesota Statutes, section 16B.97, for activities
that occur in fiscal year 2022.

(c) All grant activities must be completed by March 31, 2024.

(d) This section expires June 30, 2024.

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.

Laws 2021, First Special Session chapter 7, article 17, section 11, is amended to
read:


Sec. 11. EXPAND MOBILE CRISIS.

(a) This act includes $8,000,000 in fiscal year 2022 and $8,000,000 in fiscal year 2023
for additional funding for grants for adult mobile crisis services under Minnesota Statutes,
section 245.4661, subdivision 9, paragraph (b), clause (15).new text begin Any unexpended amounts in
fiscal year 2022 and fiscal year 2023 are available through June 30, 2024.
new text end The general fund
base in this act for this purpose is $4,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

(c) All grant activities must be completed by March 31, 2024.

(d) This section expires June 30, 2024.

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.

Laws 2021, First Special Session chapter 7, article 17, section 12, is amended to
read:


Sec. 12. PSYCHIATRIC RESIDENTIAL TREATMENT FACILITY AND CHILD
AND ADOLESCENT MOBILE TRANSITION UNIT.

(a) This act includes $2,500,000 in fiscal year 2022 and $2,500,000 in fiscal year 2023
for the commissioner of human services to create children's mental health transition and
support teams to facilitate transition back to the community of children from psychiatric
residential treatment facilities, and child and adolescent behavioral health hospitals.new text begin Any
unexpended amount in fiscal year 2022 is available through June 30, 2023.
new text end The general
fund base included in this act for this purpose is $1,875,000 in fiscal year 2024 and $0 in
fiscal year 2025.

(b) Beginning April 1, 2024, counties may fund and continue conducting activities
funded under this section.

(c) This section expires March 31, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Laws 2021, First Special Session chapter 7, article 17, section 17, subdivision 3,
is amended to read:


Subd. 3.

Respite services for older adults grants.

(a) This act includes $2,000,000 in
fiscal year 2022 and $2,000,000 in fiscal year 2023 for the commissioner of human services
to establish a grant program for respite services for older adults. The commissioner must
award grants on a competitive basis to respite service providers.new text begin Any unexpended amount
in fiscal year 2022 is available through June 30, 2023.
new text end The general fund base included in
this act for this purpose is $2,000,000 in fiscal year 2024 and $0 in fiscal year 2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This subdivision expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Laws 2021, First Special Session chapter 7, article 17, section 19, is amended to
read:


Sec. 19. CENTERS FOR INDEPENDENT LIVING HCBS ACCESS GRANT.

(a) This act includes $1,200,000 in fiscal year 2022 and $1,200,000 in fiscal year 2023
for grants to expand services to support people with disabilities from underserved
communities who are ineligible for medical assistance to live in their own homes and
communities by providing accessibility modifications, independent living services, and
public health program facilitation. The commissioner of human services must award the
grants in equal amounts to deleted text beginthe eight organizationsdeleted text endnew text begin grantees. To be eligible, a grantee must
be an organization
new text end defined in Minnesota Statutes, section 268A.01, subdivision 8. new text beginAny
unexpended amount in fiscal year 2022 is available through June 30, 2023.
new text endThe general
fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year
2025.

(b) All grant activities must be completed by March 31, 2024.

(c) This section expires June 30, 2024.

new text begin EFFECTIVE DATE. new text end

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

ARTICLE 16

LONG-TERM CARE CONSULTATION SERVICES RECODIFICATION

Section 1.

Minnesota Statutes 2020, section 256B.0911, subdivision 1, is amended to read:


Subdivision 1.

Purpose and goal.

(a) The purpose of long-term care consultation services
is to assist persons with long-term or chronic care needs in making care decisions and
selecting support and service options that meet their needs and reflect their preferences.
The availability of, and access to, information and other types of assistance, including
long-term care consultation assessment and deleted text begincommunitydeleted text end support planning, is also intended
to prevent or delay institutional placements and to provide access to transition assistance
after placement. Further, the goal of long-term care consultation services is to contain costs
associated with unnecessary institutional admissions. Long-termnew text begin carenew text end consultation services
must be available to any person regardless of public program eligibility.

(b) The commissioner of human services shall seek to maximize use of available federal
and state funds and establish the broadest program possible within the funding available.

(c) Long-term care consultation services must be coordinated with long-term care options
counseling deleted text beginprovided under subdivision 4d, section 256.975, subdivisions 7 to 7c, and section
256.01, subdivision 24
deleted text endnew text begin, long-term care options counseling for assisted living, the Disability
Hub, and preadmission screening
new text end.

(d) deleted text beginThedeleted text endnew text begin Anew text end lead agency providing long-term care consultation services shall encourage
the use of volunteers from families, religious organizations, social clubs, and similar civic
and service organizations to provide community-based services.

Sec. 2.

Minnesota Statutes 2020, section 256B.0911, subdivision 3c, is amended to read:


Subd. 3c.

deleted text beginConsultationdeleted text endnew text begin Long-term care options counselingnew text end for deleted text beginhousing with servicesdeleted text endnew text begin
assisted living
new text end.

(a) The purpose of long-term care deleted text beginconsultation for registered housing with
services
deleted text endnew text begin options counseling for assisted livingnew text end is to support persons with current or anticipated
long-term care needs in making informed choices among options that include the most
cost-effective and least restrictive settings. Prospective residents maintain the right to choose
deleted text begin housing with services ordeleted text end assisted living if that option is their preference.

(b) deleted text beginRegistered housing with services establishmentsdeleted text endnew text begin Licensed assisted living facilitiesnew text end
shall inform each prospective resident or the prospective resident's designated or legal
representative of the availability of long-term care deleted text beginconsultationdeleted text endnew text begin options counseling for
assisted living
new text end and the need to receive and verify the deleted text beginconsultationdeleted text endnew text begin counselingnew text end prior to signing
a deleted text beginlease ordeleted text end contract. Long-term care deleted text beginconsultation for registered housing with servicesdeleted text endnew text begin options
counseling for assisted living
new text end is provided as determined by the commissioner of human
services. The service is delivered under a partnership between lead agencies as defined in
subdivision deleted text begin1adeleted text endnew text begin 10new text end, paragraph deleted text begin(d)deleted text endnew text begin (g)new text end, and the Area Agencies on Aging, and is a point of
entry to a combination of telephone-based long-term care options counseling provided by
Senior LinkAge Line and in-person long-term care consultation provided by lead agencies.
The point of entry service must be provided within five working days of the request of the
prospective resident as follows:

(1) the deleted text beginconsultationdeleted text endnew text begin counselingnew text end shall be conducted with the prospective resident, or in
the alternative, the resident's designated or legal representative, if:

(i) the resident verbally requests; or

(ii) the deleted text beginregistered housing with services providerdeleted text endnew text begin assisted living facilitynew text end has documentation
of the designated or legal representative's authority to enter into a lease or contract on behalf
of the prospective resident and accepts the documentation in good faith;

(2) the deleted text beginconsultationdeleted text endnew text begin counselingnew text end shall be performed in a manner that provides objective
and complete information;

(3) the deleted text beginconsultationdeleted text endnew text begin counselingnew text end must include a review of the prospective resident's reasons
for considering deleted text beginhousing with servicesdeleted text endnew text begin assisted living servicesnew text end, the prospective resident's
personal goals, a discussion of the prospective resident's immediate and projected long-term
care needs, and alternative community services or deleted text beginhousing with servicesdeleted text end settings that may
meet the prospective resident's needs;

(4) the prospective resident deleted text beginshalldeleted text endnew text begin mustnew text end be informed of the availability of deleted text begina face-to-facedeleted text endnew text begin
an in-person
new text end visitnew text begin from a long-term care consultation team membernew text end at no charge to the
prospective resident to assist the prospective resident in assessment and planning to meet
the prospective resident's long-term care needs; and

(5) verification of counseling shall be generated and provided to the prospective resident
by Senior LinkAge Line upon completion of the telephone-based counseling.

(c) deleted text beginHousing with services establishments registered under chapter 144Ddeleted text endnew text begin An assisted
living facility licensed under chapter 144G
new text end shall:

(1) inform each prospective resident or the prospective resident's designated or legal
representative of the availability of and contact information for deleted text beginconsultationdeleted text endnew text begin options
counseling
new text end services under this subdivision;

(2) receive a copy of the verification of counseling prior to executing a deleted text beginlease or servicedeleted text end
contract with the prospective residentdeleted text begin, and prior to executing a service contract with
individuals who have previously entered into lease-only arrangements
deleted text end; and

(3) retain a copy of the verification of counseling as part of the resident's file.

(d) Emergency admissions to deleted text beginregistered housing with services establishmentsdeleted text endnew text begin licensed
assisted living facilities
new text end prior to consultation under paragraph (b) are permitted according
to policies established by the commissioner.

Sec. 3.

Minnesota Statutes 2020, section 256B.0911, subdivision 3d, is amended to read:


Subd. 3d.

Exemptionsnew text begin from long-term care options counseling for assisted
living
new text end.

Individuals shall be exempt from the requirements outlined in subdivision deleted text begin3cdeleted text endnew text begin 7enew text end in
the following circumstances:

(1) the individual is seeking a lease-only arrangement in a subsidized housing setting;

(2) the individual has previously received a long-term care consultation assessment
under deleted text beginthisdeleted text end sectionnew text begin 256B.0911new text end. In this instance, the assessor who completes the long-term
care consultationnew text begin assessmentnew text end will issue a verification code and provide it to the individual;

(3) the individual is receiving or is being evaluated for hospice services from a hospice
provider licensed under sections 144A.75 to 144A.755; or

(4) the individual has used financial planning services and created a long-term care plan
as defined by the commissioner in the 12 months prior to signing a lease or contract with a
deleted text begin registered housing with services establishmentdeleted text endnew text begin licensed assisted living facilitynew text end.

Sec. 4.

Minnesota Statutes 2020, section 256B.0911, subdivision 3e, is amended to read:


Subd. 3e.

deleted text beginConsultationdeleted text endnew text begin Long-term care options counselingnew text end at hospital discharge.

(a)
Hospitals shall refer all individuals described in paragraph (b) prior to discharge from an
inpatient hospital stay to the Senior LinkAge Line for long-term care options counseling.
Hospitals shall make these referrals using referral protocols and processes developed under
deleted text begin section 256.975,deleted text end subdivision 7. The purpose of the counseling is to support persons with
current or anticipated long-term care needs in making informed choices among options that
include the most cost-effective and least restrictive setting.

(b) The individuals who shall be referred under paragraph (a) include older adults who
are at risk of nursing home placement. Protocols for identifying at-risk individuals shall be
developed under deleted text beginsection deleted text enddeleted text begin256.975,deleted text end subdivision 7, paragraph (b), clause (12).

(c) Counseling provided under this subdivision shall meet the requirements for the
consultation required under subdivision deleted text begin3cdeleted text endnew text begin 7enew text end.

