ARTICLE 1

WORKFORCE

252.44 LEAD AGENCY BOARD RESPONSIBILITIES.

new text begin [252.54] STATEWIDE DISABILITY EMPLOYMENT TECHNICAL
ASSISTANCE CENTER.
new text end

new text begin [252.55] LEAD AGENCY EMPLOYMENT FIRST CAPACITY BUILDING
GRANTS.
new text end

new text begin [256.4761] PROVIDER CAPACITY GRANTS FOR RURAL AND
UNDERSERVED COMMUNITIES.
new text end

new text begin [256.4762] SUPPORTING NEW AMERICANS IN THE LONG-TERM CARE
WORKFORCE GRANTS.
new text end

new text begin [256B.4906] SUBMINIMUM WAGES IN HOME AND
COMMUNITY-BASED SERVICES PROHIBITION; REQUIREMENTS.
new text end

256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.

256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING
FACILITIES.

new text begin [256S.206] ASSISTED LIVING FACILITY CLOSURE PAYMENTS.
new text end

256S.21 RATE SETTING; APPLICATIONnew text begin ; EVALUATIONnew text end .

256S.2101 RATE SETTING; PHASE-IN.

256S.212 RATE SETTING; BASE WAGE INDEX.

256S.213 RATE SETTING; FACTORS.

256S.214 RATE SETTING; ADJUSTED BASE WAGE.

ARTICLE 2

AGING AND DISABILITY SERVICES

256M.42 ADULT PROTECTION GRANT ALLOCATIONS.

ARTICLE 3

BEHAVIORAL HEALTH

new text begin [254B.17] SUBSTANCE USE DISORDER INFRASTRUCTURE AND
CAPACITY-BUILDING GRANTS.
new text end

new text begin [254B.18] SOBER HOMES.
new text end

new text begin [254B.19] AMERICAN SOCIETY OF ADDICTION MEDICINE
STANDARDS OF CARE.
new text end

ARTICLE 4

DEPARTMENT OF DIRECT CARE AND TREATMENT

15.01 DEPARTMENTS OF THE STATE.

new text begin [246C.01] TITLE.
new text end

new text begin [246C.02] DEPARTMENT OF DIRECT CARE AND TREATMENT;
ESTABLISHMENT.
new text end

new text begin [246C.03] TRANSITION OF AUTHORITY; DEVELOPMENT OF A BOARD.
new text end

new text begin [246C.04] TRANSFER OF DUTIES.
new text end

new text begin [246C.05] SUCCESSOR AND EMPLOYEE PROTECTION CLAUSE.
new text end

ARTICLE 5

FORECAST ADJUSTMENTS

ARTICLE 6

APPROPRIATIONS

245G.06 INDIVIDUAL TREATMENT PLAN.

245G.11 STAFF QUALIFICATIONS.

256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING.

256S.19 MONTHLY CASE MIX BUDGET CAPS; NURSING FACILITY RESIDENTS.

SF 2934

ARTICLE 1

WORKFORCE

252.44 LEAD AGENCY BOARD RESPONSIBILITIES.

new text begin [252.54] STATEWIDE DISABILITY EMPLOYMENT TECHNICAL ASSISTANCE CENTER. new text end

new text begin [252.55] LEAD AGENCY EMPLOYMENT FIRST CAPACITY BUILDING GRANTS. new text end

new text begin [256.4761] PROVIDER CAPACITY GRANTS FOR RURAL AND UNDERSERVED COMMUNITIES. new text end

new text begin [256.4762] SUPPORTING NEW AMERICANS IN THE LONG-TERM CARE WORKFORCE GRANTS. new text end

new text begin [256B.4906] SUBMINIMUM WAGES IN HOME AND COMMUNITY-BASED SERVICES PROHIBITION; REQUIREMENTS. new text end

new text begin [252.54] STATEWIDE DISABILITY EMPLOYMENT TECHNICAL
ASSISTANCE CENTER.
new text end

new text begin [252.55] LEAD AGENCY EMPLOYMENT FIRST CAPACITY BUILDING
GRANTS.
new text end

new text begin [256.4761] PROVIDER CAPACITY GRANTS FOR RURAL AND
UNDERSERVED COMMUNITIES.
new text end

new text begin [256.4762] SUPPORTING NEW AMERICANS IN THE LONG-TERM CARE
WORKFORCE GRANTS.
new text end

new text begin [256B.4906] SUBMINIMUM WAGES IN HOME AND
COMMUNITY-BASED SERVICES PROHIBITION; REQUIREMENTS.
new text end

256R.47 RATE ADJUSTMENT FOR CRITICAL ACCESS NURSING
FACILITIES.

