SF 1692

1st Engrossment - 93rd Legislature (2023 - 2024) Posted on 10/25/2023 01:34pm

A bill for an act
relating to human services; modifying policies governing access to substance use
disorder treatment services; modifying eligibility for home and community-based
services workforce development grants; excluding workforce development grant
money from income for certain purposes; amending Minnesota Statutes 2022,
sections 62N.25, subdivision 5; 62Q.1055; 62Q.47; 169A.70, subdivisions 3, 4;
245A.043, subdivision 3; 245G.05, subdivision 2; 245G.22, subdivision 2; 254A.03,
subdivision 3; 254A.19, subdivisions 1, 3, 4, by adding subdivisions; 254B.01,
subdivision 5, by adding subdivisions; 254B.03, subdivisions 1, 2, 5; 254B.04,
subdivisions 1, 2a, by adding subdivisions; 256D.09, subdivision 2a; 256L.03,
subdivision 2; 256L.12, subdivision 8; 260B.157, subdivisions 1, 3; 260C.157,
subdivision 3; 260E.20, subdivision 1; 299A.299, subdivision 1; Laws 2021, First
Special Session chapter 7, article 17, section 20; repealing Minnesota Statutes
2022, sections 169A.70, subdivision 6; 245G.22, subdivision 19; 254A.02,
subdivision 8a; 254A.16, subdivision 6; 254A.19, subdivisions 1a, 2, 5; 254B.04,
subdivisions 2b, 2c; 254B.041, subdivision 2.

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

Section 1.

Minnesota Statutes 2022, section 62N.25, subdivision 5, is amended to read:

Subd. 5.

Benefits.

Community integrated service networks must offer the health
maintenance organization benefit set, as defined in chapter 62D, and other laws applicable
to entities regulated under chapter 62D. Community networks and chemical dependency
facilities under contract with a community network shall use the assessment criteria in
deleted text begin Minnesota Rules, parts 9530.6600 to 9530.6655, deleted text end new text begin section 245G.05 new text end when assessing enrollees
for chemical dependency treatment.

Sec. 2.

Minnesota Statutes 2022, section 62Q.1055, is amended to read:

62Q.1055 CHEMICAL DEPENDENCY.

All health plan companies shall use the assessment criteria in deleted text begin Minnesota Rules, parts
9530.6600 to 9530.6655, deleted text end new text begin section 245G.05 new text end when assessing and deleted text begin placing deleted text end new text begin treating new text end enrollees
for chemical dependency treatment.

Sec. 3.

Minnesota Statutes 2022, section 62Q.47, is amended to read:

62Q.47 ALCOHOLISM, MENTAL HEALTH, AND CHEMICAL DEPENDENCY
SERVICES.

(a) All health plans, as defined in section 62Q.01, that provide coverage for alcoholism,
mental health, or chemical dependency services, must comply with the requirements of this
section.

(b) Cost-sharing requirements and benefit or service limitations for outpatient mental
health and outpatient chemical dependency and alcoholism services, except for persons
deleted text begin placed in deleted text end new text begin seeking new text end chemical dependency services under deleted text begin Minnesota Rules, parts 9530.6600
to 9530.6655 deleted text end new text begin section 245G.05 new text end , must not place a greater financial burden on the insured or
enrollee, or be more restrictive than those requirements and limitations for outpatient medical
services.

(c) Cost-sharing requirements and benefit or service limitations for inpatient hospital
mental health and inpatient hospital and residential chemical dependency and alcoholism
services, except for persons deleted text begin placed in deleted text end new text begin seeking new text end chemical dependency services under deleted text begin Minnesota
Rules, parts 9530.6600 to 9530.6655 deleted text end new text begin section 245G.05 new text end , must not place a greater financial
burden on the insured or enrollee, or be more restrictive than those requirements and
limitations for inpatient hospital medical services.

(d) A health plan company must not impose an NQTL with respect to mental health and
substance use disorders in any classification of benefits unless, under the terms of the health
plan as written and in operation, any processes, strategies, evidentiary standards, or other
factors used in applying the NQTL to mental health and substance use disorders in the
classification are comparable to, and are applied no more stringently than, the processes,
strategies, evidentiary standards, or other factors used in applying the NQTL with respect
to medical and surgical benefits in the same classification.

(e) All health plans must meet the requirements of the federal Mental Health Parity Act
of 1996, Public Law 104-204; Paul Wellstone and Pete Domenici Mental Health Parity and
Addiction Equity Act of 2008; the Affordable Care Act; and any amendments to, and federal
guidance or regulations issued under, those acts.

(f) The commissioner may require information from health plan companies to confirm
that mental health parity is being implemented by the health plan company. Information
required may include comparisons between mental health and substance use disorder
treatment and other medical conditions, including a comparison of prior authorization
requirements, drug formulary design, claim denials, rehabilitation services, and other
information the commissioner deems appropriate.

(g) Regardless of the health care provider's professional license, if the service provided
is consistent with the provider's scope of practice and the health plan company's credentialing
and contracting provisions, mental health therapy visits and medication maintenance visits
shall be considered primary care visits for the purpose of applying any enrollee cost-sharing
requirements imposed under the enrollee's health plan.

(h) By June 1 of each year, beginning June 1, 2021, the commissioner of commerce, in
consultation with the commissioner of health, shall submit a report on compliance and
oversight to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and commerce. The report must:

(1) describe the commissioner's process for reviewing health plan company compliance
with United States Code, title 42, section 18031(j), any federal regulations or guidance
relating to compliance and oversight, and compliance with this section and section 62Q.53;

(2) identify any enforcement actions taken by either commissioner during the preceding
12-month period regarding compliance with parity for mental health and substance use
disorders benefits under state and federal law, summarizing the results of any market conduct
examinations. The summary must include: (i) the number of formal enforcement actions
taken; (ii) the benefit classifications examined in each enforcement action; and (iii) the
subject matter of each enforcement action, including quantitative and nonquantitative
treatment limitations;

(3) detail any corrective action taken by either commissioner to ensure health plan
company compliance with this section, section 62Q.53, and United States Code, title 42,
section 18031(j); and

(4) describe the information provided by either commissioner to the public about
alcoholism, mental health, or chemical dependency parity protections under state and federal
law.

The report must be written in nontechnical, readily understandable language and must be
made available to the public by, among other means as the commissioners find appropriate,
posting the report on department websites. Individually identifiable information must be
excluded from the report, consistent with state and federal privacy protections.

Sec. 4.

Minnesota Statutes 2022, section 169A.70, subdivision 3, is amended to read:

Subd. 3.

Assessment report.

(a) The assessment report must be on a form prescribed
by the commissioner and shall contain an evaluation of the convicted defendant concerning
the defendant's prior traffic and criminal record, characteristics and history of alcohol and
chemical use problems, and amenability to rehabilitation through the alcohol safety program.
The report is classified as private data on individuals as defined in section 13.02, subdivision
12.

(b) The assessment report must include:

(1) a diagnosis of the nature of the offender's chemical and alcohol involvement;

(2) an assessment of the severity level of the involvement;

(3) a recommended level of care for the offender in accordance with the criteria contained
in deleted text begin rules adopted by the commissioner of human services under section 254A.03, subdivision
3 (substance use disorder treatment rules) deleted text end new text begin section 245G.05 new text end ;

(4) an assessment of the offender's placement needs;

(5) recommendations for other appropriate remedial action or care, including aftercare
services in section 254B.01, subdivision 3, that may consist of educational programs,
one-on-one counseling, a program or type of treatment that addresses mental health concerns,
or a combination of them; and

(6) a specific explanation why no level of care or action was recommended, if applicable.

Sec. 5.

Minnesota Statutes 2022, section 169A.70, subdivision 4, is amended to read:

Subd. 4.

Assessor standards; rules; assessment time limits.