Sec. 5.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 10. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following definitions apply.
new text end

new text begin (b) "Available service and setting options" or "available options," with respect to the
home and community-based waivers under chapter 256S and sections 256B.092 and 256B.49,
means all services and settings defined under the waiver plan for which a waiver applicant
or waiver participant is eligible.
new text end

new text begin (c) "Competitive employment" means work in the competitive labor market that is
performed on a full-time or part-time basis in an integrated setting, and for which an
individual is compensated at or above the minimum wage, but not less than the customary
wage and level of benefits paid by the employer for the same or similar work performed by
individuals without disabilities.
new text end

new text begin (d) "Cost-effective" means community services and living arrangements that cost the
same as or less than institutional care. For an individual found to meet eligibility criteria
for home and community-based service programs under chapter 256S or section 256B.49,
"cost-effectiveness" has the meaning found in the federally approved waiver plan for each
program.
new text end

new text begin (e) "Independent living" means living in a setting that is not controlled by a provider.
new text end

new text begin (f) "Informed choice" has the meaning given in section 256B.4905, subdivision 1a.
new text end

new text begin (g) "Lead agency" means a county administering or a Tribe or health plan under contract
with the commissioner to administer long-term care consultation services.
new text end

new text begin (h) "Long-term care consultation services" means the activities described in subdivision
11.
new text end

new text begin (i) "Long-term care options counseling" means the services provided by sections 256.01,
subdivision 24, and 256.975, subdivision 7, and also includes telephone assistance and
follow-up after a long-term care consultation assessment has been completed.
new text end

new text begin (j) "Long-term care options counseling for assisted living" means the services provided
under section 256.975, subdivisions 7e to 7g.
new text end

new text begin (k) "Minnesota health care programs" means the medical assistance program under this
chapter and the alternative care program under section 256B.0913.
new text end

new text begin (l) "Person-centered planning" is a process that includes the active participation of a
person in the planning of the person's services, including in making meaningful and informed
choices about the person's own goals, talents, and objectives, as well as making meaningful
and informed choices about the services the person receives, the settings in which the person
receives the services, and the setting in which the person lives.
new text end

new text begin (m) "Preadmission screening" means the services provided under section 256.975,
subdivisions 7a to 7c.
new text end

Sec. 6.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 11. new text end

new text begin Long-term care consultation services. new text end

new text begin The following activities are included
in long-term care consultation services:
new text end

new text begin (1) intake for and access to assistance in identifying services needed to maintain an
individual in the most inclusive environment;
new text end

new text begin (2) transfer or referral to long-term care options counseling services for telephone
assistance and follow-up after a person requests assistance in identifying community supports
without participating in a complete long-term care consultation assessment;
new text end

new text begin (3) long-term care consultation assessments conducted according to subdivisions 17 to
21, 23, or 24, which may be completed in a hospital, nursing facility, intermediate care
facility for persons with developmental disabilities (ICF/DDs), regional treatment center,
or the person's current or planned residence;
new text end

new text begin (4) providing recommendations for and referrals to cost-effective community services
that are available to the individual;
new text end

new text begin (5) providing recommendations for institutional placement when there are no
cost-effective community services available;
new text end

new text begin (6) providing information regarding eligibility for Minnesota health care programs;
new text end

new text begin (7) determining service eligibility for the following state plan services:
new text end

new text begin (i) personal care assistance services under section 256B.0625, subdivisions 19a and 19c;
new text end

new text begin (ii) consumer support grants under section 256.476; or
new text end

new text begin (iii) community first services and supports under section 256B.85;
new text end

new text begin (8) notwithstanding provisions in Minnesota Rules, parts 9525.0004 to 9525.0024,
gaining access to the following services, including obtaining necessary diagnostic information
to determine eligibility:
new text end

new text begin (i) relocation targeted case management services available under section 256B.0621,
subdivision 2, clause (4);
new text end

new text begin (ii) case management services targeted to vulnerable adults or people with developmental
disabilities under section 256B.0924; and
new text end

new text begin (iii) case management services targeted to people with developmental disabilities under
Minnesota Rules, part 9525.0016;
new text end

new text begin (9) determining eligibility for semi-independent living services under section 252.275,
including obtaining necessary diagnostic information;
new text end

new text begin (10) determining home and community-based waiver and other service eligibility as
required under chapter 256S and sections 256B.0913, 256B.092, and 256B.49, including:
new text end

new text begin (i) level of care determination for individuals who need an institutional level of care as
determined under subdivision 26;
new text end

new text begin (ii) appropriate referrals to obtain necessary diagnostic information; and
new text end

new text begin (iii) an eligibility determination for consumer-directed community supports;
new text end

new text begin (11) providing information about competitive employment, with or without supports,
for school-age youth and working-age adults and referrals to the Disability Hub and Disability
Benefits 101 to ensure that an informed choice about competitive employment can be made;
new text end

new text begin (12) providing information about independent living to ensure that an informed choice
about independent living can be made;
new text end

new text begin (13) providing information about self-directed services and supports, including
self-directed funding options, to ensure that an informed choice about self-directed options
can be made;
new text end

new text begin (14) developing an individual's person-centered assessment summary; and
new text end

new text begin (15) providing access to assistance to transition people back to community settings after
institutional admission.
new text end

Sec. 7.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 12. new text end

new text begin Exception to use of MnCHOICES assessment; contracted assessors. new text end

new text begin (a)
A lead agency that has not implemented MnCHOICES assessments and uses contracted
assessors as of January 1, 2022, is not subject to the requirements of subdivisions 11, clauses
(7) to (9); 13; 14, paragraphs (a) to (c); 16 to 21; 23; 24; and 29 to 31.
new text end

new text begin (b) This subdivision expires upon statewide implementation of MnCHOICES assessments.
The commissioner shall notify the revisor of statutes when statewide implementation has
occurred.
new text end

Sec. 8.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 13. new text end

new text begin MnCHOICES assessor qualifications, training, and certification. new text end

new text begin (a) The
commissioner shall develop and implement a curriculum and an assessor certification
process.
new text end

new text begin (b) MnCHOICES certified assessors must:
new text end

new text begin (1) either have a bachelor's degree in social work, nursing with a public health nursing
certificate, or other closely related field with at least one year of home and community-based
experience or be a registered nurse with at least two years of home and community-based
experience; and
new text end

new text begin (2) have received training and certification specific to assessment and consultation for
long-term care services in the state.
new text end

new text begin (c) Certified assessors shall demonstrate best practices in assessment and support
planning, including person-centered planning principles, and have a common set of skills
that ensures consistency and equitable access to services statewide.
new text end

new text begin (d) Certified assessors must be recertified every three years.
new text end

Sec. 9.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 14. new text end

new text begin Use of MnCHOICES certified assessors required. new text end

new text begin (a) Each lead agency
shall use MnCHOICES certified assessors who have completed MnCHOICES training and
the certification process determined by the commissioner in subdivision 13.
new text end

new text begin (b) Each lead agency must ensure that the lead agency has sufficient numbers of certified
assessors to provide long-term consultation assessment and support planning within the
timelines and parameters of the service.
new text end

new text begin (c) A lead agency may choose, according to departmental policies, to contract with a
qualified, certified assessor to conduct assessments and reassessments on behalf of the lead
agency.
new text end

new text begin (d) Tribes and health plans under contract with the commissioner must provide long-term
care consultation services as specified in the contract.
new text end

new text begin (e) A lead agency must provide the commissioner with an administrative contact for
communication purposes.
new text end

Sec. 10.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 15. new text end

new text begin Long-term care consultation team. new text end

new text begin (a) Each county board of commissioners
shall establish a long-term care consultation team. Two or more counties may collaborate
to establish a joint local long-term care consultation team or teams.
new text end

new text begin (b) Each lead agency shall establish and maintain a team of certified assessors qualified
under subdivision 13. Each team member is responsible for providing consultation with
other team members upon request. The team is responsible for providing long-term care
consultation services to all persons located in the county who request the services, regardless
of eligibility for Minnesota health care programs. The team of certified assessors must
include, at a minimum:
new text end

new text begin (1) a social worker; and
new text end

new text begin (2) a public health nurse or registered nurse.
new text end

new text begin (c) The commissioner shall allow arrangements and make recommendations that
encourage counties and Tribes to collaborate to establish joint local long-term care
consultation teams to ensure that long-term care consultations are done within the timelines
and parameters of the service. This includes coordinated service models as required in
subdivision 1, paragraph (c).
new text end

Sec. 11.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 16. new text end

new text begin MnCHOICES certified assessors; responsibilities. new text end

new text begin (a) Certified assessors
must use person-centered planning principles to conduct an interview that identifies what
is important to the person; the person's needs for supports and health and safety concerns;
and the person's abilities, interests, and goals.
new text end

new text begin (b) Certified assessors are responsible for:
new text end

new text begin (1) ensuring persons are offered objective, unbiased access to resources;
new text end

new text begin (2) ensuring persons have the needed information to support informed choice, including
where and how they choose to live and the opportunity to pursue desired employment;
new text end

new text begin (3) determining level of care and eligibility for long-term services and supports;
new text end

new text begin (4) using the information gathered from the interview to develop a person-centered
assessment summary that reflects identified needs and support options within the context
of values, interests, and goals important to the person; and
new text end

new text begin (5) providing the person with an assessment summary of findings, support options, and
agreed-upon next steps.
new text end

Sec. 12.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 17. new text end

new text begin MnCHOICES assessments. new text end

new text begin (a) A person requesting long-term care
consultation services must be visited by a long-term care consultation team within 20
calendar days after the date on which an assessment was requested or recommended.
Assessments must be conducted according to this subdivision and subdivisions 19 to 21,
23, 24, and 29 to 31.
new text end

new text begin (b) Lead agencies shall use certified assessors to conduct the assessment.
new text end

new text begin (c) For a person with complex health care needs, a public health or registered nurse from
the team must be consulted.
new text end

new text begin (d) The lead agency must use the MnCHOICES assessment provided by the commissioner
to complete a comprehensive, conversation-based, person-centered assessment. The
assessment must include the health, psychological, functional, environmental, and social
needs of the individual necessary to develop a person-centered assessment summary that
meets the individual's needs and preferences.
new text end

new text begin (e) Except as provided in subdivision 24, an assessment must be conducted by a certified
assessor in an in-person conversational interview with the person being assessed.
new text end

Sec. 13.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 18. new text end

new text begin Exception to use of MnCHOICES assessments; long-term care consultation
team visit; notice.
new text end

new text begin (a) Until statewide implementation of MnCHOICES assessments, the
requirement under subdivision 17, paragraph (a), does not apply to an assessment of a person
requesting personal care assistance services. The commissioner shall provide at least a
90-day notice to lead agencies prior to the effective date of statewide implementation.
new text end

new text begin (b) This subdivision expires upon statewide implementation of MnCHOICES assessments.
The commissioner shall notify the revisor of statutes when statewide implementation has
occurred.
new text end

Sec. 14.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 19. new text end

new text begin MnCHOICES assessments; third-party participation. new text end

new text begin (a) The person's
legal representative, if any, must provide input during the assessment process and may do
so remotely if requested.
new text end

new text begin (b) At the request of the person, other individuals may participate in the assessment to
provide information on the needs, strengths, and preferences of the person necessary to
complete the assessment and assessment summary. Except for legal representatives or family
members invited by the person, a person participating in the assessment may not be a provider
of service or have any financial interest in the provision of services.
new text end

new text begin (c) For a person assessed for elderly waiver customized living or adult day services
under chapter 256S, with the permission of the person being assessed or the person's
designated or legal representative, the client's current or proposed provider of services may
submit a copy of the provider's nursing assessment or written report outlining its
recommendations regarding the client's care needs. The person conducting the assessment
must notify the provider of the date by which to submit this information. This information
must be provided to the person conducting the assessment prior to the assessment.
new text end

new text begin (d) For a person assessed for waiver services under section 256B.092 or 256B.49, with
the permission of the person being assessed or the person's designated legal representative,
the person's current provider of services may submit a written report outlining
recommendations regarding the person's care needs that the person completed in consultation
with someone who is known to the person and who has interaction with the person on a
regular basis. The provider must submit the report at least 60 days before the end of the
person's current service agreement. The certified assessor must consider the content of the
submitted report prior to finalizing the person's assessment or reassessment.
new text end

Sec. 15.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 20. new text end

new text begin MnCHOICES assessments; duration of validity. new text end

new text begin (a) An assessment that is
completed as part of an eligibility determination for multiple programs for the alternative
care, elderly waiver, developmental disabilities, community access for disability inclusion,
community alternative care, and brain injury waiver programs under chapter 256S and
sections 256B.0913, 256B.092, and 256B.49 is valid to establish service eligibility for no
more than 60 calendar days after the date of the assessment.
new text end

new text begin (b) The effective eligibility start date for programs in paragraph (a) can never be prior
to the date of assessment. If an assessment was completed more than 60 days before the
effective waiver or alternative care program eligibility start date, assessment and support
plan information must be updated and documented in the department's Medicaid Management
Information System (MMIS). Notwithstanding retroactive medical assistance coverage of
state plan services, the effective date of eligibility for programs included in paragraph (a)
cannot be prior to the completion date of the most recent updated assessment.
new text end

new text begin (c) If an eligibility update is completed within 90 days of the previous assessment and
documented in the department's Medicaid Management Information System (MMIS), the
effective date of eligibility for programs included in paragraph (a) is the date of the previous
in-person assessment when all other eligibility requirements are met.
new text end