Section 1.

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Sec. 2.

Subdivision 1.

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Sec. 3.

Sec. 4.

Sec. 5.

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Sec. 6.

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new text begin Subd. 2. new text end

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Sec. 7.

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new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 8.

Subd. 13.

Sec. 9.

Subd. 4.

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Sec. 10.

Subd. 5.

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Sec. 11.

Subd. 1a.

Sec. 12.

Subd. 15.

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Sec. 13.

Subd. 13.

Sec. 14.

Subd. 4a.

Sec. 15.

Subd. 5a.

Sec. 16.

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new text begin Subd. 2. new text end

Sec. 17.

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Sec. 18.

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Sec. 19.

Subd. 3.

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Sec. 20.

Subd. 5.

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Sec. 21.

Subd. 5a.

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Sec. 22.

Subd. 5b.

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Sec. 23.

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Sec. 24.

Subd. 6.

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Sec. 25.

Subd. 8.

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Sec. 26.

Subd. 9.

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Sec. 27.

Subd. 9a.

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Sec. 28.

Subd. 14.

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Sec. 29.

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Sec. 30.

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Sec. 31.

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Sec. 32.

Subd. 5.

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Sec. 33.

Subd. 6.

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Sec. 34.

Subdivision 1.

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Sec. 35.

Sec. 36.

Sec. 37.

Subd. 2.

Sec. 38.

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Sec. 39.

Subd. 3.

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Sec. 40.

Subdivision 1.

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Sec. 41.

Subd. 2.

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Sec. 42.

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Sec. 43.

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Sec. 44.

Subdivision 1.

Subd. 2.

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Sec. 45.

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Sec. 46.

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Sec. 47.

Subdivision 1.

Subd. 2.

Subd. 3.

Subd. 4.

Subd. 5.

Subd. 6.

Subd. 7.

Subd. 8.

Subd. 9.

Subd. 10.

Subd. 11.

Subd. 12.

Subd. 13.

Subd. 14.

Subd. 15.

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Sec. 48.

Subdivision 1.

Subd. 2.

Subd. 3.

Subd. 4.

Subd. 5.

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new text begin Subd. 8. new text end

new text begin Subd. 9. new text end

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Sec. 49.

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Sec. 50.

Subd. 2.

Sec. 51.

Subd. 3.

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Sec. 52.

Subd. 4.

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Sec. 53.

Subd. 7.

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Sec. 54.

Subd. 8.

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Sec. 55.

Subd. 9.

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Sec. 56.

Subd. 10.

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Sec. 57.

Subd. 11.

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Sec. 58.

Subd. 12.

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Sec. 59.

Subd. 13.

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Sec. 60.

Subd. 14.

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Sec. 61.

Subd. 15.

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Sec. 62.

Subd. 16.

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Sec. 63.

Subd. 17.

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Sec. 64.

Subdivision 1.

Sec. 65.

Sec. 5. GOVERNOR'S COUNCIL ON AN AGE-FRIENDLY MINNESOTA.

Sec. 66.

Sec. 8. AGE-FRIENDLY MINNESOTA.

Subdivision 1.

Subd. 2.

Sec. 67.

Sec. 16. RESEARCH ON ACCESS TO LONG-TERM CARE SERVICES AND
FINANCING.

Sec. 68. new text begin EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL
INTERVENTION LICENSURE STUDY.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 69. new text begin STUDY TO EXPAND ACCESS TO SERVICES FOR PEOPLE WITH
CO-OCCURRING BEHAVIORAL HEALTH CONDITIONS AND DISABILITIES.
new text end

Sec. 70. new text begin SELF-DIRECTED WORKER CONTRACT RATIFICATION.
new text end

Sec. 71. new text begin SPECIALIZED EQUIPMENT AND SUPPLIES LIMIT INCREASE.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 72. new text begin TEMPORARY GRANT FOR SMALL CUSTOMIZED LIVING
PROVIDERS.
new text end

Sec. 73. new text begin INTERAGENCY EMPLOYMENT SUPPORTS ALIGNMENT STUDY.
new text end

Sec. 74. new text begin MONITORING EMPLOYMENT OUTCOMES.
new text end

Sec. 75. new text begin PHASE-OUT OF THE USE OF SUBMINIMUM WAGE FOR MEDICAL
ASSISTANCE DISABILITY SERVICES.
new text end

Sec. 76. new text begin STUDY ON PRESUMPTIVE ELIGIBILITY FOR LONG-TERM SERVICES
AND SUPPORTS.
new text end

Sec. 77. new text begin REPEALER.
new text end

new text begin EFFECTIVE DATE. new text end

Section 1.