A chemical use assessment
required by this section must be conducted by an assessor appointed by the court. The
assessor must meet the training and qualification requirements of deleted text begin rules adopted by the
commissioner of human services under section 254A.03, subdivision 3 (substance use
disorder treatment rules) deleted text end new text begin section 245G.11, subdivisions 1 and 5 new text end . Notwithstanding section
13.82 (law enforcement data), the assessor shall have access to any police reports, laboratory
test results, and other law enforcement data relating to the current offense or previous
offenses that are necessary to complete the evaluation. deleted text begin An assessor providing an assessment
under this section may not have any direct or shared financial interest or referral relationship
resulting in shared financial gain with a treatment provider, except as authorized under
section 254A.19, subdivision 3. If an independent assessor is not available, the court may
use the services of an assessor authorized to perform assessments for the county social
services agency under a variance granted under rules adopted by the commissioner of human
services under section 254A.03, subdivision 3. deleted text end An appointment for the defendant to undergo
the assessment must be made by the court, a court services probation officer, or the court
administrator as soon as possible but in no case more than one week after the defendant's
court appearance. The assessment must be completed no later than three weeks after the
defendant's court appearance. If the assessment is not performed within this time limit, the
county where the defendant is to be sentenced shall perform the assessment. The county of
financial responsibility must be determined under chapter 256G.

Sec. 6.

Minnesota Statutes 2022, section 245A.043, subdivision 3, is amended to read:

Subd. 3.

Change of ownership process.

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

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

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

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

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

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

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

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

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

Sec. 7.

Minnesota Statutes 2022, section 245G.05, subdivision 2, is amended to read:

Subd. 2.

Assessment summary.

(a) An alcohol and drug counselor must complete an
assessment summary within three calendar days from the day of service initiation for a
residential program and within three calendar days on which a treatment session has been
provided from the day of service initiation for a client in a nonresidential program. The
comprehensive assessment summary is complete upon a qualified staff member's dated
signature. If the comprehensive assessment is used to authorize the treatment service, the
alcohol and drug counselor must prepare an assessment summary on the same date the
comprehensive assessment is completed. If the comprehensive assessment and assessment
summary are to authorize treatment services, the assessor must determine appropriate new text begin level
of care and new text end services for the client using the deleted text begin dimensions in Minnesota Rules, part 9530.6622, deleted text end new text begin
criteria established in section 254B.04, subdivision 4, new text end and document the recommendations.

(b) An assessment summary must include:

(1) a risk description according to section 245G.05 for each dimension listed in paragraph
(c);

(2) a narrative summary supporting the risk descriptions; and

(3) a determination of whether the client has a substance use disorder.

(c) An assessment summary must contain information relevant to treatment service
planning and recorded in the dimensions in clauses (1) to (6). The license holder must
consider:

(1) Dimension 1, acute intoxication/withdrawal potential; the client's ability to cope with
withdrawal symptoms and current state of intoxication;

(2) Dimension 2, biomedical conditions and complications; the degree to which any
physical disorder of the client would interfere with treatment for substance use, and the
client's ability to tolerate any related discomfort. The license holder must determine the
impact of continued substance use on the unborn child, if the client is pregnant;

(3) Dimension 3, emotional, behavioral, and cognitive conditions and complications;
the degree to which any condition or complication is likely to interfere with treatment for
substance use or with functioning in significant life areas and the likelihood of harm to self
or others;

(4) Dimension 4, readiness for change; the support necessary to keep the client involved
in treatment service;

(5) Dimension 5, relapse, continued use, and continued problem potential; the degree
to which the client recognizes relapse issues and has the skills to prevent relapse of either
substance use or mental health problems; and

(6) Dimension 6, recovery environment; whether the areas of the client's life are
supportive of or antagonistic to treatment participation and recovery.

Sec. 8.

Minnesota Statutes 2022, section 245G.22, 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 them.

(b) "Diversion" means the use of a medication for the treatment of opioid addiction being
diverted from intended use of the medication.

(c) "Guest dose" means administration of a medication used for the treatment of opioid
addiction to a person who is not a client of the program that is administering or dispensing
the medication.

(d) "Medical director" means a practitioner licensed to practice medicine in the
jurisdiction that the opioid treatment program is located who assumes responsibility for
administering all medical services performed by the program, either by performing the
services directly or by delegating specific responsibility to a practitioner of the opioid
treatment program.

(e) "Medication used for the treatment of opioid use disorder" means a medication
approved by the Food and Drug Administration for the treatment of opioid use disorder.

(f) "Minnesota health care programs" has the meaning given in section 256B.0636.

(g) "Opioid treatment program" has the meaning given in Code of Federal Regulations,
title 42, section 8.12, and includes programs licensed under this chapter.

deleted text begin (h) "Placing authority" has the meaning given in Minnesota Rules, part 9530.6605,
subpart 21a.
deleted text end

deleted text begin (i) deleted text end new text begin (h) new text end "Practitioner" means a staff member holding a current, unrestricted license to
practice medicine issued by the Board of Medical Practice or nursing issued by the Board
of Nursing and is currently registered with the Drug Enforcement Administration to order
or dispense controlled substances in Schedules II to V under the Controlled Substances Act,
United States Code, title 21, part B, section 821. Practitioner includes an advanced practice
registered nurse and physician assistant if the staff member receives a variance by the state
opioid treatment authority under section 254A.03 and the federal Substance Abuse and
Mental Health Services Administration.

deleted text begin (j) deleted text end new text begin (i) new text end "Unsupervised use" means the use of a medication for the treatment of opioid use
disorder dispensed for use by a client outside of the program setting.

Sec. 9.

Minnesota Statutes 2022, section 254A.03, subdivision 3, is amended to read:

Subd. 3.

Rules for substance use disorder care.

(a) deleted text begin The commissioner of human
services shall establish by rule criteria to be used in determining the appropriate level of
substance use disorder care for each recipient of public assistance seeking treatment for
substance misuse or substance use disorder. Upon federal approval of a comprehensive
assessment as a Medicaid benefit, or on July 1, 2018, whichever is later, and notwithstanding
the criteria in Minnesota Rules, parts 9530.6600 to 9530.6655, deleted text end An eligible vendor of
comprehensive assessments under section 254B.05 may determine deleted text begin and approve deleted text end the
appropriate level of substance use disorder treatment for a recipient of public assistance.
The process for determining an individual's financial eligibility for the behavioral health
fund or determining an individual's enrollment in or eligibility for a publicly subsidized
health plan is not affected by the individual's choice to access a comprehensive assessment
for placement.

(b) The commissioner shall develop and implement a utilization review process for
publicly funded treatment placements to monitor and review the clinical appropriateness
and timeliness of all publicly funded placements in treatment.

(c) If a screen result is positive for alcohol or substance misuse, a brief screening for
alcohol or substance use disorder that is provided to a recipient of public assistance within
a primary care clinic, hospital, or other medical setting or school setting establishes medical
necessity and approval for an initial set of substance use disorder services identified in
section 254B.05, subdivision 5. The initial set of services approved for a recipient whose
screen result is positive may include any combination of up to four hours of individual or
group substance use disorder treatment, two hours of substance use disorder treatment
coordination, or two hours of substance use disorder peer support services provided by a
qualified individual according to chapter 245G. A recipient must obtain an assessment
pursuant to paragraph (a) to be approved for additional treatment services. deleted text begin Minnesota Rules,
parts 9530.6600 to 9530.6655, and deleted text end A comprehensive assessment pursuant to section 245G.05
deleted text begin are not applicable deleted text end new text begin is not required new text end to new text begin receive new text end the initial set of services allowed under this
subdivision. A positive screen result establishes eligibility for the initial set of services
allowed under this subdivision.

deleted text begin (d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, An individual
may choose to obtain a comprehensive assessment as provided in section 245G.05.
Individuals obtaining a comprehensive assessment may access any enrolled provider that
is licensed to provide the level of service authorized pursuant to section 254A.19, subdivision
3, paragraph (d). If the individual is enrolled in a prepaid health plan, the individual must
deleted text end deleted text begin comply with any provider network requirements or limitations. This paragraph expires July
1, 2022.
deleted text end

new text begin (d) An individual may choose to obtain a comprehensive assessment as provided in
section 245G.05. Individuals obtaining a comprehensive assessment may access any enrolled
provider that is licensed to provide the level of service authorized pursuant to section
254A.19, subdivision 3. If the individual is enrolled in a prepaid health plan, the individual
must comply with any provider network requirements or limitations.
new text end

Sec. 10.

Minnesota Statutes 2022, section 254A.19, subdivision 1, is amended to read:

Subdivision 1.

Persons arrested outside of home county.