Sec. 16.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 21. new text end

new text begin MnCHOICES assessments; exceptions following institutional stay. new text end

new text begin (a) A
person receiving home and community-based waiver services under section 256B.0913,
256B.092, or 256B.49 or chapter 256S may return to a community with home and
community-based waiver services under the same waiver without being assessed or reassessed
under this section if the person temporarily entered one of the following for 121 or fewer
days:
new text end

new text begin (1) a hospital;
new text end

new text begin (2) an institution of mental disease;
new text end

new text begin (3) a nursing facility;
new text end

new text begin (4) an intensive residential treatment services program;
new text end

new text begin (5) a transitional care unit; or
new text end

new text begin (6) an inpatient substance use disorder treatment setting.
new text end

new text begin (b) Nothing in paragraph (a) changes annual long-term care consultation reassessment
requirements, payment for institutional or treatment services, medical assistance financial
eligibility, or any other law.
new text end

Sec. 17.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 22. new text end

new text begin MnCHOICES reassessments. new text end

new text begin (a) Prior to a reassessment, the certified assessor
must review the person's most recent assessment.
new text end

new text begin (b) Reassessments must:
new text end

new text begin (1) be tailored using the professional judgment of the assessor to the person's known
needs, strengths, preferences, and circumstances;
new text end

new text begin (2) provide information to support the person's informed choice and opportunities to
express choice regarding activities that contribute to quality of life, as well as information
and opportunity to identify goals related to desired employment, community activities, and
preferred living environment;
new text end

new text begin (3) provide a review of the most recent assessment, the current support plan's effectiveness
and monitoring of services, and the development of an updated person-centered assessment
summary;
new text end

new text begin (4) verify continued eligibility, offer alternatives as warranted, and provide an opportunity
for quality assurance of service delivery; and
new text end

new text begin (5) be conducted annually or as required by federal and state laws.
new text end

new text begin (c) The certified assessor and the individual responsible for developing the support plan
must ensure the continuity of care for the person receiving services and complete the updated
assessment summary and the updated support plan no more than 60 days after the
reassessment visit.
new text end

new text begin (d) The commissioner shall develop mechanisms for providers and case managers to
share information with the assessor to facilitate a reassessment and support planning process
tailored to the person's current needs and preferences.
new text end

Sec. 18.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 23. new text end

new text begin MnCHOICES reassessments; option for alternative and self-directed
waiver services.
new text end

new text begin (a) At the time of reassessment, the certified assessor shall assess a person
receiving waiver residential supports and services and currently residing in a setting listed
in clauses (1) to (5) to determine if the person would prefer to be served in a
community-living setting as defined in section 256B.49, subdivision 23, or in a setting not
controlled by a provider, or to receive integrated community supports as described in section
245D.03, subdivision 1, paragraph (c), clause (8). The certified assessor shall offer the
person through a person-centered planning process the option to receive alternative housing
and service options. This paragraph applies to those currently residing in a:
new text end

new text begin (1) community residential setting;
new text end

new text begin (2) licensed adult foster care home that is either not the primary residence of the license
holder or in which the license holder is not the primary caregiver;
new text end

new text begin (3) family adult foster care residence;
new text end

new text begin (4) customized living setting; or
new text end

new text begin (5) supervised living facility.
new text end

new text begin (b) At the time of reassessment, the certified assessor shall assess each person receiving
waiver day services to determine if that person would prefer to receive employment services
as described in section 245D.03, subdivision 1, paragraph (c), clauses (5) to (7). The certified
assessor shall describe to the person through a person-centered planning process the option
to receive employment services.
new text end

new text begin (c) At the time of reassessment, the certified assessor shall assess each person receiving
non-self-directed waiver services to determine if that person would prefer an available
service and setting option that would permit self-directed services and supports. The certified
assessor shall describe to the person through a person-centered planning process the option
to receive self-directed services and supports.
new text end

Sec. 19.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 24. new text end

new text begin Remote reassessments. new text end

new text begin (a) Assessments performed according to subdivisions
17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the
requirements of this subdivision. Remote reassessments conducted by interactive video or
telephone may substitute for in-person reassessments.
new text end

new text begin (b) For services provided by the developmental disabilities waiver under section
256B.092, and the community access for disability inclusion, community alternative care,
and brain injury waiver programs under section 256B.49, remote reassessments may be
substituted for two consecutive reassessments if followed by an in-person reassessment.
new text end

new text begin (c) For services provided by alternative care under section 256B.0913, essential
community supports under section 256B.0922, and the elderly waiver under chapter 256S,
remote reassessments may be substituted for one reassessment if followed by an in-person
reassessment.
new text end

new text begin (d) A remote reassessment is permitted only if the person being reassessed, or the person's
legal representative, and the lead agency case manager both agree that there is no change
in the person's condition, there is no need for a change in service, and that a remote
reassessment is appropriate.
new text end

new text begin (e) The person being reassessed, or the person's legal representative, may refuse a remote
reassessment at any time.
new text end

new text begin (f) During a remote reassessment, if the certified assessor determines an in-person
reassessment is necessary in order to complete the assessment, the lead agency shall schedule
an in-person reassessment.
new text end

new text begin (g) All other requirements of an in-person reassessment apply to a remote reassessment,
including updates to a person's support plan.
new text end

Sec. 20.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 25. new text end

new text begin Reassessments for Rule 185 case management. new text end

new text begin Unless otherwise required
by federal law, the county agency is not required to conduct or arrange for an annual needs
reassessment by a certified assessor for people receiving Rule 185 case management under
Minnesota Rules, part 9525.0016. The case manager who works on behalf of the person to
identify the person's needs and to minimize the impact of the disability on the person's life
must instead develop a person-centered service plan based on the person's assessed needs
and preferences. The person-centered service plan must be reviewed annually for persons
with developmental disabilities who are receiving only case management services under
Minnesota Rules, part 9525.0016, and who make an informed choice to decline an assessment
under this section.
new text end

Sec. 21.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 26. new text end

new text begin Determination of institutional level of care. new text end

new text begin (a) The determination of need
for hospital and intermediate care facility levels of care must be made according to criteria
developed by the commissioner, and in section 256B.092, using forms developed by the
commissioner.
new text end

new text begin (b) The determination of need for nursing facility level of care must be made based on
criteria in section 144.0724, subdivision 11.
new text end

Sec. 22.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 27. new text end

new text begin Transition assistance. new text end

new text begin (a) Lead agency certified assessors shall provide
transition assistance to persons residing in a nursing facility, hospital, regional treatment
center, or intermediate care facility for persons with developmental disabilities who request
or are referred for assistance.
new text end

new text begin (b) Transition assistance must include:
new text end

new text begin (1) assessment;
new text end

new text begin (2) referrals to long-term care options counseling under section 256.975, subdivision 7,
for support plan implementation and to Minnesota health care programs, including home
and community-based waiver services and consumer-directed options through the waivers;
and
new text end

new text begin (3) referrals to programs that provide assistance with housing.
new text end

new text begin (c) Transition assistance must also include information about the Centers for Independent
Living, Disability Hub, and other organizations that can provide assistance with relocation
efforts and information about contacting these organizations to obtain their assistance and
support.
new text end

new text begin (d) The lead agency shall ensure that:
new text end

new text begin (1) referrals for in-person assessments are taken from long-term care options counselors
as provided for in section 256.975, subdivision 7, paragraph (b), clause (11);
new text end

new text begin (2) persons assessed in institutions receive information about available transition
assistance;
new text end

new text begin (3) the assessment is completed for persons within 20 calendar days of the date of request
or recommendation for assessment;
new text end

new text begin (4) there is a plan for transition and follow-up for the individual's return to the community,
including notification of other local agencies when a person may require assistance from
agencies located in another county; and
new text end

new text begin (5) relocation targeted case management as defined in section 256B.0621, subdivision
2, clause (4), is authorized for an eligible medical assistance recipient.
new text end

Sec. 23.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 28. new text end

new text begin Transition assistance; nursing home residents under 65 years of age. new text end

new text begin (a)
Upon referral from the Senior LinkAge Line, individuals under 65 years of age who are
admitted to nursing facilities on an emergency basis with only a telephone screening must
receive an in-person assessment from the long-term care consultation team member of the
county in which the facility is located within the timeline established by the commissioner
based on review of data.
new text end

new text begin (b) At the in-person assessment, the long-term care consultation team member or county
case manager must:
new text end

new text begin (1) perform the activities required under subdivision 27; and
new text end

new text begin (2) present information about home and community-based options, including
consumer-directed options, so the individual can make informed choices.
new text end

new text begin (c) If the individual chooses home and community-based services, the long-term care
consultation team member or case manager must complete a written relocation plan within
20 working days of the visit. The plan must describe the services needed to move the
individual out of the facility and a timeline for the move that is designed to ensure a smooth
transition to the individual's home and community.
new text end

new text begin (d) For individuals under 21 years of age, a screening interview that recommends nursing
facility admission must be in person and approved by the commissioner before the individual
is admitted to the nursing facility.
new text end

new text begin (e) An individual under 65 years of age residing in a nursing facility must receive an
in-person assessment at least every 12 months to review the person's service choices and
available alternatives unless the individual indicates in writing that annual visits are not
desired. In this case, the individual must receive an in-person assessment at least once every
36 months for the same purposes.
new text end

new text begin (f) Notwithstanding subdivision 33, the commissioner may pay county agencies directly
for in-person assessments for individuals under 65 years of age who are being considered
for placement or residing in a nursing facility.
new text end

Sec. 24.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 29. new text end

new text begin Support planning. new text end

new text begin (a) The certified assessor and the individual responsible
for developing the support plan must complete the assessment summary and the support
plan no more than 60 calendar days after the assessment visit.
new text end

new text begin (b) The person or the person's legal representative must be provided with a written
assessment summary within the timelines established by the commissioner, regardless of
whether the person is eligible for Minnesota health care programs.
new text end

new text begin (c) For a person being assessed for elderly waiver services under chapter 256S, a provider
who submitted information under subdivision 19, paragraph (c), must receive the final
written support plan when available.
new text end

new text begin (d) The written support plan must include:
new text end

new text begin (1) a summary of assessed needs as defined in subdivision 17, paragraphs (d) and (e);
new text end

new text begin (2) the individual's options and choices to meet identified needs, including all available
options for:
new text end

new text begin (i) case management services and providers;
new text end

new text begin (ii) employment services, settings, and providers;
new text end

new text begin (iii) living arrangements;
new text end

new text begin (iv) self-directed services and supports, including self-directed budget options; and
new text end

new text begin (v) service provided in a non-disability-specific setting;
new text end

new text begin (3) identification of health and safety risks and how those risks will be addressed,
including personal risk management strategies;
new text end

new text begin (4) referral information; and
new text end

new text begin (5) informal caregiver supports, if applicable.
new text end

new text begin (e) For a person determined eligible for state plan home care under subdivision 11, clause
(7), the person or person's legal representative must also receive a copy of the home care
service plan developed by the certified assessor.
new text end

Sec. 25.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 30. new text end

new text begin Assessment and support planning; supplemental information. new text end

new text begin The lead
agency must give the person receiving long-term care consultation services or the person's
legal representative materials and forms supplied by the commissioner containing the
following information:
new text end

new text begin (1) written recommendations for community-based services and consumer-directed
options;
new text end

new text begin (2) documentation that the most cost-effective alternatives available were offered to the
person;
new text end

new text begin (3) the need for and purpose of preadmission screening conducted by long-term care
options counselors according to section 256.975, subdivisions 7a to 7c, if the person selects
nursing facility placement. If the person selects nursing facility placement, the lead agency
shall forward information needed to complete the level of care determinations and screening
for developmental disability and mental illness collected during the assessment to the
long-term care options counselor using forms provided by the commissioner;
new text end

new text begin (4) the role of long-term care consultation assessment and support planning in eligibility
determination for waiver and alternative care programs and state plan home care, case
management, and other services as defined in subdivision 11, clauses (7) to (10);
new text end

new text begin (5) information about Minnesota health care programs;
new text end

new text begin (6) the person's freedom to accept or reject the recommendations of the team;
new text end

new text begin (7) the person's right to confidentiality under the Minnesota Government Data Practices
Act, chapter 13;
new text end

new text begin (8) the certified assessor's decision regarding the person's need for institutional level of
care as determined under criteria established in subdivision 26 and regarding eligibility for
all services and programs as defined in subdivision 11, clauses (7) to (10);
new text end

new text begin (9) the person's right to appeal the certified assessor's decision regarding eligibility for
all services and programs as defined in subdivision 11, clauses (5), (7) to (10), and (15),
and the decision regarding the need for institutional level of care or the lead agency's final
decisions regarding public programs eligibility according to section 256.045, subdivision
3. The certified assessor must verbally communicate this appeal right to the person and
must visually point out where in the document the right to appeal is stated; and
new text end

new text begin (10) documentation that available options for employment services, independent living,
and self-directed services and supports were described to the person.
new text end