Subd. 3.

Sec. 2.

Subd. 3.

new text begin EFFECTIVE DATE. new text end

Sec. 3.

Subd. 9.

new text begin EFFECTIVE DATE. new text end

Sec. 4.

Subd. 17.

new text begin EFFECTIVE DATE. new text end

Sec. 5.

Subd. 17b.

Sec. 6.

Subd. 18a.

new text begin EFFECTIVE DATE. new text end

Sec. 7.

Subd. 18h.

new text begin EFFECTIVE DATE. new text end

Sec. 8.

Subdivision 1.

Subd. 2.

Subd. 3.

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Sec. 9.

Subd. 2.

Section 1.

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Sec. 2.

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Sec. 3.

Subdivision 1.

Sec. 4.

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Sec. 5.

Subdivision 1.

Sec. 6.

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Sec. 7.

Subd. 3.

Sec. 8.

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Sec. 9.

Subd. 2.

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Sec. 10.

Subd. 15.

Sec. 11.

Subd. 10.

Sec. 12.

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Sec. 13.

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Sec. 14.

Subd. 6.

Sec. 15.

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Sec. 16.

Subd. 8.

Sec. 17.

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Sec. 18.

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Sec. 19.

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Sec. 20.

Subdivision 1.

Sec. 21.

Subd. 1a.

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Sec. 22.

Subd. 5.

Sec. 23.

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new text begin Subd. 2. new text end

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Sec. 24.

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new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

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Sec. 25.

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new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 26.

Subd. 2.

Sec. 27.

Subd. 4.

Sec. 28.

Subd. 3.

Sec. 29.

Subd. 2.

new text begin EFFECTIVE DATE. new text end

Sec. 30.

Subdivision 1.

Sec. 31.

Subd. 5.

Sec. 32.

Subd. 2.

Sec. 33. new text begin RATE INCREASE FOR MENTAL HEALTH ADULT DAY TREATMENT.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 34. new text begin ROOM AND BOARD COSTS IN CHILDREN'S RESIDENTIAL
FACILITIES.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 35. new text begin REVISED PAYMENT METHODOLOGY FOR OPIOID TREATMENT
PROGRAMS.
new text end

new text begin EFFECTIVE DATE. new text end

Sec. 36. new text begin STUDY ON MEDICAL ASSISTANCE TRADITIONAL HEALING
BEHAVIORAL HEALTH SERVICES IN CORRECTIONAL FACILITIES AND
CONTINGENCY MANAGEMENT.
new text end

Sec. 37. new text begin REVISOR INSTRUCTION.
new text end

Sec. 38. new text begin REPEALER.
new text end

Section 1.

new text begin EFFECTIVE DATE. new text end

Sec. 2.

Subdivision 1.

new text begin EFFECTIVE DATE. new text end

Sec. 3.

Subd. 1a.

new text begin EFFECTIVE DATE. new text end

Sec. 4.

Sec. 5.

new text begin EFFECTIVE DATE. new text end

Sec. 6.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin EFFECTIVE DATE. new text end

Sec. 7.

Sec. 8.

Sec. 9. new text begin REVISOR INSTRUCTION.
new text end

new text begin EFFECTIVE DATE. new text end

Section 1. new text begin DEPARTMENT OF HUMAN SERVICES FORECAST ADJUSTMENT.
new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

Sec. 3. new text begin EFFECTIVE DATE.
new text end

Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.
new text end

Sec. 2. new text begin COMMISSIONER OF HUMAN
SERVICES
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

new text begin Subd. 5. new text end

new text begin Subd. 6. new text end

new text begin Subd. 7. new text end

new text begin Subd. 8. new text end

new text begin Subd. 9. new text end

new text begin Subd. 10. new text end

new text begin Subd. 11. new text end

new text begin Subd. 12. new text end

new text begin Subd. 13. new text end

new text begin Subd. 14. new text end

new text begin Subd. 15. new text end

new text begin Subd. 16. new text end

new text begin Subd. 17. new text end

new text begin Subd. 18. new text end

new text begin Subd. 19. new text end

new text begin Subd. 20. new text end

new text begin Subd. 21. new text end

Sec. 3. new text begin TRANSFERS.
new text end

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

APPENDIX

Subd. 2.