When a chemical use
assessment is required deleted text begin under Minnesota Rules, parts 9530.6600 to 9530.6655, deleted text end for a person
who is arrested and taken into custody by a peace officer outside of the person's county of
residence, the deleted text begin assessment must be completed by the person's county of residence no later
than three weeks after the assessment is initially requested. If the assessment is not performed
within this time limit, the county where the person is to be sentenced shall perform the
assessment deleted text end new text begin county where the person is detained must give access to an assessor qualified
under section 254A.19, subdivision 3 new text end . The county of financial responsibility is determined
under chapter 256G.

Sec. 11.

Minnesota Statutes 2022, section 254A.19, subdivision 3, is amended to read:

Subd. 3.

deleted text begin Financial conflicts of interest. deleted text end new text begin Comprehensive assessments. new text end

deleted text begin (a) Except as
provided in paragraph (b), (c), or (d), an assessor conducting a chemical use assessment
under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any direct or shared
financial interest or referral relationship resulting in shared financial gain with a treatment
provider.
deleted text end

deleted text begin (b) A county may contract with an assessor having a conflict described in paragraph (a)
if the county documents that:
deleted text end

deleted text begin (1) the assessor is employed by a culturally specific service provider or a service provider
with a program designed to treat individuals of a specific age, sex, or sexual preference;
deleted text end

deleted text begin (2) the county does not employ a sufficient number of qualified assessors and the only
qualified assessors available in the county have a direct or shared financial interest or a
referral relationship resulting in shared financial gain with a treatment provider; or
deleted text end

deleted text begin (3) the county social service agency has an existing relationship with an assessor or
service provider and elects to enter into a contract with that assessor to provide both
assessment and treatment under circumstances specified in the county's contract, provided
the county retains responsibility for making placement decisions.
deleted text end

deleted text begin (c) The county may contract with a hospital to conduct chemical assessments if the
requirements in subdivision 1a are met.
deleted text end

deleted text begin An assessor under this paragraph may not place clients in treatment. The assessor shall
gather required information and provide it to the county along with any required
documentation. The county shall make all placement decisions for clients assessed by
assessors under this paragraph.
deleted text end

deleted text begin (d) deleted text end An eligible vendor under section 254B.05 conducting a comprehensive assessment
for an individual seeking treatment shall approve the nature, intensity level, and duration
of treatment service if a need for services is indicated, but the individual assessed can access
any enrolled provider that is licensed to provide the level of service authorized, including
the provider or program that completed the assessment. If an individual is enrolled in a
prepaid health plan, the individual must comply with any provider network requirements
or limitations.

Sec. 12.

Minnesota Statutes 2022, section 254A.19, subdivision 4, is amended to read:

Subd. 4.

Civil commitments.

deleted text begin A Rule 25 assessment, under Minnesota Rules, part
9530.6615, deleted text end new text begin For the purposes of determining level of care, a comprehensive assessment new text end does
not need to be completed for an individual being committed as a chemically dependent
person, as defined in section 253B.02, and for the duration of a civil commitment under
section 253B.065, 253B.09, or 253B.095 in order for a county to access the behavioral
health fund under section 254B.04. The county must determine if the individual meets the
financial eligibility requirements for the behavioral health fund under section 254B.04.
deleted text begin Nothing in this subdivision prohibits placement in a treatment facility or treatment program
governed under this chapter or Minnesota Rules, parts 9530.6600 to 9530.6655.
deleted text end

Sec. 13.

Minnesota Statutes 2022, section 254A.19, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Assessments for detoxification programs. new text end

new text begin For detoxification programs licensed
under chapter 245A according to Minnesota Rules, parts 9530.6510 to 9530.6590, a
"chemical use assessment" is a comprehensive assessment and assessment summary
completed according to the requirements of section 245G.05 and a "chemical dependency
assessor" or "assessor" is an individual who meets the qualifications of section 245G.11,
subdivisions 1 and 5.
new text end

Sec. 14.

Minnesota Statutes 2022, section 254A.19, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Assessments for children's residential facilities. new text end

new text begin For children's residential
facilities licensed under chapter 245A according to Minnesota Rules, parts 2960.0010 to
2960.0220 and 2960.0430 to 2960.0490, a "chemical use assessment" is a comprehensive
assessment and assessment summary completed according to the requirements of section
245G.05 and must be completed by an individual who meets the qualifications of section
245G.11, subdivisions 1 and 5.
new text end

Sec. 15.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 2a. new text end

new text begin Behavioral health fund. new text end

new text begin "Behavioral health fund" means money allocated
for payment of treatment services under chapter 254B.
new text end

Sec. 16.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 2b. new text end

new text begin Client. new text end

new text begin "Client" means an individual who has requested substance use disorder
services or for whom substance use disorder services have been requested.
new text end

Sec. 17.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 2c. new text end

new text begin Co-payment. new text end

new text begin "Co-payment" means:
new text end

new text begin (1) the amount an insured person is obligated to pay before the person's third-party
payment source is obligated to make a payment; or
new text end

new text begin (2) the amount an insured person is obligated to pay in addition to the amount the person's
third-party payment source is obligated to pay.
new text end

Sec. 18.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 4c. new text end

new text begin Department. new text end

new text begin "Department" means the Department of Human Services.
new text end

Sec. 19.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 4d. new text end

new text begin Drug and Alcohol Abuse Normative Evaluation System or DAANES. new text end

new text begin "Drug
and Alcohol Abuse Normative Evaluation System" or "DAANES" means the reporting
system used to collect all substance use disorder treatment data across all levels of care and
providers.
new text end

Sec. 20.

Minnesota Statutes 2022, section 254B.01, subdivision 5, is amended to read:

Subd. 5.

Local agency.

"Local agency" means the agency designated by a board of
county commissioners, a local social services agency, or a human services board deleted text begin to make
placements and submit state invoices according to Laws 1986, chapter 394, sections 8 to
20 deleted text end new text begin authorized under section 254B.03, subdivision 1, to determine financial eligibility for
the behavioral health fund new text end .

Sec. 21.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 6a. new text end

new text begin Minor child. new text end

new text begin "Minor child" means an individual under the age of 18 years.
new text end

Sec. 22.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 6b. new text end

new text begin Policyholder. new text end

new text begin "Policyholder" means a person who has a third-party payment
policy under which a third-party payment source has an obligation to pay all or part of a
client's treatment costs.
new text end

Sec. 23.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Responsible relative. new text end

new text begin "Responsible relative" means a person who is a member
of the client's household and is the client's spouse or the parent of a minor child who is a
client.
new text end

Sec. 24.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 10. new text end

new text begin Third-party payment source new text end

new text begin "Third-party payment source" means a person,
entity, or public or private agency other than medical assistance or general assistance medical
care that has a probable obligation to pay all or part of the costs of a client's substance use
disorder treatment.
new text end

Sec. 25.

Minnesota Statutes 2022, section 254B.01, is amended by adding a subdivision
to read:

new text begin Subd. 11. new text end

new text begin Vendor. new text end

new text begin "Vendor" means a provider of substance use disorder treatment
services that meets the criteria established in section 254B.05, and that has applied to
participate as a provider in the medical assistance program according to Minnesota Rules,
part 9505.0195.
new text end

Sec. 26.

Minnesota Statutes 2022, section 254B.03, subdivision 1, is amended to read:

Subdivision 1.

Local agency duties.

(a) Every local agency deleted text begin shall deleted text end new text begin must determine financial
eligibility for substance use disorder services and new text end provide substance use disorder services
to persons residing within its jurisdiction who meet criteria established by the commissioner
deleted text begin for placement in a substance use disorder residential or nonresidential treatment service deleted text end .
Substance use disorder money must be administered by the local agencies according to law
and rules adopted by the commissioner under sections 14.001 to 14.69.

(b) In order to contain costs, the commissioner of human services shall select eligible
vendors of substance use disorder services who can provide economical and appropriate
treatment. Unless the local agency is a social services department directly administered by
a county or human services board, the local agency shall not be an eligible vendor under
section 254B.05. The commissioner may approve proposals from county boards to provide
services in an economical manner or to control utilization, with safeguards to ensure that
necessary services are provided. If a county implements a demonstration or experimental
medical services funding plan, the commissioner shall transfer the money as appropriate.

deleted text begin (c) A culturally specific vendor that provides assessments under a variance under
Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to persons
not covered by the variance.
deleted text end

deleted text begin (d) Notwithstanding Minnesota Rules, parts 9530.6600 to 9530.6655, deleted text end new text begin (c) new text end An individual
may choose to obtain a comprehensive assessment as provided in section 245G.05.
Individuals obtaining a comprehensive assessment may access any enrolled provider that
is licensed to provide the level of service authorized pursuant to section 254A.19, subdivision
3 deleted text begin , paragraph (d) deleted text end . If the individual is enrolled in a prepaid health plan, the individual must
comply with any provider network requirements or limitations.

deleted text begin (e) deleted text end new text begin (d) new text end Beginning July 1, 2022, local agencies shall not make placement location
determinations.