Sec. 26.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 31. new text end

new text begin Assessment and support planning; right to final decision. new text end

new text begin The person has
the right to make the final decision:
new text end

new text begin (1) between institutional placement and community placement after the recommendations
have been provided under subdivision 30, clause (1), except as provided in section 256.975,
subdivision 7a, paragraph (d);
new text end

new text begin (2) between community placement in a setting controlled by a provider and living
independently in a setting not controlled by a provider;
new text end

new text begin (3) between day services and employment services; and
new text end

new text begin (4) regarding available options for self-directed services and supports, including
self-directed funding options.
new text end

Sec. 27.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 32. new text end

new text begin Administrative activity. new text end

new text begin (a) The commissioner shall:
new text end

new text begin (1) streamline the processes, including timelines for when assessments need to be
completed;
new text end

new text begin (2) provide the services in this section; and
new text end

new text begin (3) implement integrated solutions to automate the business processes to the extent
necessary for support plan approval, reimbursement, program planning, evaluation, and
policy development.
new text end

new text begin (b) The commissioner shall work with lead agencies responsible for conducting long-term
care consultation services to:
new text end

new text begin (1) modify the MnCHOICES application and assessment policies to create efficiencies
while ensuring federal compliance with medical assistance and long-term services and
supports eligibility criteria; and
new text end

new text begin (2) develop a set of measurable benchmarks sufficient to demonstrate quarterly
improvement in the average time per assessment and other mutually agreed upon measures
of increasing efficiency.
new text end

new text begin (c) The commissioner shall collect data on the benchmarks developed under paragraph
(b) and provide to the lead agencies and the chairs and ranking minority members of the
legislative committees with jurisdiction over human services an annual trend analysis of
the data in order to demonstrate the commissioner's compliance with the requirements of
this subdivision.
new text end

Sec. 28.

Minnesota Statutes 2020, section 256B.0911, is amended by adding a subdivision
to read:


new text begin Subd. 33. new text end

new text begin Payment for long-term care consultation services. new text end

new text begin (a) Payments for long-term
care consultation services are available to the county or counties to cover staff salaries and
expenses to provide the services described in subdivision 11. The county shall employ, or
contract with other agencies to employ, within the limits of available funding, sufficient
personnel to provide long-term care consultation services while meeting the state's long-term
care outcomes and objectives as defined in subdivision 1.
new text end

new text begin (b) The county is accountable for meeting local objectives as approved by the
commissioner in the biennial home and community-based services quality assurance plan.
The county must document its compliance with the local objectives on a form provided by
the commissioner.
new text end

new text begin (c) The state shall pay 81.9 percent of the nonfederal share as reimbursement to the
counties.
new text end

Sec. 29. new text beginDIRECTION TO COMMISSIONER; TRANSITION PROCESS.
new text end

new text begin (a) The commissioner of human services shall update references to statutes recodified
in this act when printed material is replaced and new printed material is obtained in the
normal course of business. The commissioner is not required to replace existing printed
material to comply with this act.
new text end

new text begin (b) The commissioner of human services shall update references to statutes recodified
in this act when online documents and websites are edited in the normal course of business.
The commissioner is not required to edit online documents and websites merely to comply
with this act.
new text end

new text begin (c) The commissioner of human services shall update references to statutes recodified
in this act when the home and community-based service waiver plans are updated in the
normal course of business. The commissioner is not required to update the home and
community-based service waiver plans merely to comply with this act.
new text end

Sec. 30. new text beginREVISOR INSTRUCTION.
new text end

new text begin (a) The revisor of statutes shall renumber each section of Minnesota Statutes listed in
column A with the number listed in column B. The revisor shall also make necessary
cross-reference changes consistent with the renumbering.
new text end

new text begin Column A
new text end
new text begin Column B
new text end
new text begin 256B.0911, subdivision 3c
new text end
new text begin 256.975, subdivision 7e
new text end
new text begin 256B.0911, subdivision 3d
new text end
new text begin 256.975, subdivision 7f
new text end
new text begin 256B.0911, subdivision 3e
new text end
new text begin 256.975, subdivision 7g
new text end

new text begin (b) The revisor of statutes, in consultation with the House of Representatives Research
Department; the Office of Senate Counsel, Research and Fiscal Analysis; and the Department
of Human Services, shall make necessary cross-reference changes and remove statutory
cross-references in Minnesota Statutes to conform with the recodification in this act. The
revisor may make technical and other necessary changes to sentence structure to preserve
the meaning of the text. The revisor may alter the coding in this act to incorporate statutory
changes made by other law in a regular or special session of the 2022 legislature. If a
provision stricken in this act is also amended in a regular or special session of the 2022
legislature by other law, the revisor shall restore the stricken language and give effect to
the amendment, notwithstanding Minnesota Statutes, section 645.30.
new text end

new text begin (c) If a provision repealed in this article is also amended by a section in this act or any
other act in a regular or special session of the 2022 legislature, the revisor of statutes, in
consultation with the House Research Department, Office of Senate Counsel, Research and
Fiscal Analysis, and the Department of Human Services, shall give effect to the amendment
and incorporate the amendment consistent with the recodification of Minnesota Statutes,
section 256B.0911, by this article, notwithstanding any law to the contrary. When
incorporating any such amendment, the revisor of statutes, in consultation with the House
Research Department, Office of Senate Counsel, Research and Fiscal Analysis, and the
Department of Human Services, may make technical and other necessary changes to sentence
structure to preserve the meaning of the text of the recodification.
new text end

Sec. 31. new text beginREPEALER.
new text end

new text begin Minnesota Statutes 2020, section 256B.0911, subdivisions 2b, 2c, 3, 3b, 3g, 4d, 4e, 5,
and 6,
new text end new text begin are repealed.
new text end

new text begin Minnesota Statutes 2021 Supplement, section 256B.0911, subdivisions 1a, 3a, and 3f, new text end new text begin
are repealed.
new text end

Sec. 32. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 31 are effective July 1, 2022.
new text end

ARTICLE 17

LONG-TERM CARE CONSULTATION SERVICES RECODIFICATION;
CONFORMING CHANGES

Section 1.

Minnesota Statutes 2021 Supplement, section 144.0724, subdivision 4, is
amended to read:


Subd. 4.

Resident assessment schedule.

(a) A facility must conduct and electronically
submit to the federal database MDS assessments that conform with the assessment schedule
defined by the Long Term Care Facility Resident Assessment Instrument User's Manual,
version 3.0, or its successor issued by the Centers for Medicare and Medicaid Services. The
commissioner of health may substitute successor manuals or question and answer documents
published by the United States Department of Health and Human Services, Centers for
Medicare and Medicaid Services, to replace or supplement the current version of the manual
or document.

(b) The assessments required under the Omnibus Budget Reconciliation Act of 1987
(OBRA) used to determine a case mix classification for reimbursement include the following:

(1) a new admission comprehensive assessment, which must have an assessment reference
date (ARD) within 14 calendar days after admission, excluding readmissions;

(2) an annual comprehensive assessment, which must have an ARD within 92 days of
a previous quarterly review assessment or a previous comprehensive assessment, which
must occur at least once every 366 days;

(3) a significant change in status comprehensive assessment, which must have an ARD
within 14 days after the facility determines, or should have determined, that there has been
a significant change in the resident's physical or mental condition, whether an improvement
or a decline, and regardless of the amount of time since the last comprehensive assessment
or quarterly review assessment;

(4) a quarterly review assessment must have an ARD within 92 days of the ARD of the
previous quarterly review assessment or a previous comprehensive assessment;

(5) any significant correction to a prior comprehensive assessment, if the assessment
being corrected is the current one being used for RUG classification;

(6) any significant correction to a prior quarterly review assessment, if the assessment
being corrected is the current one being used for RUG classification;

(7) a required significant change in status assessment when:

(i) all speech, occupational, and physical therapies have ended. The ARD of this
assessment must be set on day eight after all therapy services have ended; and

(ii) isolation for an infectious disease has ended. The ARD of this assessment must be
set on day 15 after isolation has ended; and

(8) any modifications to the most recent assessments under clauses (1) to (7).

(c) In addition to the assessments listed in paragraph (b), the assessments used to
determine nursing facility level of care include the following:

(1) preadmission screening completed under section 256.975, subdivisions 7a to 7c, by
the Senior LinkAge Line or other organization under contract with the Minnesota Board on
Aging; and

(2) a nursing facility level of care determination as provided for under section 256B.0911,
subdivision deleted text begin4edeleted text end
new text begin 26new text end, as part of a face-to-face long-term care consultation assessment completed
under section 256B.0911, by a county, tribe, or managed care organization under contract
with the Department of Human Services.

Sec. 2.

Minnesota Statutes 2020, section 144.0724, subdivision 11, is amended to read:


Subd. 11.

Nursing facility level of care.

(a) For purposes of medical assistance payment
of long-term care services, a recipient must be determined, using assessments defined in
subdivision 4, to meet one of the following nursing facility level of care criteria:

(1) the person requires formal clinical monitoring at least once per day;

(2) the person needs the assistance of another person or constant supervision to begin
and complete at least four of the following activities of living: bathing, bed mobility, dressing,
eating, grooming, toileting, transferring, and walking;

(3) the person needs the assistance of another person or constant supervision to begin
and complete toileting, transferring, or positioning and the assistance cannot be scheduled;

(4) the person has significant difficulty with memory, using information, daily decision
making, or behavioral needs that require intervention;

(5) the person has had a qualifying nursing facility stay of at least 90 days;

(6) the person meets the nursing facility level of care criteria determined 90 days after
admission or on the first quarterly assessment after admission, whichever is later; or

(7) the person is determined to be at risk for nursing facility admission or readmission
through a face-to-face long-term care consultation assessment as specified in section
256B.0911, deleted text beginsubdivision 3a, 3b, or 4ddeleted text endnew text begin subdivision 17 to 21, 23, 24, 27, or 28new text end, by a county,
tribe, or managed care organization under contract with the Department of Human Services.
The person is considered at risk under this clause if the person currently lives alone or will
live alone or be homeless without the person's current housing and also meets one of the
following criteria:

(i) the person has experienced a fall resulting in a fracture;

(ii) the person has been determined to be at risk of maltreatment or neglect, including
self-neglect; or

(iii) the person has a sensory impairment that substantially impacts functional ability
and maintenance of a community residence.

(b) The assessment used to establish medical assistance payment for nursing facility
services must be the most recent assessment performed under subdivision 4, paragraph (b),
that occurred no more than 90 calendar days before the effective date of medical assistance
eligibility for payment of long-term care services. In no case shall medical assistance payment
for long-term care services occur prior to the date of the determination of nursing facility
level of care.

(c) The assessment used to establish medical assistance payment for long-term care
services provided under chapter 256S and section 256B.49 and alternative care payment
for services provided under section 256B.0913 must be the most recent face-to-face
assessment performed under section 256B.0911, deleted text beginsubdivision 3a, 3b, or 4ddeleted text endnew text begin subdivisions 17
to 21, 23, 24, 27, or 28
new text end, that occurred no more than 60 calendar days before the effective
date of medical assistance eligibility for payment of long-term care services.

Sec. 3.

Minnesota Statutes 2021 Supplement, section 144.0724, subdivision 12, as amended
by Laws 2022, chapter 55, article 1, section 36, is amended to read:


Subd. 12.

Appeal of nursing facility level of care determination.

(a) A resident or
prospective resident whose level of care determination results in a denial of long-term care
services can appeal the determination as outlined in section 256B.0911, subdivision deleted text begin3a,
paragraph (j)
deleted text endnew text begin 30new text end, clause (9).