Subd. 8.

Subd. 6b.

Subd. 4.

Bill Text Versions

Section 1.

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Sec. 2.

Subdivision 1.

new text begin EFFECTIVE DATE. new text end

Sec. 3.

Sec. 4.

Sec. 5.

new text begin EFFECTIVE DATE. new text end

Sec. 6.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

Sec. 7.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

new text begin Subd. 3. new text end

new text begin Subd. 4. new text end

Sec. 8.

Subd. 13.

Sec. 9.

Subd. 4.

new text begin EFFECTIVE DATE. new text end

Sec. 10.

Subd. 5.

new text begin EFFECTIVE DATE. new text end

Sec. 11.

Subd. 1a.

Sec. 12.

Subd. 15.

new text begin EFFECTIVE DATE. new text end

Sec. 13.

Subd. 13.

Sec. 14.

Subd. 4a.

Sec. 15.

Subd. 5a.

Sec. 16.

new text begin Subdivision 1. new text end

new text begin Subd. 2. new text end

Sec. 17.

new text begin Subd. 1b. new text end

Sec. 18.

new text begin Subd. 1c. new text end

Sec. 19.

Subd. 3.

new text begin EFFECTIVE DATE. new text end

Sec. 20.

new text begin Special certificate prohibition. new text end

Applicability.

new text begin Establishment and authority. new text end

new text begin Eligibility. new text end

new text begin Allowable grant activities. new text end

new text begin Definition. new text end

new text begin Grant program established. new text end

new text begin Eligibility. new text end

new text begin Allowable grant activities. new text end

MnCHOICES assessor qualifications, training, and certification.

Eligibility for funding for services for nonmedical assistance recipients.

Services covered under alternative care.

Case management services.

EIDBI provider qualifications.

Case management.

Informed choice in employment policy.

Employment first implementation for disability waiver services.

new text begin Subminimum wage outcome reporting. new text end

new text begin Prohibition of subminimum wages. new text end

new text begin Direct support worker annual labor market survey. new text end

new text begin Annual labor market report. new text end

Applicable services.

Base wage index; establishment and updates.

Base wage index; calculations.

Standard component value adjustments.

new text begin Competitive workforce factor updates and adjustments. new text end

Residential support services; generally.

Unit-based services with programming; component values and calculation
of payment rates.

Unit-based services without programming; component values and
calculation of payment rates.

Respite services; component values and calculation of payment rates.

Exceptions.

new text begin Payments for family residential and life sharing services. new text end

new text begin ICF/DD rate transition. new text end

new text begin Services provided by parents and spouses. new text end

Payment rates; component values.

Payment rates; rate determination.

Persons entitled to receive aid.

Foster care limit.

new text begin Monthly case mix budget caps for consumer-directed community
supports. new text end

Calculation of monthly conversion budget deleted text begin cap without consumer-directed
community supportsdeleted text end new text begin capsnew text end .

Capitation payments.

Reimbursement rates.

new text begin Assisted living facility closure payments provided. new text end

new text begin Definitions. new text end

new text begin Application. new text end

new text begin Issuing closure payments. new text end

new text begin Interagency coordination. new text end

new text begin Application of rate setting. new text end

new text begin Evaluation of rate setting. new text end

Phase-in for disability waiver customized living rates.

Phase-in for elderly waiver rates.

new text begin Spending requirements. new text end

new text begin Updating services rates. new text end

new text begin Updating home-delivered meals rate. new text end

Updating SOC codes.

Home management and support services base wage.

Home care aide base wage.

Home health aide base wage.

Medication setups by licensed nurse base wage.

Chore services base wage.

Companion services base wage.

Homemaker deleted text begin services anddeleted text end assistance with personal care base wage.

Homemaker deleted text begin services anddeleted text end cleaning base wage.

Homemaker deleted text begin services anddeleted text end home management base wage.

In-home respite care services base wage.

Out-of-home respite care services base wage.

Individual community living support base wage.

Registered nurse base wage.

deleted text begin Social workerdeleted text end new text begin Unlicensed supervisornew text end base wage.

new text begin Adult day services base wage. new text end

Payroll taxes and benefits factor.