Sec. 27.

Minnesota Statutes 2022, section 254B.03, subdivision 2, is amended to read:

Subd. 2.

Behavioral health fund payment.

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

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

(2) concurrently receiving a substance use disorder treatment service in a program
licensed by the commissioner and reimbursed by the behavioral health fund.

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

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

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

(1) a description of the proposed treatment program; and

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

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

Sec. 28.

Minnesota Statutes 2022, section 254B.03, subdivision 5, is amended to read:

Subd. 5.

Rules; appeal.

The commissioner shall adopt rules as necessary to implement
this chapter. deleted text begin The commissioner shall establish an appeals process for use by recipients when
services certified by the county are disputed. The commissioner shall adopt rules and
standards for the appeal process to assure adequate redress for persons referred to
inappropriate services.
deleted text end

Sec. 29.

Minnesota Statutes 2022, section 254B.04, subdivision 1, is amended to read:

Subdivision 1.

deleted text begin Eligibility. deleted text end new text begin Scope and applicability. new text end

deleted text begin (a) Persons eligible for benefits
under Code of Federal Regulations, title 25, part 20, who meet the income standards of
section 256B.056, subdivision 4, and are not enrolled in medical assistance, are entitled to
behavioral health fund services. State money appropriated for this paragraph must be placed
in a separate account established for this purpose.
deleted text end

deleted text begin (b) Persons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 260E.20, subdivision 1, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county shall
pay for out-of-home placement costs, if applicable.
deleted text end

deleted text begin (c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible
for room and board services under section 254B.05, subdivision 5, paragraph (b), clause
(12).
deleted text end

new text begin This section governs the administration of the behavioral health fund, establishes the
criteria to be applied by local agencies to determine a client's financial eligibility under the
behavioral health fund, and determines a client's obligation to pay for substance use disorder
treatment services.
new text end

Sec. 30.

Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

new text begin Client eligibility. new text end

new text begin (a) Persons eligible for benefits under Code of Federal
Regulations, title 25, part 20, who meet the income standards of section 256B.056,
subdivision 4, and are not enrolled in medical assistance, are entitled to behavioral health
fund services. State money appropriated for this paragraph must be placed in a separate
account established for this purpose.
new text end

new text begin (b) Persons with dependent children who are determined to be in need of chemical
dependency treatment pursuant to an assessment under section 260E.20, subdivision 1, or
a case plan under section 260C.201, subdivision 6, or 260C.212, shall be assisted by the
local agency to access needed treatment services. Treatment services must be appropriate
for the individual or family, which may include long-term care treatment or treatment in a
facility that allows the dependent children to stay in the treatment facility. The county shall
pay for out-of-home placement costs, if applicable.
new text end

new text begin (c) Notwithstanding paragraph (a), persons enrolled in medical assistance are eligible
for room and board services under section 254B.05, subdivision 5, paragraph (b), clause
(12).
new text end

new text begin (d) A client is eligible to have substance use disorder treatment paid for with funds from
the behavioral health fund when the client:
new text end

new text begin (1) is eligible for MFIP as determined under chapter 256J;
new text end

new text begin (2) is eligible for medical assistance as determined under Minnesota Rules, parts
9505.0010 to 9505.0150;
new text end

new text begin (3) is eligible for general assistance, general assistance medical care, or work readiness
as determined under Minnesota Rules, parts 9500.1200 to 9500.1318; or
new text end

new text begin (4) has income that is within current household size and income guidelines for entitled
persons, as defined in this subdivision and subdivision 7.
new text end

new text begin (e) Clients who meet the financial eligibility requirement in paragraph (a) and who have
a third-party payment source are eligible for the behavioral health fund if the third-party
payment source pays less than 100 percent of the cost of treatment services for eligible
clients.
new text end

new text begin (f) A client is ineligible to have substance use disorder treatment services paid for with
behavioral health fund money if the client:
new text end

new text begin (1) has an income that exceeds current household size and income guidelines for entitled
persons as defined in this subdivision and subdivision 7; or
new text end

new text begin (2) has an available third-party payment source that will pay the total cost of the client's
treatment.
new text end

new text begin (g) A client who is disenrolled from a state prepaid health plan during a treatment episode
is eligible for continued treatment service that is paid for by the behavioral health fund until
the treatment episode is completed or the client is re-enrolled in a state prepaid health plan
if the client:
new text end

new text begin (1) continues to be enrolled in MinnesotaCare, medical assistance, or general assistance
medical care; or
new text end

new text begin (2) is eligible according to paragraphs (a) and (b) and is determined eligible by a local
agency under section 254B.04.
new text end

new text begin (h) When a county commits a client under chapter 253B to a regional treatment center
for substance use disorder services and the client is ineligible for the behavioral health fund,
the county is responsible for the payment to the regional treatment center according to
section 254B.05, subdivision 4.
new text end

Sec. 31.

Minnesota Statutes 2022, section 254B.04, subdivision 2a, is amended to read:

Subd. 2a.

Eligibility for deleted text begin treatment in residential settings deleted text end new text begin room and board services
for persons in outpatient substance use disorder treatment new text end .

deleted text begin Notwithstanding provisions
of Minnesota Rules, part 9530.6622, subparts 5 and 6, related to an assessor's discretion in
making placements to residential treatment settings, deleted text end A person eligible for new text begin room and board new text end
services under deleted text begin this deleted text end section new text begin 254B.05, subdivision 5, paragraph (b), clause (12), new text end must score
at level 4 on assessment dimensions related to new text begin readiness to change, new text end relapse, continued use,
or recovery environment in order to be assigned to services with a room and board component
reimbursed under this section. Whether a treatment facility has been designated an institution
for mental diseases under United States Code, title 42, section 1396d, shall not be a factor
in making placements.

Sec. 32.

Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision
to read:

new text begin Subd. 4. new text end

new text begin Assessment criteria and risk descriptions. new text end

new text begin (a) The level of care determination
must follow criteria approved by the commissioner.
new text end

new text begin (b) Dimension 1: Acute intoxication/withdrawal potential. A vendor must use the criteria
in Dimension 1 to determine a client's acute intoxication and withdrawal potential, the
client's ability to cope with withdrawal symptoms, and the client's current state of
intoxication.
new text end

new text begin "0" The client displays full functioning with good ability to tolerate and cope with
withdrawal discomfort, and the client shows no signs or symptoms of intoxication or
withdrawal or diminishing signs or symptoms.
new text end

new text begin "1" The client can tolerate and cope with withdrawal discomfort. The client displays
mild to moderate intoxication or signs and symptoms interfering with daily functioning but
does not immediately endanger self or others. The client poses a minimal risk of severe
withdrawal.
new text end

new text begin "2" The client has some difficulty tolerating and coping with withdrawal discomfort.
The client's intoxication may be severe but responds to support and treatment such that the
client does not immediately endanger self or others. The client displays moderate signs and
symptoms of withdrawal with moderate risk of severe withdrawal.
new text end

new text begin "3" The client tolerates and copes with withdrawal discomfort poorly. The client has
severe intoxication, such that the client endangers self or others, or intoxication has not
abated with less intensive services. The client displays severe signs and symptoms of
withdrawal, has a risk of severe but manageable withdrawal, or has worsening withdrawal
despite detoxification at less intensive level.
new text end

new text begin "4" The client is incapacitated with severe signs and symptoms. The client displays
severe withdrawal and is a danger to self or others.
new text end

new text begin (c) Dimension 2: biomedical conditions and complications. The vendor must use the
criteria in Dimension 2 to determine a client's biomedical conditions and complications, the
degree to which any physical disorder of the client would interfere with treatment for
substance use, and the client's ability to tolerate any related discomfort. If the client is
pregnant, the provider must determine the impact of continued substance use on the unborn
child.
new text end

new text begin "0" The client displays full functioning with good ability to cope with physical discomfort.
new text end

new text begin "1" The client tolerates and copes with physical discomfort and is able to get the services
that the client needs.
new text end