(b) The commissioner of human services shall ensure that notice of changes in eligibility
due to a nursing facility level of care determination is provided to each affected recipient
or the recipient's guardian at least 30 days before the effective date of the change. The notice
shall include the following information:

(1) how to obtain further information on the changes;

(2) how to receive assistance in obtaining other services;

(3) a list of community resources; and

(4) appeal rights.

Sec. 4.

Minnesota Statutes 2020, section 256.975, subdivision 7a, is amended to read:


Subd. 7a.

Preadmission screening activities related to nursing facility admissions.

(a)
All individuals seeking admission to Medicaid-certified nursing facilities, including certified
boarding care facilities, must be screened prior to admission regardless of income, assets,
or funding sources for nursing facility care, except as described in subdivision 7b, paragraphs
(a) and (b). The purpose of the screening is to determine the need for nursing facility level
of care as described in section 256B.0911, subdivision deleted text begin4edeleted text endnew text begin 26new text end, and to complete activities
required under federal law related to mental illness and developmental disability as outlined
in paragraph (b).

(b) A person who has a diagnosis or possible diagnosis of mental illness or developmental
disability must receive a preadmission screening before admission regardless of the
exemptions outlined in subdivision 7b, paragraphs (a) and (b), to identify the need for further
evaluation and specialized services, unless the admission prior to screening is authorized
by the local mental health authority or the local developmental disabilities case manager,
or unless authorized by the county agency according to Public Law 101-508.

(c) The following criteria apply to the preadmission screening:

(1) requests for preadmission screenings must be submitted via an online form developed
by the commissioner;

(2) the Senior LinkAge Line must use forms and criteria developed by the commissioner
to identify persons who require referral for further evaluation and determination of the need
for specialized services; and

(3) the evaluation and determination of the need for specialized services must be done
by:

(i) a qualified independent mental health professional, for persons with a primary or
secondary diagnosis of a serious mental illness; or

(ii) a qualified developmental disability professional, for persons with a primary or
secondary diagnosis of developmental disability. For purposes of this requirement, a qualified
developmental disability professional must meet the standards for a qualified developmental
disability professional under Code of Federal Regulations, title 42, section 483.430.

(d) The local county mental health authority or the state developmental disability authority
under Public Laws 100-203 and 101-508 may prohibit admission to a nursing facility if the
individual does not meet the nursing facility level of care criteria or needs specialized
services as defined in Public Laws 100-203 and 101-508. For purposes of this section,
"specialized services" for a person with developmental disability means active treatment as
that term is defined under Code of Federal Regulations, title 42, section 483.440 (a)(1).

(e) In assessing a person's needs, the screener shall:

(1) use an automated system designated by the commissioner;

(2) consult with care transitions coordinators, physician, or advanced practice registered
nurse; and

(3) consider the assessment of the individual's physician or advanced practice registered
nurse.

new text begin (f) new text endOther personnel may be included in the level of care determination as deemed
necessary by the screener.

Sec. 5.

Minnesota Statutes 2020, section 256.975, subdivision 7b, is amended to read:


Subd. 7b.

Exemptions and emergency admissions.

(a) Exemptions from the federal
screening requirements outlined in subdivision 7a, paragraphs (b) and (c), are limited to:

(1) a person who, having entered an acute care facility from a certified nursing facility,
is returning to a certified nursing facility; or

(2) a person transferring from one certified nursing facility in Minnesota to another
certified nursing facility in Minnesota.

(b) Persons who are exempt from preadmission screening for purposes of level of care
determination include:

(1) persons described in paragraph (a);

(2) an individual who has a contractual right to have nursing facility care paid for
indefinitely by the Veterans Administration;

(3) an individual enrolled in a demonstration project under section 256B.69, subdivision
8, at the time of application to a nursing facility; and

(4) an individual currently being served under the alternative care program or under a
home and community-based services waiver authorized under section 1915(c) of the federal
Social Security Act.

(c) Persons admitted to a Medicaid-certified nursing facility from the community on an
emergency basis as described in paragraph (d) or from an acute care facility on a nonworking
day must be screened the first working day after admission.

(d) Emergency admission to a nursing facility prior to screening is permitted when all
of the following conditions are met:

(1) a person is admitted from the community to a certified nursing or certified boarding
care facility during Senior LinkAge Line nonworking hours;

(2) a physician or advanced practice registered nurse has determined that delaying
admission until preadmission screening is completed would adversely affect the person's
health and safety;

(3) there is a recent precipitating event that precludes the client from living safely in the
community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
inability to continue to provide care;

(4) the attending physician or advanced practice registered nurse has authorized the
emergency placement and has documented the reason that the emergency placement is
recommended; and

(5) the Senior LinkAge Line is contacted on the first working day following the
emergency admission.

new text begin (e) new text endTransfer of a patient from an acute care hospital to a nursing facility is not considered
an emergency except for a person who has received hospital services in the following
situations: hospital admission for observation, care in an emergency room without hospital
admission, or following hospital 24-hour bed care and from whom admission is being sought
on a nonworking day.

deleted text begin (e)deleted text endnew text begin (f)new text end A nursing facility must provide written information to all persons admitted
regarding the person's right to request and receive long-term care consultation services as
defined in section 256B.0911, subdivision deleted text begin1adeleted text endnew text begin 11new text end. The information must be provided prior
to the person's discharge from the facility and in a format specified by the commissioner.

Sec. 6.

Minnesota Statutes 2020, section 256.975, subdivision 7c, is amended to read:


Subd. 7c.

Screening requirements.

(a) A person may be screened for nursing facility
admission by telephone or in a face-to-face screening interview. The Senior LinkAge Line
shall identify each individual's needs using the following categories:

(1) the person needs no face-to-face long-term care consultation assessment completed
under section 256B.0911, deleted text beginsubdivision 3a, 3b, or 4ddeleted text endnew text begin subdivisions 17 to 21, 24, 27 or 28new text end, by
a county, tribe, or managed care organization under contract with the Department of Human
Services to determine the need for nursing facility level of care based on information obtained
from other health care professionals;

(2) the person needs an immediate face-to-face long-term care consultation assessment
completed under section 256B.0911, deleted text beginsubdivision 3a, 3b, or 4ddeleted text endnew text begin subdivisions 17 to 21, 24,
27, or 28
new text end, by a county, tribe, or managed care organization under contract with the
Department of Human Services to determine the need for nursing facility level of care and
complete activities required under subdivision 7a; or

(3) the person may be exempt from screening requirements as outlined in subdivision
7b, but will need deleted text begintransitionaldeleted text endnew text begin transitionnew text end assistance after admission or in-person follow-along
after a return home.

(b) new text beginThe Senior LinkAge Line shall refer new text endindividuals under 65 years of age who are
admitted to nursing facilities with only a telephone screening deleted text beginmust receive a face-to-facedeleted text endnew text begin
for an in-person
new text end assessment from the long-term care consultation team member of the county
in which the facility is located or from the recipient's county case manager deleted text beginwithin 40 calendar
days of admission
deleted text end as described in section 256B.0911, subdivision deleted text begin4ddeleted text endnew text begin 28new text end, paragraph deleted text begin(c)deleted text endnew text begin (a)new text end.

(c) Persons admitted on a nonemergency basis to a Medicaid-certified nursing facility
must be screened prior to admission.

(d) Screenings provided by the Senior LinkAge Line must include processes to identify
persons who may require transition assistance described in subdivision 7, paragraph (b),
clause (12), and section 256B.0911, subdivision deleted text begin3bdeleted text endnew text begin 27new text end.

Sec. 7.

Minnesota Statutes 2020, section 256.975, subdivision 7d, is amended to read:


Subd. 7d.

Payment for preadmission screening.

deleted text beginFundingdeleted text end new text begin(a) The Department of Human
Services shall provide funding
new text endfor preadmission screening deleted text beginshall be provideddeleted text end to the Minnesota
Board on Aging deleted text beginby the Department of Human Servicesdeleted text end to cover screener salaries and
expenses to provide the services described in subdivisions 7a to 7c. The Minnesota Board
on Aging shallnew text begin:
new text end

new text begin (1)new text end employ, or contract with other agencies to employ, within the limits of available
funding, sufficient personnel to provide preadmission screening and level of care
determination servicesnew text begin;new text end and deleted text beginshall
deleted text end

new text begin (2)new text end seek to maximize federal funding for the service as provided under section 256.01,
subdivision
2, paragraph (aa).

new text begin (b) The Department of Human Services shall provide funding for preadmission screening
follow-up to the Disability Hub for the under-60 population to cover options counseling
salaries and expenses to provide the services described in subdivisions 7a to 7c. The
Disability Hub shall:
new text end

new text begin (1) employ, or contract with other agencies to employ, within the limits of available
funding, sufficient personnel to provide preadmission screening follow-up services; and
new text end

new text begin (2) seek to maximize federal funding for the service as provided under section 256.01,
subdivision 2, paragraph (aa).
new text end

Sec. 8.

Minnesota Statutes 2020, section 256B.051, subdivision 4, is amended to read:


Subd. 4.

Assessment requirements.

(a) An individual's assessment of functional need
must be conducted by one of the following methods:

(1) an assessor according to the criteria established in section 256B.0911, deleted text beginsubdivision
deleted text end
deleted text begin 3adeleted text endnew text begin subdivisions 17 to 21, 23, 24, and 29 to 31new text end, using a format established by the
commissioner;

(2) documented need for services as verified by a professional statement of need as
defined in section 256I.03, subdivision 12; or

(3) according to the continuum of care coordinated assessment system established in
Code of Federal Regulations, title 24, section 578.3, using a format established by the
commissioner.

(b) An individual must be reassessed within one year of initial assessment, and annually
thereafter.

Sec. 9.

Minnesota Statutes 2020, section 256B.0646, is amended to read:


256B.0646 MINNESOTA RESTRICTED RECIPIENT PROGRAM; PERSONAL
CARE ASSISTANCE SERVICES.

(a) When a recipient's use of personal care assistance services or community first services
and supports under section 256B.85 results in abusive or fraudulent billing, the commissioner
may place a recipient in the Minnesota restricted recipient program under Minnesota Rules,
part 9505.2165. A recipient placed in the Minnesota restricted recipient program under this
section must: (1) use a designated traditional personal care assistance provider agency; and
(2) obtain a new assessment under section 256B.0911, including consultation with a registered
or public health nurse on the long-term care consultation team pursuant to section 256B.0911,
subdivision deleted text begin3deleted text endnew text begin 15new text end, paragraph (b), clause (2).

(b) A recipient must comply with additional conditions for the use of personal care
assistance services or community first services and supports if the commissioner determines
it is necessary to prevent future misuse of personal care assistance services or abusive or
fraudulent billing. Additional conditions may include but are not limited to restricting service
authorizations for a duration of no more than one month and requiring a qualified professional
to monitor and report services on a monthly basis.

(c) A recipient placed in the Minnesota restricted recipient program under this section
may appeal the placement according to section 256.045.

Sec. 10.

Minnesota Statutes 2020, section 256B.0659, subdivision 3a, is amended to read:


Subd. 3a.

Assessment; defined.

(a) "Assessment" means a review and evaluation of a
recipient's need for personal care assistance services conducted in person. Assessments for
personal care assistance services shall be conducted by the county public health nurse or a
certified public health nurse under contract with the county except when a long-term care
consultation assessment is being conducted for the purposes of determining a person's
eligibility for home and community-based waiver services including personal care assistance
services according to section 256B.0911. During the transition to MnCHOICES, a certified
assessor may complete the assessment defined in this subdivision. An in-person assessment
must include: documentation of health status, determination of need, evaluation of service
effectiveness, identification of appropriate services, service plan development or modification,
coordination of services, referrals and follow-up to appropriate payers and community
resources, completion of required reports, recommendation of service authorization, and
consumer education. Once the need for personal care assistance services is determined under
this section, the county public health nurse or certified public health nurse under contract
with the county is responsible for communicating this recommendation to the commissioner
and the recipient. An in-person assessment must occur at least annually or when there is a
significant change in the recipient's condition or when there is a change in the need for
personal care assistance services. A service update may substitute for the annual face-to-face
assessment when there is not a significant change in recipient condition or a change in the
need for personal care assistance service. A service update may be completed by telephone,
used when there is no need for an increase in personal care assistance services, and used
for two consecutive assessments if followed by a face-to-face assessment. A service update
must be completed on a form approved by the commissioner. A service update or review
for temporary increase includes a review of initial baseline data, evaluation of service
effectiveness, redetermination of service need, modification of service plan and appropriate
referrals, update of initial forms, obtaining service authorization, and deleted text beginon goingdeleted text endnew text begin ongoingnew text end
consumer education. Assessments or reassessments must be completed on forms provided
by the commissioner within 30 days of a request for home care services by a recipient or
responsible party.