General and administrative factor.

Program plan support factor.

Registered nurse management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end .

deleted text begin Social workerdeleted text end new text begin Unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage
componentnew text end .

new text begin Facility and equipment factor. new text end

new text begin Food, supplies, and transportation factor. new text end

new text begin Supplies and transportation factor. new text end

new text begin Absence factor. new text end

Home management and support services component rate.

Home care aide services component rate.

Home health aide services component rate.

Chore services rate.

Companion services rate.

Homemaker deleted text begin services anddeleted text end assistance with personal care rate.

Homemaker deleted text begin services anddeleted text end cleaning rate.

Homemaker deleted text begin services anddeleted text end home management rate.

In-home respite care services rates.

Out-of-home respite care services rates.

Individual community living support rate.

Home-delivered meals rate.

Adult day services rate.

Adult day services bath rate.

Use of data.

Age-friendly community grants.

Technical assistance grants.

Application fee for initial license or certification.

Asset limitations for certain individuals.

Employed persons with disabilities.

Transportation costs.

Documentation required.

Access to medical services.

new text begin Nonemergency medical transportation provisions related to new text end managed
care.

Formula.

Payment.

deleted text begin Prohibition on supplanting existing moneydeleted text end new text begin Purpose of expendituresnew text end .

new text begin Required expenditures. new text end

new text begin County performance on adult protection measures. new text end

new text begin American Indian adult protection. new text end

Case mix indices.

new text begin American Society of Addiction Medicine criteria or ASAM
criteria. new text end

new text begin Protective factors. new text end

Comprehensive assessment.

new text begin Comprehensive assessment requirements. new text end

General.

new text begin Individual treatment plan contents and process. new text end

Treatment plan review.

new text begin Frequency of treatment plan reviews. new text end

Additional treatment service.

Nonmedication treatment services; documentation.

Mental health certified peer specialist qualifications.

new text begin Peer recovery qualifications. new text end

new text begin Peer recovery scope of practice. new text end

Standard diagnostic assessment; required elements.

new text begin American Society of Addiction Medicine criteria or ASAM
criteria. new text end

Recovery community organization.

new text begin Skilled treatment services. new text end

new text begin Sober home. new text end

new text begin Comprehensive assessment. new text end

Licensure required.

Room and board provider requirements.

Rate requirements.

new text begin Culturally responsive recovery community grants. new text end

new text begin Withdrawal management start-up and capacity-building grants. new text end

new text begin Requirements. new text end

new text begin Certification. new text end

new text begin Registry. new text end

new text begin Bill of rights. new text end

new text begin Private right of action. new text end

new text begin Level of care requirements. new text end

new text begin Patient referral arrangement agreement. new text end

new text begin Evidence-based practices. new text end

new text begin Program outreach plan. new text end

Membership.

Grants.

State agency hearings.

Eligibility.

Scope.

Certified peer specialist deleted text begin training anddeleted text end certification.

Provider participation.

Applicability.

Additional unclassified positions.

new text begin Authority until board is developed and powers defined. new text end

new text begin Development of Department of Direct Care and Treatment Board. new text end

new text begin Total Appropriation
new text end

new text begin Forecasted Programs
new text end

new text begin Total Appropriation
new text end

new text begin Central Office; Operations
new text end

new text begin Central Office; Health Care
new text end

new text begin Central Office; Continuing Care for
Older Adults
new text end

new text begin Central Office; Behavioral Health,
Housing, and Deaf and Hard of Hearing
Services
new text end

new text begin Forecasted Programs; Minnesota
Supplemental Aid
new text end

new text begin Forecasted Programs; Medical
Assistance
new text end

new text begin Forecasted Programs; Alternative Care
new text end

new text begin Forecasted Programs; Behavioral
Health Fund
new text end

new text begin Grant Programs; Children and
Community Service Grants
new text end

new text begin Grant Programs; Other Long-Term
Care Grants
new text end

new text begin Grant Programs; Aging and Adult
Services Grants
new text end

new text begin Grant Programs; Disabilities Grants
new text end

new text begin Grant Programs; Adult Mental Health
Grants
new text end

new text begin Grant Programs; Chemical
Dependency Treatment Support Grants
new text end

new text begin Direct Care and Treatment - Transfer
Authority
new text end

new text begin Direct Care and Treatment - Mental
Health and Substance Abuse
new text end

new text begin Direct Care and Treatment -
Community-Based Services
new text end

new text begin Direct Care and Treatment - Forensic
Services
new text end

new text begin Direct Care and Treatment - Sex
Offender Program
new text end

new text begin Direct Care and Treatment -
Operations
new text end

new text begin Grants. new text end

new text begin Administration. new text end

Plan contents.