new text begin "2" The client has difficulty tolerating and coping with physical problems or has other
biomedical problems that interfere with recovery and treatment. The client neglects or does
not seek care for serious biomedical problems.
new text end

new text begin "3" The client tolerates and copes poorly with physical problems or has poor general
health. The client neglects the client's medical problems without active assistance.
new text end

new text begin "4" The client is unable to participate in substance use disorder treatment and has severe
medical problems, a condition that requires immediate intervention, or is incapacitated.
new text end

new text begin (d) Dimension 3: Emotional, behavioral, and cognitive conditions and complications.
The vendor must use the criteria in Dimension 3 to determine a client's: emotional, behavioral,
and cognitive conditions and complications; the degree to which any condition or
complication is likely to interfere with treatment for substance use or with functioning in
significant life areas; and the likelihood of harm to self or others.
new text end

new text begin "0" The client has good impulse control and coping skills and presents no risk of harm
to self or others. The client functions in all life areas and displays no emotional, behavioral,
or cognitive problems or the problems are stable.
new text end

new text begin "1" The client has impulse control and coping skills. The client presents a mild to
moderate risk of harm to self or others or displays symptoms of emotional, behavioral, or
cognitive problems. The client has a mental health diagnosis and is stable. The client
functions adequately in significant life areas.
new text end

new text begin "2" The client has difficulty with impulse control and lacks coping skills. The client has
thoughts of suicide or harm to others without means; however, the thoughts may interfere
with participation in some activities. The client has difficulty functioning in significant life
areas. The client has moderate symptoms of emotional, behavioral, or cognitive problems.
The client is able to participate in most treatment activities.
new text end

new text begin "3" The client has a severe lack of impulse control and coping skills. The client also has
frequent thoughts of suicide or harm to others including a plan and the means to carry out
the plan. In addition, the client is severely impaired in significant life areas and has severe
symptoms of emotional, behavioral, or cognitive problems that interfere with the client's
participation in treatment activities.
new text end

new text begin "4" The client has severe emotional or behavioral symptoms that place the client or
others at acute risk of harm. The client also has intrusive thoughts of harming self or others.
The client is unable to participate in treatment activities.
new text end

new text begin (e) Dimension 4: Readiness for change. The vendor must use the criteria in Dimension
4 to determine a client's readiness for change and the support necessary to keep the client
involved in treatment services.
new text end

new text begin "0" The client is cooperative, motivated, ready to change, admits problems, committed
to change, and engaged in treatment as a responsible participant.
new text end

new text begin "1" The client is motivated with active reinforcement to explore treatment and strategies
for change but ambivalent about illness or need for change.
new text end

new text begin "2" The client displays verbal compliance, but lacks consistent behaviors; has low
motivation for change; and is passively involved in treatment.
new text end

new text begin "3" The client displays inconsistent compliance, minimal awareness of either the client's
addiction or mental disorder, and is minimally cooperative.
new text end

new text begin "4" The client is:
new text end

new text begin (i) noncompliant with treatment and has no awareness of addiction or mental disorder
and does not want or is unwilling to explore change or is in total denial of the client's illness
and its implications; or
new text end

new text begin (ii) the client is dangerously oppositional to the extent that the client is a threat of
imminent harm to self and others.
new text end

new text begin (f) Dimension 5: Relapse, continued use, and continued problem potential. The vendor
must use the criteria in Dimension 5 to determine a client's relapse, continued use, and
continued problem potential and the degree to which the client recognizes relapse issues
and has the skills to prevent relapse of either substance use or mental health problems.
new text end

new text begin "0" The client recognizes risk well and is able to manage potential problems.
new text end

new text begin "1" The client recognizes relapse issues and prevention strategies but displays some
vulnerability for further substance use or mental health problems.
new text end

new text begin "2" The client has:
new text end

new text begin (i) minimal recognition and understanding of relapse and recidivism issues and displays
moderate vulnerability for further substance use or mental health problems; or
new text end

new text begin (ii) some coping skills inconsistently applied.
new text end

new text begin "3" The client has poor recognition and understanding of relapse and recidivism issues
and displays moderately high vulnerability for further substance use or mental health
problems. The client has few coping skills and rarely applies coping skills.
new text end

new text begin "4" The client has no coping skills to arrest mental health or addiction illnesses or prevent
relapse. The client has no recognition or understanding of relapse and recidivism issues and
displays high vulnerability for further substance use disorder or mental health problems.
new text end

new text begin (g) Dimension 6: Recovery environment. The vendor must use the criteria in Dimension
6 to determine a client's recovery environment, whether the areas of the client's life are
supportive of or antagonistic to treatment participation and recovery.
new text end

new text begin "0" The client is engaged in structured meaningful activity and has a supportive significant
other, family, and living environment.
new text end

new text begin "1" The client has passive social network support, or family and significant other are
not interested in the client's recovery. The client is engaged in structured meaningful activity.
new text end

new text begin "2" The client is engaged in structured, meaningful activity, but peers, family, significant
other, and living environment are unsupportive, or there is criminal justice involvement by
the client or among the client's peers, significant other, or in the client's living environment.
new text end

new text begin "3" The client is not engaged in structured meaningful activity and the client's peers,
family, significant other, and living environment are unsupportive, or there is significant
criminal justice system involvement.
new text end

new text begin "4" The client has:
new text end

new text begin (i) a chronically antagonistic significant other, living environment, family, peer group,
or long-term criminal justice involvement that is harmful to recovery or treatment progress;
or
new text end

new text begin (ii) the client has an actively antagonistic significant other, family, work, or living
environment that poses an immediate threat to the client's safety and well-being.
new text end

Sec. 33.

Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision
to read:

new text begin Subd. 5. new text end

new text begin Local agency responsibility to provide services. new text end

new text begin The local agency may employ
individuals to conduct administrative activities and facilitate access to substance use disorder
treatment services.
new text end

Sec. 34.

Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision
to read:

new text begin Subd. 6. new text end

new text begin Local agency to determine client financial eligibility. new text end

new text begin (a) The local agency
shall determine a client's financial eligibility for the behavioral health fund according to
section 254B.04, subdivision 1a, with the income calculated prospectively for one year from
the date of comprehensive assessment. The local agency shall pay for eligible clients
according to chapter 256G. The local agency shall enter the financial eligibility span within
ten calendar days of request. Client eligibility must be determined using forms prescribed
by the department. To determine a client's eligibility, the local agency must determine the
client's income, the size of the client's household, the availability of a third-party payment
source, and a responsible relative's ability to pay for the client's substance use disorder
treatment.
new text end

new text begin (b) A client who is a minor child must not be deemed to have income available to pay
for substance use disorder treatment, unless the minor child is responsible for payment under
section 144.347 for substance use disorder treatment services sought under section 144.343,
subdivision 1.
new text end

new text begin (c) The local agency must determine the client's household size as follows:
new text end

new text begin (1) if the client is a minor child, the household size includes the following persons living
in the same dwelling unit:
new text end

new text begin (i) the client;
new text end

new text begin (ii) the client's birth or adoptive parents; and
new text end

new text begin (iii) the client's siblings who are minors; and
new text end

new text begin (2) if the client is an adult, the household size includes the following persons living in
the same dwelling unit:
new text end

new text begin (i) the client;
new text end

new text begin (ii) the client's spouse;
new text end

new text begin (iii) the client's minor children; and
new text end

new text begin (iv) the client's spouse's minor children.
new text end

new text begin For purposes of this paragraph, household size includes a person listed in clauses (1) and
(2) who is in an out-of-home placement if a person listed in clause (1) or (2) is contributing
to the cost of care of the person in out-of-home placement.
new text end

new text begin (d) The local agency must determine the client's current prepaid health plan enrollment,
the availability of a third-party payment source, including the availability of total payment,
partial payment, and amount of co-payment.
new text end

new text begin (e) The local agency must provide the required eligibility information to the department
in the manner specified by the department.
new text end

new text begin (f) The local agency shall require the client and policyholder to conditionally assign to
the department the client and policyholder's rights and the rights of minor children to benefits
or services provided to the client if the department is required to collect from a third-party
pay source.
new text end

new text begin (g) The local agency must redetermine a client's eligibility for the behavioral health fund
every 12 months.
new text end

new text begin (h) A client, responsible relative, and policyholder must provide income or wage
verification, household size verification, and must make an assignment of third-party payment
rights under paragraph (f). If a client, responsible relative, or policyholder does not comply
with the provisions of this subdivision, the client is ineligible for behavioral health fund
payment for substance use disorder treatment, and the client and responsible relative must
be obligated to pay for the full cost of substance use disorder treatment services provided
to the client.
new text end

Sec. 35.

Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision
to read:

new text begin Subd. 7. new text end

new text begin Client fees. new text end

new text begin A client whose household income is within current household size
and income guidelines for entitled persons as defined in section 254B.04, subdivision 1a,
must pay no fee for care related to substance use disorder, including drug screens.
new text end

Sec. 36.

Minnesota Statutes 2022, section 254B.04, is amended by adding a subdivision
to read:

new text begin Subd. 8. new text end

new text begin Vendor must participate in DAANES system. new text end

new text begin To be eligible for payment
under the behavioral health fund, a vendor must participate in the Drug and Alcohol Abuse
Normative Evaluation System (DAANES) or submit to the commissioner the information
required in the DAANES in the format specified by the commissioner.
new text end

Sec. 37.

Minnesota Statutes 2022, section 256D.09, subdivision 2a, is amended to read:

Subd. 2a.

Vendor payments for drug dependent persons.

If, at the time of application
or at any other time, there is a reasonable basis for questioning whether a person applying
for or receiving financial assistance is drug dependent, as defined in section 254A.02,
subdivision 5, the person shall be referred for a chemical health assessment, and only
emergency assistance payments or general assistance vendor payments may be provided
until the assessment is complete and the results of the assessment made available to the
county agency. A reasonable basis for referring an individual for an assessment exists when:

(1) the person has required detoxification two or more times in the past 12 months;

(2) the person appears intoxicated at the county agency as indicated by two or more of
the following:

(i) the odor of alcohol;

(ii) slurred speech;

(iii) disconjugate gaze;

(iv) impaired balance;

(v) difficulty remaining awake;

(vi) consumption of alcohol;

(vii) responding to sights or sounds that are not actually present;

(viii) extreme restlessness, fast speech, or unusual belligerence;

(3) the person has been involuntarily committed for drug dependency at least once in
the past 12 months; or

(4) the person has received treatment, including domiciliary care, for drug abuse or
dependency at least twice in the past 12 months.

The assessment and determination of drug dependency, if any, must be made by an
assessor qualified under deleted text begin Minnesota Rules, part 9530.6615, subpart 2 deleted text end new text begin section 245G.11,
subdivisions 1 and 5 new text end , to perform an assessment of chemical use. The county shall only
provide emergency general assistance or vendor payments to an otherwise eligible applicant
or recipient who is determined to be drug dependent, except up to 15 percent of the grant
amount the person would otherwise receive may be paid in cash. Notwithstanding subdivision
1, the commissioner of human services shall also require county agencies to provide
assistance only in the form of vendor payments to all eligible recipients who assert substance
use disorder as a basis for eligibility under section 256D.05, subdivision 1, paragraph (a),
clauses (1) and (5).

The determination of drug dependency shall be reviewed at least every 12 months. If
the county determines a recipient is no longer drug dependent, the county may cease vendor
payments and provide the recipient payments in cash.

Sec. 38.

Minnesota Statutes 2022, section 256L.03, subdivision 2, is amended to read:

Subd. 2.

Substance use disorder.

Beginning July 1, 1993, covered health services shall
include individual outpatient treatment of substance use disorder by a qualified health
professional or outpatient program.

Persons who may need substance use disorder services under the provisions of this
chapter deleted text begin shall be assessed by a local agency as defined under section 254B.01 deleted text end new text begin must be
assessed by a qualified professional as defined in section 245G.11, subdivisions 1 and 5 new text end ,
and under the assessment provisions of section 254A.03, subdivision 3. A local agency or
managed care plan under contract with the Department of Human Services must deleted text begin place deleted text end new text begin offer
services to new text end a person in need of substance use disorder services deleted text begin as provided in Minnesota
Rules, parts 9530.6600 to 9530.6655 deleted text end new text begin based on the recommendations of section 245G.05 new text end .
Persons who are recipients of medical benefits under the provisions of this chapter and who
are financially eligible for behavioral health fund services provided under the provisions of
chapter 254B shall receive substance use disorder treatment services under the provisions
of chapter 254B only if:

(1) they have exhausted the substance use disorder benefits offered under this chapter;
or

(2) an assessment indicates that they need a level of care not provided under the provisions
of this chapter.

Recipients of covered health services under the children's health plan, as provided in
Minnesota Statutes 1990, section 256.936, and as amended by Laws 1991, chapter 292,
article 4, section 17, and recipients of covered health services enrolled in the children's
health plan or the MinnesotaCare program after October 1, 1992, pursuant to Laws 1992,
chapter 549, article 4, sections 5 and 17, are eligible to receive substance use disorder
benefits under this subdivision.

Sec. 39.

Minnesota Statutes 2022, section 256L.12, subdivision 8, is amended to read:

Subd. 8.

Substance use disorder assessments.

The managed care plan shall be
responsible for assessing the need and deleted text begin placement for deleted text end new text begin provision of new text end substance use disorder
services according to criteria set forth in deleted text begin Minnesota Rules, parts 9530.6600 to 9530.6655 deleted text end new text begin
section 245G.05 new text end .

Sec. 40.

Minnesota Statutes 2022, section 260B.157, subdivision 1, is amended to read:

Subdivision 1.

Investigation.

Upon request of the court the local social services agency
or probation officer shall investigate the personal and family history and environment of
any minor coming within the jurisdiction of the court under section 260B.101 and shall
report its findings to the court. The court may order any minor coming within its jurisdiction
to be examined by a duly qualified physician, psychiatrist, or psychologist appointed by the
court.

The court shall order a chemical use assessment conducted when a child is (1) found to
be delinquent for violating a provision of chapter 152, or for committing a felony-level
violation of a provision of chapter 609 if the probation officer determines that alcohol or
drug use was a contributing factor in the commission of the offense, or (2) alleged to be
delinquent for violating a provision of chapter 152, if the child is being held in custody
under a detention order. The assessor's qualifications new text begin must comply with section 245G.11,
subdivisions 1 and 5, new text end and the assessment criteria deleted text begin shall deleted text end new text begin must new text end comply with deleted text begin Minnesota Rules,
parts 9530.6600 to 9530.6655 deleted text end new text begin section 245G.05 new text end . If funds under chapter 254B are to be used
to pay for the recommended treatment, the assessment deleted text begin and placement deleted text end must comply with all
provisions of deleted text begin Minnesota Rules, parts 9530.6600 to 9530.6655 and 9530.7000 to 9530.7030 deleted text end new text begin
sections 245G.05 and 254B.04 new text end . The commissioner of human services shall reimburse the
court for the cost of the chemical use assessment, up to a maximum of $100.

The court shall order a children's mental health screening conducted when a child is
found to be delinquent. The screening shall be conducted with a screening instrument
approved by the commissioner of human services and shall be conducted by a mental health
practitioner as defined in section 245.4871, subdivision 26, or a probation officer who is
trained in the use of the screening instrument. If the screening indicates a need for assessment,
the local social services agency, in consultation with the child's family, shall have a diagnostic
assessment conducted, including a functional assessment, as defined in section 245.4871.

With the consent of the commissioner of corrections and agreement of the county to pay
the costs thereof, the court may, by order, place a minor coming within its jurisdiction in
an institution maintained by the commissioner for the detention, diagnosis, custody and
treatment of persons adjudicated to be delinquent, in order that the condition of the minor
be given due consideration in the disposition of the case. Any funds received under the
provisions of this subdivision shall not cancel until the end of the fiscal year immediately
following the fiscal year in which the funds were received. The funds are available for use
by the commissioner of corrections during that period and are hereby appropriated annually
to the commissioner of corrections as reimbursement of the costs of providing these services
to the juvenile courts.

Sec. 41.

Minnesota Statutes 2022, section 260B.157, subdivision 3, is amended to read:

Subd. 3.

Juvenile treatment screening team.

(a) The local social services agency shall
establish a juvenile treatment screening team to conduct screenings and prepare case plans
under this subdivision. The team, which may be the team constituted under section 245.4885
or 256B.092 or deleted text begin Minnesota Rules, parts 9530.6600 to 9530.6655 deleted text end new text begin chapter 254B new text end , shall consist
of social workers, juvenile justice professionals, and persons with expertise in the treatment
of juveniles who are emotionally disabled, chemically dependent, or have a developmental
disability. The team shall involve parents or guardians in the screening process as appropriate.
The team may be the same team as defined in section 260C.157, subdivision 3.