(b) This subdivision expires when notification is given by the commissioner as described
in section 256B.0911, subdivision deleted text begin3adeleted text endnew text begin 18new text end.

Sec. 11.

Minnesota Statutes 2020, section 256B.0913, subdivision 4, is amended to read:


Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

(a)
Funding for services under the alternative care program is available to persons who meet
the following criteria:

(1) the person is a citizen of the United States or a United States national;

(2) the person has been determined by a community assessment under section 256B.0911
to be a person who would require the level of care provided in a nursing facility, as
determined under section 256B.0911, subdivision deleted text begin4edeleted text endnew text begin 26new text end, but for the provision of services
under the alternative care program;

(3) the person is age 65 or older;

(4) the person would be eligible for medical assistance within 135 days of admission to
a nursing facility;

(5) the person is not ineligible for the payment of long-term care services by the medical
assistance program due to an asset transfer penalty under section 256B.0595 or equity
interest in the home exceeding $500,000 as stated in section 256B.056;

(6) the person needs long-term care services that are not funded through other state or
federal funding, or other health insurance or other third-party insurance such as long-term
care insurance;

(7) except for individuals described in clause (8), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256S.18. This monthly limit does not prohibit the
alternative care client from payment for additional services, but in no case may the cost of
additional services purchased under this section exceed the difference between the client's
monthly service limit defined under section 256S.04, and the alternative care program
monthly service limit defined in this paragraph. If care-related supplies and equipment or
environmental modifications and adaptations are or will be purchased for an alternative
care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive
months beginning with the month of purchase. If the monthly cost of a recipient's other
alternative care services exceeds the monthly limit established in this paragraph, the annual
cost of the alternative care services shall be determined. In this event, the annual cost of
alternative care services shall not exceed 12 times the monthly limit described in this
paragraph;

(8) for individuals assigned a case mix classification A as described under section
256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies
in bathing, dressing, grooming, walking, and eating when the dependency score in eating
is three or greater as determined by an assessment performed under section 256B.0911, the
monthly cost of alternative care services funded by the program cannot exceed $593 per
month for all new participants enrolled in the program on or after July 1, 2011. This monthly
limit shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in section 256S.18. This monthly
limit does not prohibit the alternative care client from payment for additional services, but
in no case may the cost of additional services purchased exceed the difference between the
client's monthly service limit defined in this clause and the limit described in clause (7) for
case mix classification A; and

(9) the person is making timely payments of the assessed monthly fee. A person is
ineligible if payment of the fee is over 60 days past due, unless the person agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee payments.

new text begin (b) new text endThe lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

deleted text begin (b)deleted text endnew text begin (c)new text end Alternative care funding under this subdivision is not available for a person who
is a medical assistance recipient or who would be eligible for medical assistance without a
spenddown or waiver obligation. A person whose initial application for medical assistance
and the elderly waiver program is being processed may be served under the alternative care
program for a period up to 60 days. If the individual is found to be eligible for medical
assistance, medical assistance must be billed for services payable under the federally
approved elderly waiver plan and delivered from the date the individual was found eligible
for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
care funds may not be used to pay for any service the cost of which: (i) is payable by medical
assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a
medical assistance income spenddown for a person who is eligible to participate in the
federally approved elderly waiver program under the special income standard provision.

deleted text begin (c)deleted text endnew text begin (d)new text end Alternative care funding is not available for a person who resides in a licensed
nursing home, certified boarding care home, hospital, or intermediate care facility, except
for case management services which are provided in support of the discharge planning
process for a nursing home resident or certified boarding care home resident to assist with
a relocation process to a community-based setting.

deleted text begin (d)deleted text endnew text begin (e)new text end Alternative care funding is not available for a person whose income is greater
than the maintenance needs allowance under section 256S.05, but equal to or less than 120
percent of the federal poverty guideline effective July 1 in the fiscal year for which alternative
care eligibility is determined, who would be eligible for the elderly waiver with a waiver
obligation.

Sec. 12.

Minnesota Statutes 2020, section 256B.092, subdivision 1a, is amended to read:


Subd. 1a.

Case management services.

(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described in
the federally approved waiver application.

(b) Case management service activities provided to or arranged for a person include:

(1) development of the person-centered coordinated service and support plan under
subdivision 1b;

(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options, including all service options available under the
waiver plan;

(3) consulting with relevant medical experts or service providers;

(4) assisting the person in the identification of potential providers of chosen services,
including:

(i) providers of services provided in a non-disability-specific setting;

(ii) employment service providers;

(iii) providers of services provided in settings that are not controlled by a provider; and

(iv) providers of financial management services;

(5) assisting the person to access services and assisting in appeals under section 256.045;

(6) coordination of services, if coordination is not provided by another service provider;

(7) evaluation and monitoring of the services identified in the coordinated service and
support plan, which must incorporate at least one annual face-to-face visit by the case
manager with each person; and

(8) reviewing coordinated service and support plans and providing the lead agency with
recommendations for service authorization based upon the individual's needs identified in
the coordinated service and support plan.

(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.
Case management services must be provided by a public or private agency that is enrolled
as a medical assistance provider determined by the commissioner to meet all of the
requirements in the approved federal waiver plans. Case management services must not be
provided to a recipient by a private agency that has a financial interest in the provision of
any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision deleted text begin1a, paragraph (e)deleted text endnew text begin 10new text end.

(d) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
person-centered coordinated service and support plan and habilitation plan.

(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than ten hours of case management
education and disability-related training each year. The education and training must include
person-centered planning. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision deleted text begin1a, paragraph
(f)
deleted text endnew text begin 10new text end.

Sec. 13.

Minnesota Statutes 2020, section 256B.092, subdivision 1b, is amended to read:


Subd. 1b.

Coordinated service and support plan.

(a) Each recipient of home and
community-based waivered services shall be provided a copy of the written person-centered
coordinated service and support plan that:

(1) is developed with and signed by the recipient within the timelines established by the
commissioner and section 256B.0911, subdivision deleted text begin3a, paragraph (e)deleted text endnew text begin 29new text end;

(2) includes the person's need for service, including identification of service needs that
will be or that are met by the person's relatives, friends, and others, as well as community
services used by the general public;

(3) reasonably ensures the health and welfare of the recipient;

(4) identifies the person's preferences for services as stated by the person, the person's
legal guardian or conservator, or the parent if the person is a minor, including the person's
choices made on self-directed options, services and supports to achieve employment goals,
and living arrangements;

(5) provides for an informed choice, as defined in section 256B.77, subdivision 2,
paragraph (o), of service and support providers, and identifies all available options for case
management services and providers;

(6) identifies long-range and short-range goals for the person;

(7) identifies specific services and the amount and frequency of the services to be provided
to the person based on assessed needs, preferences, and available resources. The
person-centered coordinated service and support plan shall also specify other services the
person needs that are not available;

(8) identifies the need for an individual program plan to be developed by the provider
according to the respective state and federal licensing and certification standards, and
additional assessments to be completed or arranged by the provider after service initiation;

(9) identifies provider responsibilities to implement and make recommendations for
modification to the coordinated service and support plan;

(10) includes notice of the right to request a conciliation conference or a hearing under
section 256.045;

(11) is agreed upon and signed by the person, the person's legal guardian or conservator,
or the parent if the person is a minor, and the authorized county representative;

(12) is reviewed by a health professional if the person has overriding medical needs that
impact the delivery of services; and

(13) includes the authorized annual and monthly amounts for the services.

(b) In developing the person-centered coordinated service and support plan, the case
manager is encouraged to include the use of volunteers, religious organizations, social clubs,
and civic and service organizations to support the individual in the community. The lead
agency must be held harmless for damages or injuries sustained through the use of volunteers
and agencies under this paragraph, including workers' compensation liability.

(c) Approved, written, and signed changes to a consumer's services that meet the criteria
in this subdivision shall be an addendum to that consumer's individual service plan.

Sec. 14.

Minnesota Statutes 2020, section 256B.0922, subdivision 1, is amended to read:


Subdivision 1.

Essential community supports.

(a) The purpose of the essential
community supports program is to provide targeted services to persons age 65 and older
who need essential community support, but whose needs do not meet the level of care
required for nursing facility placement under section 144.0724, subdivision 11.

(b) Essential community supports are available not to exceed $400 per person per month.
Essential community supports may be used as authorized within an authorization period
not to exceed 12 months. Services must be available to a person who:

(1) is age 65 or older;

(2) is not eligible for medical assistance;

(3) has received a community assessment under section 256B.0911, deleted text beginsubdivision 3a or
3b
deleted text endnew text begin subdivisions 17 to 21, 23, 24, or 27new text end, and does not require the level of care provided in a
nursing facility;

(4) meets the financial eligibility criteria for the alternative care program under section
256B.0913, subdivision 4;

(5) has a community support plan; and

(6) has been determined by a community assessment under section 256B.0911,
deleted text begin subdivision 3a or 3bdeleted text endnew text begin subdivisions 17 to 21, 23, 24 or 27new text end, to be a person who would require
provision of at least one of the following services, as defined in the approved elderly waiver
plan, in order to maintain their community residence:

(i) adult day services;

(ii) caregiver support;

(iii) homemaker support;

(iv) chores;

(v) a personal emergency response device or system;

(vi) home-delivered meals; or

(vii) community living assistance as defined by the commissioner.

(c) The person receiving any of the essential community supports in this subdivision
must also receive service coordination, not to exceed $600 in a 12-month authorization
period, as part of their community support plan.

(d) A person who has been determined to be eligible for essential community supports
must be reassessed at least annually and continue to meet the criteria in paragraph (b) to
remain eligible for essential community supports.

(e) The commissioner is authorized to use federal matching funds for essential community
supports as necessary and to meet demand for essential community supports as outlined in
subdivision 2, and that amount of federal funds is appropriated to the commissioner for this
purpose.

Sec. 15.

Minnesota Statutes 2020, section 256B.49, subdivision 12, is amended to read:


Subd. 12.

Informed choice.

Persons who are determined likely to require the level of
care provided in a nursing facility as determined under section 256B.0911, subdivision deleted text begin4edeleted text endnew text begin
26
new text end, or a hospital shall be informed of the home and community-based support alternatives
to the provision of inpatient hospital services or nursing facility services. Each person must
be given the choice of either institutional or home and community-based services using the
provisions described in section 256B.77, subdivision 2, paragraph (p).

Sec. 16.

Minnesota Statutes 2020, section 256B.49, subdivision 13, is amended to read:


Subd. 13.

Case management.

(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:

(1) finalizing the person-centered written coordinated service and support plan within
the timelines established by the commissioner and section 256B.0911, subdivision deleted text begin3a,
paragraph (e)
deleted text endnew text begin 29new text end;

(2) informing the recipient or the recipient's legal guardian or conservator of service
options, including all service options available under the waiver plans;

(3) assisting the recipient in the identification of potential service providers of chosen
services, including:

(i) available options for case management service and providers;

(ii) providers of services provided in a non-disability-specific setting;

(iii) employment service providers;

(iv) providers of services provided in settings that are not community residential settings;
and

(v) providers of financial management services;

(4) assisting the recipient to access services and assisting with appeals under section
256.045; and

(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:

(1) finalizing the person-centered coordinated service and support plan;

(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved person-centered coordinated service and support plan; and

(3) adjustments to the person-centered coordinated service and support plan.

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's coordinated service and support plan. For
purposes of this section, "private agency" means any agency that is not identified as a lead
agency under section 256B.0911, subdivision deleted text begin1a, paragraph (e)deleted text endnew text begin 10new text end.