Recovery peer qualifications.

Family residential services; component values and calculation of payment rates.

Calculation of monthly conversion budget cap with consumer-directed community supports.

new text begin Special certificate prohibition. new text end

Applicability.

new text begin Establishment and authority. new text end

new text begin Eligibility. new text end

new text begin Allowable grant activities. new text end

new text begin Definition. new text end

new text begin Grant program established. new text end

new text begin Eligibility. new text end

new text begin Allowable grant activities. new text end

MnCHOICES assessor qualifications, training, and certification.

Eligibility for funding for services for nonmedical assistance recipients.

Services covered under alternative care.

Case management services.

EIDBI provider qualifications.

Case management.

Informed choice in employment policy.

Employment first implementation for disability waiver services.

new text begin Subminimum wage outcome reporting. new text end

new text begin Prohibition of subminimum wages. new text end

new text begin Direct support worker annual labor market survey. new text end

new text begin Annual labor market report. new text end

Applicable services.

Unit-based services with programming; component values and calculation
of payment rates.

Unit-based services without programming; component values and
calculation of payment rates.

new text begin Monthly case mix budget caps for consumer-directed community
supports. new text end

Engrossments
Introduction		Posted on 03/14/2023
1st Engrossment		Posted on 04/11/2023
2nd Engrossment		Posted on 04/17/2023
3rd Engrossment		Posted on 04/18/2023
4th Engrossment		Posted on 05/21/2023

Unofficial Engrossments
1st Unofficial Engrossment		Posted on 04/21/2023
2nd Unofficial Engrossment		Posted on 04/27/2023

Conference Committee Reports
CCR-SF2934A		Posted on 05/18/2023

A bill for an act
relating to human services; modifying provisions governing the care provider
workforce, aging and disability services, and behavioral health; establishing the
Department of Behavioral Health; making forecast adjustments; requiring reports;
making technical and conforming changes; establishing certain grants; appropriating
money; amending Minnesota Statutes 2022, sections 15.01; 15.06, subdivision 1;
43A.08, subdivision 1a; 177.24, by adding a subdivision; 245A.10, subdivision
3; 245D.03, subdivision 1; 245G.01, by adding subdivisions; 245G.05, subdivision
1, by adding a subdivision; 245G.06, subdivisions 1, 3, by adding subdivisions;
245G.07, subdivision 2; 245G.22, subdivision 15; 245I.04, subdivision 10, by
adding subdivisions; 245I.10, subdivision 6; 252.44; 254B.01, subdivision 8, by
adding subdivisions; 254B.05, subdivisions 1, 1a, 5; 256.042, subdivisions 2, 4;
256.045, subdivision 3; 256.478, subdivision 2; 256B.056, subdivision 3; 256B.057,
subdivision 9; 256B.0615, subdivisions 1, 5; 256B.0625, subdivisions 17, 17b,
18a, 18h; 256B.0759, subdivision 2; 256B.0911, subdivision 13; 256B.0913,
subdivisions 4, 5; 256B.092, subdivision 1a; 256B.0949, subdivision 15; 256B.49,
subdivision 13; 256B.4905, subdivisions 4a, 5a; 256B.4912, by adding subdivisions;
256B.4914, subdivisions 3, 5, 5a, 5b, 6, 8, 9, 9a, 14, by adding subdivisions;
256B.5012, by adding a subdivision; 256B.85, by adding a subdivision; 256B.851,
subdivisions 5, 6; 256D.425, subdivision 1; 256M.42; 256R.17, subdivision 2;
256R.25; 256R.47; 256S.15, subdivision 2; 256S.18, by adding a subdivision;
256S.19, subdivision 3; 256S.203, subdivisions 1, 2; 256S.21; 256S.2101;
256S.211, by adding subdivisions; 256S.212; 256S.213; 256S.214; 256S.215,
subdivisions 2, 3, 4, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17; 268.19, subdivision 1;
Laws 2021, chapter 30, article 12, section 5, as amended; Laws 2021, First Special
Session chapter 7, article 17, sections 8; 16; proposing coding for new law in
Minnesota Statutes, chapters 252; 254B; 256; 256B; 256S; proposing coding for
new law as Minnesota Statutes, chapter 246C; repealing Minnesota Statutes 2022,
sections 245G.06, subdivision 2; 245G.11, subdivision 8; 256B.4914, subdivision
6b; 256S.19, subdivision 4.