(b) If the court, prior to, or as part of, a final disposition, proposes to place a child:

(1) for the primary purpose of treatment for an emotional disturbance, and residential
placement is consistent with section 260.012, a developmental disability, or chemical
dependency in a residential treatment facility out of state or in one which is within the state
and licensed by the commissioner of human services under chapter 245A; or

(2) in any out-of-home setting potentially exceeding 30 days in duration, including a
post-dispositional placement in a facility licensed by the commissioner of corrections or
human services, the court shall notify the county welfare agency. The county's juvenile
treatment screening team must either:

(i) screen and evaluate the child and file its recommendations with the court within 14
days of receipt of the notice; or

(ii) elect not to screen a given case, and notify the court of that decision within three
working days.

(c) If the screening team has elected to screen and evaluate the child, the child may not
be placed for the primary purpose of treatment for an emotional disturbance, a developmental
disability, or chemical dependency, in a residential treatment facility out of state nor in a
residential treatment facility within the state that is licensed under chapter 245A, unless one
of the following conditions applies:

(1) a treatment professional certifies that an emergency requires the placement of the
child in a facility within the state;

(2) the screening team has evaluated the child and recommended that a residential
placement is necessary to meet the child's treatment needs and the safety needs of the
community, that it is a cost-effective means of meeting the treatment needs, and that it will
be of therapeutic value to the child; or

(3) the court, having reviewed a screening team recommendation against placement,
determines to the contrary that a residential placement is necessary. The court shall state
the reasons for its determination in writing, on the record, and shall respond specifically to
the findings and recommendation of the screening team in explaining why the
recommendation was rejected. The attorney representing the child and the prosecuting
attorney shall be afforded an opportunity to be heard on the matter.

Sec. 42.

Minnesota Statutes 2022, section 260C.157, subdivision 3, is amended to read:

Subd. 3.

Juvenile treatment screening team.

(a) The responsible social services agency
shall establish a juvenile treatment screening team to conduct screenings under this chapter
and chapter 260D, for a child to receive treatment for an emotional disturbance, a
developmental disability, or related condition in a residential treatment facility licensed by
the commissioner of human services under chapter 245A, or licensed or approved by a tribe.
A screening team is not required for a child to be in: (1) a residential facility specializing
in prenatal, postpartum, or parenting support; (2) a facility specializing in high-quality
residential care and supportive services to children and youth who have been or are at risk
of becoming victims of sex trafficking or commercial sexual exploitation; (3) supervised
settings for youth who are 18 years of age or older and living independently; or (4) a licensed
residential family-based treatment facility for substance abuse consistent with section
260C.190. Screenings are also not required when a child must be placed in a facility due to
an emotional crisis or other mental health emergency.

(b) The responsible social services agency shall conduct screenings within 15 days of a
request for a screening, unless the screening is for the purpose of residential treatment and
the child is enrolled in a prepaid health program under section 256B.69, in which case the
agency shall conduct the screening within ten working days of a request. The responsible
social services agency shall convene the juvenile treatment screening team, which may be
constituted under section 245.4885 new text begin , 254B.05, new text end or 256B.092 deleted text begin or Minnesota Rules, parts
9530.6600 to 9530.6655 deleted text end . The team shall consist of social workers; persons with expertise
in the treatment of juveniles who are emotionally disturbed, chemically dependent, or have
a developmental disability; and the child's parent, guardian, or permanent legal custodian.
The team may include the child's relatives as defined in section 260C.007, subdivisions 26b
and 27, the child's foster care provider, and professionals who are a resource to the child's
family such as teachers, medical or mental health providers, and clergy, as appropriate,
consistent with the family and permanency team as defined in section 260C.007, subdivision
16a. Prior to forming the team, the responsible social services agency must consult with the
child's parents, the child if the child is age 14 or older, and, if applicable, the child's tribe
to obtain recommendations regarding which individuals to include on the team and to ensure
that the team is family-centered and will act in the child's best interests. If the child, child's
parents, or legal guardians raise concerns about specific relatives or professionals, the team
should not include those individuals. This provision does not apply to paragraph (c).

(c) If the agency provides notice to tribes under section 260.761, and the child screened
is an Indian child, the responsible social services agency must make a rigorous and concerted
effort to include a designated representative of the Indian child's tribe on the juvenile
treatment screening team, unless the child's tribal authority declines to appoint a
representative. The Indian child's tribe may delegate its authority to represent the child to
any other federally recognized Indian tribe, as defined in section 260.755, subdivision 12.
The provisions of the Indian Child Welfare Act of 1978, United States Code, title 25, sections
1901 to 1963, and the Minnesota Indian Family Preservation Act, sections 260.751 to
260.835, apply to this section.

(d) If the court, prior to, or as part of, a final disposition or other court order, proposes
to place a child with an emotional disturbance or developmental disability or related condition
in residential treatment, the responsible social services agency must conduct a screening.
If the team recommends treating the child in a qualified residential treatment program, the
agency must follow the requirements of sections 260C.70 to 260C.714.

The court shall ascertain whether the child is an Indian child and shall notify the
responsible social services agency and, if the child is an Indian child, shall notify the Indian
child's tribe as paragraph (c) requires.

(e) When the responsible social services agency is responsible for placing and caring
for the child and the screening team recommends placing a child in a qualified residential
treatment program as defined in section 260C.007, subdivision 26d, the agency must: (1)
begin the assessment and processes required in section 260C.704 without delay; and (2)
conduct a relative search according to section 260C.221 to assemble the child's family and
permanency team under section 260C.706. Prior to notifying relatives regarding the family
and permanency team, the responsible social services agency must consult with the child's
parent or legal guardian, the child if the child is age 14 or older, and, if applicable, the child's
tribe to ensure that the agency is providing notice to individuals who will act in the child's
best interests. The child and the child's parents may identify a culturally competent qualified
individual to complete the child's assessment. The agency shall make efforts to refer the
assessment to the identified qualified individual. The assessment may not be delayed for
the purpose of having the assessment completed by a specific qualified individual.

(f) When a screening team determines that a child does not need treatment in a qualified
residential treatment program, the screening team must:

(1) document the services and supports that will prevent the child's foster care placement
and will support the child remaining at home;

(2) document the services and supports that the agency will arrange to place the child
in a family foster home; or

(3) document the services and supports that the agency has provided in any other setting.

(g) When the Indian child's tribe or tribal health care services provider or Indian Health
Services provider proposes to place a child for the primary purpose of treatment for an
emotional disturbance, a developmental disability, or co-occurring emotional disturbance
and chemical dependency, the Indian child's tribe or the tribe delegated by the child's tribe
shall submit necessary documentation to the county juvenile treatment screening team,
which must invite the Indian child's tribe to designate a representative to the screening team.

(h) The responsible social services agency must conduct and document the screening in
a format approved by the commissioner of human services.

Sec. 43.

Minnesota Statutes 2022, section 260E.20, subdivision 1, is amended to read:

Subdivision 1.

General duties.

(a) The local welfare agency shall offer services to
prevent future maltreatment, safeguarding and enhancing the welfare of the maltreated child,
and supporting and preserving family life whenever possible.

(b) If the report alleges a violation of a criminal statute involving maltreatment or child
endangerment under section 609.378, the local law enforcement agency and local welfare
agency shall coordinate the planning and execution of their respective investigation and
assessment efforts to avoid a duplication of fact-finding efforts and multiple interviews.
Each agency shall prepare a separate report of the results of the agency's investigation or
assessment.

(c) In cases of alleged child maltreatment resulting in death, the local agency may rely
on the fact-finding efforts of a law enforcement investigation to make a determination of
whether or not maltreatment occurred.

(d) When necessary, the local welfare agency shall seek authority to remove the child
from the custody of a parent, guardian, or adult with whom the child is living.

(e) In performing any of these duties, the local welfare agency shall maintain an
appropriate record.

(f) In conducting a family assessment or investigation, the local welfare agency shall
gather information on the existence of substance abuse and domestic violence.

(g) If the family assessment or investigation indicates there is a potential for abuse of
alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
the local welfare agency deleted text begin shall conduct deleted text end new text begin must coordinate new text end a deleted text begin chemical use deleted text end new text begin comprehensive new text end
assessment pursuant to deleted text begin Minnesota Rules, part 9530.6615 deleted text end new text begin section 245G.05 new text end .