(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(e) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than ten hours of case management
education and disability-related training each year. The education and training must include
person-centered planning. For the purposes of this section, "person-centered planning" or
"person-centered" has the meaning given in section 256B.0911, subdivision deleted text begin1a, paragraph
(f)
deleted text endnew text begin 10new text end.

Sec. 17.

Minnesota Statutes 2021 Supplement, section 256B.49, subdivision 14, is amended
to read:


Subd. 14.

Assessment and reassessment.

(a) Assessments and reassessments shall be
conducted by certified assessors according to section 256B.0911, deleted text beginsubdivision 2bdeleted text endnew text begin subdivisions
13 and 14
new text end.

(b) There must be a determination that the client requires a hospital level of care or a
nursing facility level of care as defined in section 256B.0911, subdivision deleted text begin4edeleted text endnew text begin 26new text end, at initial
and subsequent assessments to initiate and maintain participation in the waiver program.

(c) Regardless of other assessments identified in section 144.0724, subdivision 4, as
appropriate to determine nursing facility level of care for purposes of medical assistance
payment for nursing facility services, only assessments conducted according to section
256B.0911, subdivisions deleted text begin3a, 3b, and 4ddeleted text endnew text begin 17 to 21, 23, 24, and 27 to 31new text end, that result in a hospital
level of care determination or a nursing facility level of care determination must be accepted
for purposes of initial and ongoing access to waiver services payment.

(d) Recipients who are found eligible for home and community-based services under
this section before their 65th birthday may remain eligible for these services after their 65th
birthday if they continue to meet all other eligibility factors.

Sec. 18.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 2, is amended
to read:


Subd. 2.

Definitions.

(a) For the purposes of this section and section 256B.851, the terms
defined in this subdivision have the meanings given.

(b) "Activities of daily living" or "ADLs" means:

(1) dressing, including assistance with choosing, applying, and changing clothing and
applying special appliances, wraps, or clothing;

(2) grooming, including assistance with basic hair care, oral care, shaving, applying
cosmetics and deodorant, and care of eyeglasses and hearing aids. Grooming includes nail
care, except for recipients who are diabetic or have poor circulation;

(3) bathing, including assistance with basic personal hygiene and skin care;

(4) eating, including assistance with hand washing and applying orthotics required for
eating, transfers, or feeding;

(5) transfers, including assistance with transferring the participant from one seating or
reclining area to another;

(6) mobility, including assistance with ambulation and use of a wheelchair. Mobility
does not include providing transportation for a participant;

(7) positioning, including assistance with positioning or turning a participant for necessary
care and comfort; and

(8) toileting, including assistance with bowel or bladder elimination and care, transfers,
mobility, positioning, feminine hygiene, use of toileting equipment or supplies, cleansing
the perineal area, inspection of the skin, and adjusting clothing.

(c) "Agency-provider model" means a method of CFSS under which a qualified agency
provides services and supports through the agency's own employees and policies. The agency
must allow the participant to have a significant role in the selection and dismissal of support
workers of their choice for the delivery of their specific services and supports.

(d) "Behavior" means a description of a need for services and supports used to determine
the home care rating and additional service units. The presence of Level I behavior is used
to determine the home care rating.

(e) "Budget model" means a service delivery method of CFSS that allows the use of a
service budget and assistance from a financial management services (FMS) provider for a
participant to directly employ support workers and purchase supports and goods.

(f) "Complex health-related needs" means an intervention listed in clauses (1) to (8) that
has been ordered by a physician, advanced practice registered nurse, or physician's assistant
and is specified in a community support plan, including:

(1) tube feedings requiring:

(i) a gastrojejunostomy tube; or

(ii) continuous tube feeding lasting longer than 12 hours per day;

(2) wounds described as:

(i) stage III or stage IV;

(ii) multiple wounds;

(iii) requiring sterile or clean dressing changes or a wound vac; or

(iv) open lesions such as burns, fistulas, tube sites, or ostomy sites that require specialized
care;

(3) parenteral therapy described as:

(i) IV therapy more than two times per week lasting longer than four hours for each
treatment; or

(ii) total parenteral nutrition (TPN) daily;

(4) respiratory interventions, including:

(i) oxygen required more than eight hours per day;

(ii) respiratory vest more than one time per day;

(iii) bronchial drainage treatments more than two times per day;

(iv) sterile or clean suctioning more than six times per day;

(v) dependence on another to apply respiratory ventilation augmentation devices such
as BiPAP and CPAP; and

(vi) ventilator dependence under section 256B.0651;

(5) insertion and maintenance of catheter, including:

(i) sterile catheter changes more than one time per month;

(ii) clean intermittent catheterization, and including self-catheterization more than six
times per day; or

(iii) bladder irrigations;

(6) bowel program more than two times per week requiring more than 30 minutes to
perform each time;

(7) neurological intervention, including:

(i) seizures more than two times per week and requiring significant physical assistance
to maintain safety; or

(ii) swallowing disorders diagnosed by a physician, advanced practice registered nurse,
or physician's assistant and requiring specialized assistance from another on a daily basis;
and

(8) other congenital or acquired diseases creating a need for significantly increased direct
hands-on assistance and interventions in six to eight activities of daily living.

(g) "Community first services and supports" or "CFSS" means the assistance and supports
program under this section needed for accomplishing activities of daily living, instrumental
activities of daily living, and health-related tasks through hands-on assistance to accomplish
the task or constant supervision and cueing to accomplish the task, or the purchase of goods
as defined in subdivision 7, clause (3), that replace the need for human assistance.

(h) "Community first services and supports service delivery plan" or "CFSS service
delivery plan" means a written document detailing the services and supports chosen by the
participant to meet assessed needs that are within the approved CFSS service authorization,
as determined in subdivision 8. Services and supports are based on the coordinated service
and support plan identified in sections 256B.092, subdivision 1b, and 256S.10.

(i) "Consultation services" means a Minnesota health care program enrolled provider
organization that provides assistance to the participant in making informed choices about
CFSS services in general and self-directed tasks in particular, and in developing a
person-centered CFSS service delivery plan to achieve quality service outcomes.

(j) "Critical activities of daily living" means transferring, mobility, eating, and toileting.

(k) "Dependency" in activities of daily living means a person requires hands-on assistance
or constant supervision and cueing to accomplish one or more of the activities of daily living
every day or on the days during the week that the activity is performed; however, a child
must not be found to be dependent in an activity of daily living if, because of the child's
age, an adult would either perform the activity for the child or assist the child with the
activity and the assistance needed is the assistance appropriate for a typical child of the
same age.

(l) "Extended CFSS" means CFSS services and supports provided under CFSS that are
included in the CFSS service delivery plan through one of the home and community-based
services waivers and as approved and authorized under chapter 256S and sections 256B.092,
subdivision 5
, and 256B.49, which exceed the amount, duration, and frequency of the state
plan CFSS services for participants. Extended CFSS excludes the purchase of goods.

(m) "Financial management services provider" or "FMS provider" means a qualified
organization required for participants using the budget model under subdivision 13 that is
an enrolled provider with the department to provide vendor fiscal/employer agent financial
management services (FMS).

(n) "Health-related procedures and tasks" means procedures and tasks related to the
specific assessed health needs of a participant that can be taught or assigned by a
state-licensed health care or mental health professional and performed by a support worker.

(o) "Instrumental activities of daily living" means activities related to living independently
in the community, including but not limited to: meal planning, preparation, and cooking;
shopping for food, clothing, or other essential items; laundry; housecleaning; assistance
with medications; managing finances; communicating needs and preferences during activities;
arranging supports; and assistance with traveling around and participating in the community,
including traveling to medical appointments. For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the individual CFSS service delivery plan.

(p) "Lead agency" has the meaning given in section 256B.0911, subdivision deleted text begin1a, paragraph
(e)
deleted text endnew text begin 10new text end.

(q) "Legal representative" means parent of a minor, a court-appointed guardian, or
another representative with legal authority to make decisions about services and supports
for the participant. Other representatives with legal authority to make decisions include but
are not limited to a health care agent or an attorney-in-fact authorized through a health care
directive or power of attorney.

(r) "Level I behavior" means physical aggression toward self or others or destruction of
property that requires the immediate response of another person.

(s) "Medication assistance" means providing verbal or visual reminders to take regularly
scheduled medication, and includes any of the following supports listed in clauses (1) to
(3) and other types of assistance, except that a support worker must not determine medication
dose or time for medication or inject medications into veins, muscles, or skin:

(1) under the direction of the participant or the participant's representative, bringing
medications to the participant including medications given through a nebulizer, opening a
container of previously set-up medications, emptying the container into the participant's
hand, opening and giving the medication in the original container to the participant, or
bringing to the participant liquids or food to accompany the medication;

(2) organizing medications as directed by the participant or the participant's representative;
and

(3) providing verbal or visual reminders to perform regularly scheduled medications.

(t) "Participant" means a person who is eligible for CFSS.

(u) "Participant's representative" means a parent, family member, advocate, or other
adult authorized by the participant or participant's legal representative, if any, to serve as a
representative in connection with the provision of CFSS. If the participant is unable to assist
in the selection of a participant's representative, the legal representative shall appoint one.

(v) "Person-centered planning process" means a process that is directed by the participant
to plan for CFSS services and supports.

(w) "Service budget" means the authorized dollar amount used for the budget model or
for the purchase of goods.

(x) "Shared services" means the provision of CFSS services by the same CFSS support
worker to two or three participants who voluntarily enter into a written agreement to receive
services at the same time, in the same setting, and through the same agency-provider or
FMS provider.

(y) "Support worker" means a qualified and trained employee of the agency-provider
as required by subdivision 11b or of the participant employer under the budget model as
required by subdivision 14 who has direct contact with the participant and provides services
as specified within the participant's CFSS service delivery plan.

(z) "Unit" means the increment of service based on hours or minutes identified in the
service agreement.

(aa) "Vendor fiscal employer agent" means an agency that provides financial management
services.

(bb) "Wages and benefits" means the hourly wages and salaries, the employer's share
of FICA taxes, Medicare taxes, state and federal unemployment taxes, workers' compensation,
mileage reimbursement, health and dental insurance, life insurance, disability insurance,
long-term care insurance, uniform allowance, contributions to employee retirement accounts,
or other forms of employee compensation and benefits.

(cc) "Worker training and development" means services provided according to subdivision
18a for developing workers' skills as required by the participant's individual CFSS service
delivery plan that are arranged for or provided by the agency-provider or purchased by the
participant employer. These services include training, education, direct observation and
supervision, and evaluation and coaching of job skills and tasks, including supervision of
health-related tasks or behavioral supports.

Sec. 19.

Minnesota Statutes 2021 Supplement, section 256B.85, subdivision 5, is amended
to read:


Subd. 5.

Assessment requirements.

(a) The assessment of functional need must:

(1) be conducted by a certified assessor according to the criteria established in section
256B.0911, deleted text beginsubdivision 3adeleted text endnew text begin subdivisions 17 to 21, 23, 24, and 29 to 31new text end;

(2) be conducted face-to-face, initially and at least annually thereafter, or when there is
a significant change in the participant's condition or a change in the need for services and
supports, or at the request of the participant when the participant experiences a change in
condition or needs a change in the services or supports; and

(3) be completed using the format established by the commissioner.

(b) The results of the assessment and any recommendations and authorizations for CFSS
must be determined and communicated in writing by the lead agency's assessor as defined
in section 256B.0911 to the participant or the participant's representative and chosen CFSS
providers within ten business days and must include the participant's right to appeal the
assessment under section 256.045, subdivision 3.

(c) The lead agency assessor may authorize a temporary authorization for CFSS services
to be provided under the agency-provider model. The lead agency assessor may authorize
a temporary authorization for CFSS services to be provided under the agency-provider
model without using the assessment process described in this subdivision. Authorization
for a temporary level of CFSS services under the agency-provider model is limited to the
time specified by the commissioner, but shall not exceed 45 days. The level of services
authorized under this paragraph shall have no bearing on a future authorization. For CFSS
services needed beyond the 45-day temporary authorization, the lead agency must conduct
an assessment as described in this subdivision and participants must use consultation services
to complete their orientation and selection of a service model.

Sec. 20.

Minnesota Statutes 2020, section 256S.02, subdivision 15, is amended to read:


Subd. 15.