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

Minnesota Statutes 2022, section 177.24, is amended by adding a subdivision
to read:

new text begin (a) On or after August 1, 2026, employers
must not hire any new employee with a disability at a wage that is less than the highest
applicable minimum wage, regardless of whether the employer holds a special certificate
from the United States Department of Labor under section 14(c) of the federal Fair Labor
Standards Act.
new text end

new text begin (b) On or after August 1, 2028, an employer must not pay an employee with a disability
less than the highest applicable minimum wage, regardless of whether the employer holds
a special certificate from the United States Department of Labor under section 14(c) of the
federal Fair Labor Standards Act.
new text end

Minnesota Statutes 2022, section 245D.03, subdivision 1, is amended to read:

(a) The commissioner shall regulate the provision of home
and community-based services to persons with disabilities and persons age 65 and older
pursuant to this chapter. The licensing standards in this chapter govern the provision of
basic support services and intensive support services.

(b) Basic support services provide the level of assistance, supervision, and care that is
necessary to ensure the health and welfare of the person and do not include services that
are specifically directed toward the training, treatment, habilitation, or rehabilitation of the
person. Basic support services include:

(1) in-home and out-of-home respite care services as defined in section 245A.02,
subdivision 15, and under the brain injury, community alternative care, community access
for disability inclusion, developmental disabilities, and elderly waiver plans, excluding
out-of-home respite care provided to children in a family child foster care home licensed
under Minnesota Rules, parts 2960.3000 to 2960.3100, when the child foster care license
holder complies with the requirements under section 245D.06, subdivisions 5, 6, 7, and 8,
or successor provisions; and section 245D.061 or successor provisions, which must be
stipulated in the statement of intended use required under Minnesota Rules, part 2960.3000,
subpart 4;

(2) adult companion services as defined under the brain injury, community access for
disability inclusion, community alternative care, and elderly waiver plans, excluding adult
companion services provided under the Corporation for National and Community Services
Senior Companion Program established under the Domestic Volunteer Service Act of 1973,
Public Law 98-288;

(3) personal support as defined under the developmental disabilities waiver plan;

(4) 24-hour emergency assistance, personal emergency response as defined under the
community access for disability inclusion and developmental disabilities waiver plans;

(5) night supervision services as defined under the brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(6) homemaker services as defined under the community access for disability inclusion,
brain injury, community alternative care, developmental disabilities, and elderly waiver
plans, excluding providers licensed by the Department of Health under chapter 144A and
those providers providing cleaning services only;

(7) individual community living support under section 256S.13; and

(8) individualized home supports services as defined under the brain injury, community
alternative care, and community access for disability inclusion, and developmental disabilities
waiver plans.

(c) Intensive support services provide assistance, supervision, and care that is necessary
to ensure the health and welfare of the person and services specifically directed toward the
training, habilitation, or rehabilitation of the person. Intensive support services include:

(1) intervention services, including:

(i) positive support services as defined under the brain injury and community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(ii) in-home or out-of-home crisis respite services as defined under the brain injury,
community access for disability inclusion, community alternative care, and developmental
disabilities waiver plans; and

(iii) specialist services as defined under the current brain injury, community access for
disability inclusion, community alternative care, and developmental disabilities waiver
plans;

(2) in-home support services, including:

(i) in-home family support and supported living services as defined under the
developmental disabilities waiver plan;

(ii) independent living services training as defined under the brain injury and community
access for disability inclusion waiver plans;

(iii) semi-independent living services;

(iv) individualized home support with training services as defined under the brain injury,
community alternative care, community access for disability inclusion, and developmental
disabilities waiver plans; and

(v) individualized home support with family training services as defined under the brain
injury, community alternative care, community access for disability inclusion, and
developmental disabilities waiver plans;

(3) residential supports and services, including:

(i) supported living services as defined under the developmental disabilities waiver plan
provided in a family or corporate child foster care residence, a family adult foster care
residence, a community residential setting, or a supervised living facility;