(h) The agency may use either a family assessment or investigation to determine whether
the child is safe when responding to a report resulting from birth match data under section
260E.03, subdivision 23, paragraph (c). If the child subject of birth match data is determined
to be safe, the agency shall consult with the county attorney to determine the appropriateness
of filing a petition alleging the child is in need of protection or services under section
260C.007, subdivision 6, clause (16), in order to deliver needed services. If the child is
determined not to be safe, the agency and the county attorney shall take appropriate action
as required under section 260C.503, subdivision 2.

Sec. 44.

Minnesota Statutes 2022, section 299A.299, subdivision 1, is amended to read:

Subdivision 1.

Establishment of team.

A county, a multicounty organization of counties
formed by an agreement under section 471.59, or a city with a population of no more than
50,000, may establish a multidisciplinary chemical abuse prevention team. The chemical
abuse prevention team may include, but not be limited to, representatives of health, mental
health, public health, law enforcement, educational, social service, court service, community
education, religious, and other appropriate agencies, and parent and youth groups. For
purposes of this section, "chemical abuse" has the meaning given in deleted text begin Minnesota Rules, part
9530.6605, subpart 6 deleted text end new text begin section 254A.02, subdivision 6a new text end . When possible the team must
coordinate its activities with existing local groups, organizations, and teams dealing with
the same issues the team is addressing.

Sec. 45.

Laws 2021, First Special Session chapter 7, article 17, section 20, is amended to
read:

Sec. 20. HCBS WORKFORCE DEVELOPMENT GRANT.

new text begin Subdivision 1. new text end

new text begin Appropriation. new text end

(a) This act includes $0 in fiscal year 2022 and $5,588,000
in fiscal year 2023 to address challenges related to attracting and maintaining direct care
workers who provide home and community-based services for people with disabilities and
older adults. The general fund base included in this act for this purpose is $5,588,000 in
fiscal year 2024 and $0 in fiscal year 2025.

(b) At least 90 percent of funding for this provision must be directed to workers who
earn deleted text begin 200 deleted text end new text begin 300 new text end percent or less of the most current federal poverty level issued by the United
States Department of Health and Human Services.

(c) The commissioner must consult with stakeholders to finalize a report detailing the
final plan for use of the funds. The commissioner must publish the report by March 1, 2022,
and notify the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services policy and finance.

new text begin Subd. 2. new text end

new text begin Public assistance eligibility. new text end

new text begin Notwithstanding any law to the contrary, workforce
development grant money received under this section is not income, assets, or personal
property for purposes of determining eligibility or recertifying eligibility for:
new text end

new text begin (1) child care assistance programs under Minnesota Statutes, chapter 119B;
new text end

new text begin (2) general assistance, Minnesota supplemental aid, and food support under Minnesota
Statutes, chapter 256D;
new text end

new text begin (3) housing support under Minnesota Statutes, chapter 256I;
new text end

new text begin (4) Minnesota family investment program and diversionary work program under
Minnesota Statutes, chapter 256J; and
new text end

new text begin (5) economic assistance programs under Minnesota Statutes, chapter 256P.
new text end

new text begin Subd. 3. new text end

new text begin Medical assistance eligibility. new text end

new text begin Notwithstanding any law to the contrary,
workforce development grant money received under this section is not income or assets for
the purposes of determining eligibility for medical assistance under Minnesota Statutes,
section 256B.056, subdivision 1a, paragraph (a); 3; or 3c; or 256B.057, subdivision 3, 3a,
or 3b.
new text end

Sec. 46. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall renumber the subdivisions in Minnesota Statutes, section
254B.01, in alphabetical order and correct any cross-reference changes that result.
new text end

Sec. 47. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2022, sections 169A.70, subdivision 6; 245G.22, subdivision 19;
254A.02, subdivision 8a; 254A.16, subdivision 6; 254A.19, subdivisions 1a, 2, and 5;
254B.04, subdivisions 2b and 2c; and 254B.041, subdivision 2, new text end new text begin are repealed.
new text end

APPENDIX

Repealed Minnesota Statutes: S1692-1

169A.70 ALCOHOL SAFETY PROGRAMS; CHEMICAL USE ASSESSMENTS.

Subd. 6.

Method of assessment.

(a) As used in this subdivision, "collateral contact" means an oral or written communication initiated by an assessor for the purpose of gathering information from an individual or agency, other than the offender, to verify or supplement information provided by the offender during an assessment under this section. The term includes contacts with family members and criminal justice agencies.

(b) An assessment conducted under this section must include at least one personal interview with the offender designed to make a determination about the extent of the offender's past and present chemical and alcohol use or abuse. It must also include collateral contacts and a review of relevant records or reports regarding the offender including, but not limited to, police reports, arrest reports, driving records, chemical testing records, and test refusal records. If the offender has a probation officer, the officer must be the subject of a collateral contact under this subdivision. If an assessor is unable to make collateral contacts, the assessor shall specify why collateral contacts were not made.

245G.22 OPIOID TREATMENT PROGRAMS.

Subd. 19.

Placing authorities.

A program must provide certain notification and client-specific updates to placing authorities for a client who is enrolled in Minnesota health care programs. At the request of the placing authority, the program must provide client-specific updates, including but not limited to informing the placing authority of positive drug testings and changes in medications used for the treatment of opioid use disorder ordered for the client.

254A.02 DEFINITIONS.

Subd. 8a.

Placing authority.

"Placing authority" means a county, prepaid health plan, or tribal governing board governed by Minnesota Rules, parts 9530.6600 to 9530.6655.

254A.16 RESPONSIBILITIES OF THE COMMISSIONER.

Subd. 6.

Monitoring.

The commissioner shall gather and placing authorities shall provide information to measure compliance with Minnesota Rules, parts 9530.6600 to 9530.6655. The commissioner shall specify the format for data collection to facilitate tracking, aggregating, and using the information.

254A.19 CHEMICAL USE ASSESSMENTS.

Subd. 1a.

Emergency room patients.

A county may enter into a contract with a hospital to provide chemical use assessments under Minnesota Rules, parts 9530.6600 to 9530.6655, for patients admitted to an emergency room or inpatient hospital when:

(1) an assessor is not available; and

(2) detoxification services in the county are at full capacity.

Subd. 2.

Probation officer as contact.

When a chemical use assessment is required under Minnesota Rules, parts 9530.6600 to 9530.6655, for a person who is on probation or under other correctional supervision, the assessor, either orally or in writing, shall contact the person's probation officer to verify or supplement the information provided by the person.

Subd. 5.

Assessment via telehealth.

Notwithstanding Minnesota Rules, part 9530.6615, subpart 3, item A, a chemical use assessment may be conducted via telehealth as defined in section 256B.0625, subdivision 3b.

254B.04 ELIGIBILITY FOR BEHAVIORAL HEALTH FUND SERVICES.

Subd. 2b.

Eligibility for placement in opioid treatment programs.

Prior to placement of an individual who is determined by the assessor to require treatment for opioid addiction, the assessor must provide educational information concerning treatment options for opioid addiction, including the use of a medication for the use of opioid addiction. The commissioner shall develop educational materials supported by research and updated periodically that must be used by assessors to comply with this requirement.

Subd. 2c.

Eligibility to receive peer recovery support and treatment service coordination.

Notwithstanding Minnesota Rules, part 9530.6620, subpart 6, a placing authority may authorize peer recovery support and treatment service coordination for a person who scores a severity of one or more in dimension 4, 5, or 6, under Minnesota Rules, part 9530.6622. Authorization for peer recovery support and treatment service coordination under this subdivision does not need to be provided in conjunction with treatment services under Minnesota Rules, part 9530.6622, subpart 4, 5, or 6.

254B.041 SUBSTANCE USE DISORDER RULES.

Subd. 2.

Vendor collections; rule amendment.

The commissioner may amend Minnesota Rules, parts 9530.7000 to 9530.7025, to require a vendor of substance use disorder transitional and extended care rehabilitation services to collect the cost of care received under a program from an eligible person who has been determined to be partially responsible for treatment costs, and to remit the collections to the commissioner. The commissioner shall pay to a vendor, for the collections, an amount equal to five percent of the collections remitted to the commissioner by the vendor.