Lead agency.

"Lead agency" means a county administering long-term care
consultation services as defined in section 256B.0911, subdivision deleted text begin1adeleted text endnew text begin 10new text end, or a tribe or
managed care organization under contract with the commissioner to administer long-term
care consultation services as defined in section 256B.0911, subdivision deleted text begin1adeleted text endnew text begin 10new text end.

Sec. 21.

Minnesota Statutes 2020, section 256S.02, subdivision 20, is amended to read:


Subd. 20.

Nursing facility level of care determination.

"Nursing facility level of care
determination" refers to determination of institutional level of care described in section
256B.0911, subdivision deleted text begin4edeleted text endnew text begin 26new text end.

Sec. 22.

Minnesota Statutes 2021 Supplement, section 256S.05, subdivision 2, is amended
to read:


Subd. 2.

Nursing facility level of care determination required.

Notwithstanding other
assessments identified in section 144.0724, subdivision 4, only assessments conducted
according to section 256B.0911deleted text begin, subdivisions 3, 3a, and 3b,deleted text end that result in a nursing facility
level of care determination at initial and subsequent assessments shall be accepted for
purposes of a participant's initial and ongoing participation in the elderly waiver and a
service provider's access to service payments under this chapter.

Sec. 23.

Minnesota Statutes 2020, section 256S.06, subdivision 1, is amended to read:


Subdivision 1.

Initial assessments.

A lead agency shall provide each participant with
an initial long-term care consultation assessment of strengths, informal supports, and need
for services according to section 256B.0911deleted text begin, subdivisions 3, 3a, and 3bdeleted text end.

Sec. 24.

Minnesota Statutes 2020, section 256S.06, subdivision 2, is amended to read:


Subd. 2.

Annual reassessments.

At least every 12 months, a lead agency shall provide
each participant with an annual long-term care consultation reassessment according to
section 256B.0911, subdivisions deleted text begin3, 3a, and 3bdeleted text endnew text begin 22 to 25new text end.

Sec. 25.

Minnesota Statutes 2020, section 256S.10, subdivision 2, is amended to read:


Subd. 2.

Plan development timeline.

Within the timelines established by the
commissioner and section 256B.0911, subdivision deleted text begin3a, paragraph (e)deleted text endnew text begin 29new text end, the case manager
must develop with the participant and the participant must sign the participant's individualized
written coordinated service and support plan.

Sec. 26. new text beginREVISOR INSTRUCTION.
new text end

new text begin (a) The revisor of statutes shall change the term "coordinated service and support plan"
and similar terms to "support plan" and similar terms wherever these terms appear in
Minnesota Statutes, sections 144G.911, 245A.11, 245D.02, 245D.04, 245D.05, 245D.051,
245D.06, 245D.061, 245D.07, 245D.071, 245D.081, 245D.09, 245D.091, 245D.095,
245D.11, 245D.22, 245D.31, 252.41, 252.42, 252.44, 252.45, 252A.02, 256B.0913,
256B.092, 256B.49, 256B.4911, 256B.4914, 256B.85, 256S.01, 256S.08, 256S.09, 256S.10,
256S.11, and 325F.722. The revisor shall also make necessary grammatical changes related
to the change in terms in order to preserve the meaning of the text.
new text end

new text begin (b) The revisor of statutes shall change the term "community support plan" and similar
terms to "assessment summary" and similar terms wherever these terms appear in Minnesota
Statutes, sections 245.462, 245.4711, 245.477, 245.4835, 245.4871, 245.4873, 245.4881,
245.4885, 245.4887, 245D.091, 256.975, 256B.0623, 256B.0659, 256B.092, 256B.0922,
256B.4911, 256B.4914, and 256B.85. The revisor shall also make necessary grammatical
changes related to the change in terms in order to preserve the meaning of the text.
new text end

Sec. 27. new text beginEFFECTIVE DATE.
new text end

new text begin Sections 1 to 26 are effective July 1, 2022.
new text end

APPENDIX

Repealed Minnesota Statutes: H4065-3

62U.10 HEALTH CARE TRANSFER, SAVINGS, AND REPAYMENT.

No active language found for: 62U.10.3

144.1911 INTERNATIONAL MEDICAL GRADUATES ASSISTANCE PROGRAM.

No active language found for: 144.1911.10

144.564 MONITORING OF SUBACUTE OR TRANSITIONAL CARE SERVICES.

No active language found for: 144.564.3

144A.483 AGENCY QUALITY IMPROVEMENT PROGRAM.

No active language found for: 144A.483.2

No active language found for: 144G.07.6

150A.091 FEES.

No active language found for: 150A.091.3

No active language found for: 150A.091.15

No active language found for: 150A.091.17

No active language found for: 245.981

245A.03 WHO MUST BE LICENSED.

No active language found for: 245A.03.5

245F.15 STAFF QUALIFICATIONS.

No active language found for: 245F.15.2

245G.11 STAFF QUALIFICATIONS.

No active language found for: 245G.11.2

No active language found for: 246.0136

No active language found for: 246.131

246B.03 LICENSURE, EVALUATION, AND GRIEVANCE RESOLUTION.

No active language found for: 246B.03.2

No active language found for: 246B.035

No active language found for: 252.025.7

No active language found for: 252.035

No active language found for: 254A.04

254A.21 FETAL ALCOHOL SPECTRUM DISORDERS PREVENTION GRANTS.

(a) The commissioner of human services shall award a grant to a statewide organization that focuses solely on prevention of and intervention with fetal alcohol spectrum disorders. The grant recipient must make subgrants to eligible regional collaboratives in rural and urban areas of the state for the purposes specified in paragraph (c).

(b) "Eligible regional collaboratives" means a partnership between at least one local government or tribal government and at least one community-based organization and, where available, a family home visiting program. For purposes of this paragraph, a local government includes a county or a multicounty organization, a county-based purchasing entity, or a community health board.

(c) Eligible regional collaboratives must use subgrant funds to reduce the incidence of fetal alcohol spectrum disorders and other prenatal drug-related effects in children in Minnesota by identifying and serving pregnant women suspected of or known to use or abuse alcohol or other drugs. Eligible regional collaboratives must provide intensive services to women with substance use disorder to increase positive birth outcomes.

(d) An eligible regional collaborative that receives a subgrant under this section must report to the grant recipient by January 15 of each year on the services and programs funded by the subgrant. The report must include measurable outcomes for the previous year, including the number of pregnant women served and the number of toxic-free babies born. The grant recipient must compile the information in the subgrant reports and submit a summary report to the commissioner of human services by February 15 of each year.

No active language found for: 254B.14.1

No active language found for: 254B.14.2

No active language found for: 254B.14.3

No active language found for: 254B.14.4

No active language found for: 254B.14.5

No active language found for: 254B.14.6

256.01 COMMISSIONER OF HUMAN SERVICES; POWERS, DUTIES.

No active language found for: 256.01.31

256B.057 ELIGIBILITY REQUIREMENTS FOR SPECIAL CATEGORIES.

No active language found for: 256B.057.7

256B.0638 OPIOID PRESCRIBING IMPROVEMENT PROGRAM.

No active language found for: 256B.0638.7

256B.0911 LONG-TERM CARE CONSULTATION SERVICES.

No active language found for: 256B.0911.1a

No active language found for: 256B.0911.2b

No active language found for: 256B.0911.2c

No active language found for: 256B.0911.3

No active language found for: 256B.0911.3a

No active language found for: 256B.0911.3b

No active language found for: 256B.0911.3f

No active language found for: 256B.0911.3g

No active language found for: 256B.0911.4d

No active language found for: 256B.0911.4e

No active language found for: 256B.0911.5

No active language found for: 256B.0911.6

256B.0943 CHILDREN'S THERAPEUTIC SERVICES AND SUPPORTS.

Subd. 8a.

Level II mental health behavioral aide.

The commissioner of human services, in collaboration with children's mental health providers and the Board of Trustees of the Minnesota State Colleges and Universities, shall develop a certificate program for level II mental health behavioral aides.

256B.69 PREPAID HEALTH PLANS.

No active language found for: 256B.69.20

No active language found for: 256D.055

256R.08 REPORTING OF FINANCIAL STATEMENTS.

No active language found for: 256R.08.2

501C.0408 TRUST FOR CARE OF ANIMAL.

No active language found for: 501C.0408.4

No active language found for: 501C.1206

Repealed Minnesota Session Laws: H4065-3

Laws 1998, chapter 382, article 1, section 23 by Laws 2022, chapter 98, article 14, section 33

Sec. 23.

Laws 1995, chapter 257, article 1, section 34, is amended to read:


Sec. 34. REPORT.

(a) The commissioner of human services shall evaluate all child support programs and enforcement mechanisms

to determine the following:

(1) Minnesota's performance on the child support and incentive measures submitted by the federal Office of Child Support to the United States Congress;

(2) Minnesota's performance relative to other states;

(3) individual county performance; and

(4) recommendations for further improvement.

(b) The commissioner shall evaluate in separate categories the federal, state, and local government costs of child support enforcement in this state. The evaluation must also include a representative sample of private business costs relating to child support enforcement based on a survey of at least 50 Minnesota businesses and nonprofit organizations.

(c) The commissioner shall also report on the amount of child support arrearages in this state with separate categories for the amount of child support in arrears for 90 days, six months, one year, and two or more years. The report must establish a process for determining when an arrearage is considered uncollectible based on the age of the arrearage and likelihood of collection of the amount owed. The amounts determined to be uncollectible must be deducted from the total amount of outstanding arrearages for purposes of determining arrearages that are considered collectible.

(d) The first report on these topics shall be submitted to the legislature by January 1, 1999, and subsequent reports shall be submitted biennially before January 15 of each odd-numbered year.

Repealed Minnesota Rule: H4065-3

2960.0460 STAFF QUALIFICATIONS.

Subp. 2.

Qualifications applying to employees with direct resident contact.

An employee working directly with residents must be at least 21 years of age and must, at the time of hiring, document meeting the qualifications in item A or B.

A.

A program director, supervisor, counselor, or any other person who has direct resident contact must be free of chemical use problems for at least the two years immediately preceding hiring and freedom from chemical use problems must be maintained during employment.

B.

Overnight staff must be free of chemical use problems for at least one year preceding their hiring and maintain freedom from chemical use problems during their employment.

9530.6565 STAFF QUALIFICATIONS.

Subp. 2.

Continuing employment requirement.

License holders must require freedom from chemical use problems as a condition of continuing employment. Staff must remain free of chemical use problems although they are not required to sign statements after the initial statement required by subpart 1, item A. Staff with chemical use problems must be immediately removed from any responsibilities that include direct client contact.

9555.6255 RESIDENT'S RIGHTS.

Subpart 1.

Information about rights.

The operator shall ensure that a resident and a resident's legal representative are given, at admission:

A.

an explanation and copy of the resident's rights specified in subparts 2 to 7;

B.

a written summary of the Vulnerable Adults Act prepared by the department; and

C.

the name, address, and telephone number of the local agency to which a resident or a resident's legal representative may submit an oral or written complaint.

Subp. 2.

Right to use telephone.

A resident has the right to daily, private access to and use of a non-coin operated telephone for local calls and long distance calls made collect or paid for by the resident.

Subp. 3.

Right to receive and send mail.

A resident has the right to receive and send uncensored, unopened mail.

Subp. 4.

Right to privacy.

A resident has the right to personal privacy and privacy for visits from others, and the respect of individuality and cultural identity. Privacy must be respected by operators, caregivers, household members, and volunteers by knocking on the door of a resident's bedroom and seeking consent before entering, except in an emergency, and during toileting, bathing, and other activities of personal hygiene, except as needed for resident safety or assistance as noted in the resident's individual record.

Subp. 5.

Right to use personal property.

A resident has the right to keep and use personal clothing and possessions as space permits, unless to do so would infringe on the health, safety, or rights of other residents or household members.

Subp. 6.

Right to associate.

A resident has the right to meet with or refuse to meet with visitors and participate in activities of commercial, religious, political, and community groups without interference if the activities do not infringe on the rights of other residents or household members.

Subp. 7.

Married residents.

Married residents have the right to privacy for visits by their spouses, and, if both spouses are residents of the adult foster home, they have the right to share a bedroom and bed.