(ii) foster care services as defined in the brain injury, community alternative care, and
community access for disability inclusion waiver plans provided in a family or corporate
child foster care residence, a family adult foster care residence, or a community residential
setting;

(iii) community residential services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans provided in a corporate child foster care residence, a community residential
setting, or a supervised living facility;

(iv) family residential services as defined in the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans
provided in a family child foster care residence or a family adult foster care residence; deleted text begin and
deleted text end

(v) residential services provided to more than four persons with developmental disabilities
in a supervised living facility, including ICFs/DD;new text begin and
new text end

new text begin (vi) life sharing as defined in the brain injury, community alternative care, community
access for disability inclusion, and developmental disabilities waiver plans;
new text end

(4) day services, including:

(i) structured day services as defined under the brain injury waiver plan;

(ii) day services under sections 252.41 to 252.46, and as defined under the brain injury,
community alternative care, community access for disability inclusion, and developmental
disabilities waiver plans;

(iii) day training and habilitation services under sections 252.41 to 252.46, and as defined
under the developmental disabilities waiver plan; and

(iv) prevocational services as defined under the brain injury, community alternative care,
community access for disability inclusion, and developmental disabilities waiver plans; and

(5) employment exploration services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(6) employment development services as defined under the brain injury, community
alternative care, community access for disability inclusion, and developmental disabilities
waiver plans;

(7) employment support services as defined under the brain injury, community alternative
care, community access for disability inclusion, and developmental disabilities waiver plans;
and

(8) integrated community support as defined under the brain injury and community
access for disability inclusion waiver plans beginning January 1, 2021, and community
alternative care and developmental disabilities waiver plans beginning January 1, 2023.

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 252.44, is amended to read:

When the need for day services in a county or tribe has been determined under section
252.28, the board of commissioners for that lead agency shall:

(1) authorize the delivery of services according to the support plans and support plan
addendums required as part of the lead agency's provision of case management services
under sections 256B.0913, subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision
15; and 256S.10 and Minnesota Rules, parts 9525.0004 to 9525.0036;

(2) ensure that transportation is provided or arranged by the vendor in the most efficient
and reasonable way possible; deleted text begin and
deleted text end

(3) monitor and evaluate the cost and effectiveness of the servicesdeleted text begin .deleted text end new text begin ;
new text end

new text begin (4) ensure that on or after August 1, 2026, employers do not hire any new employee at
a wage that is less than the highest applicable minimum wage, regardless of whether the
employer holds a special certificate from the United States Department of Labor under
section 14(c) of the federal Fair Labor Standards Act; and
new text end

new text begin (5) ensure that on or after August 1, 2028, any day service program, including county,
Tribal, or privately funded day services, pay employees with disabilities the highest applicable
minimum wage, regardless of whether the employer holds a special certificate from the
United States Department of Labor under section 14(c) of the federal Fair Labor Standards
Act.
new text end

new text begin The commissioner must establish a statewide technical assistance center to provide
resources and assistance to programs, people, and families to support individuals with
disabilities to achieve meaningful and competitive employment in integrated settings. Duties
of the technical assistance center include but are not limited to:
new text end

new text begin (1) offering provider business model transition support to ensure ongoing access to
employment and day services;
new text end

new text begin (2) identifying and providing training on innovative, promising, and emerging practices;
new text end

new text begin (3) maintaining a resource clearinghouse to serve as a hub of information to ensure
programs, people, and families have access to high-quality materials and information;
new text end

new text begin (4) fostering innovation and actionable progress by providing direct technical assistance
to programs; and
new text end

new text begin (5) cultivating partnerships and mentorship across support programs, people, and families
in the exploration of and successful transition to competitive, integrated employment.
new text end

new text begin The commissioner shall establish a grant program to expand lead agency capacity to
support people with disabilities to contemplate, explore, and maintain competitive, integrated
employment options. Allowable uses of funds include:
new text end

new text begin (1) enhancing resources and staffing to support people and families in understanding
employment options and navigating service options;
new text end

new text begin (2) implementing and testing innovative approaches to better support people with
disabilities and their families in achieving competitive, integrated employment; and
new text end

new text begin (3) other activities approved by the commissioner.
new text end

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

new text begin (a) The commissioner of human services
shall award grants to organizations that provide community-based services to rural or
underserved communities. The grants must be used to build organizational capacity to
provide home and community-based services in the state and to build new or expanded
infrastructure to access medical assistance reimbursement.
new text end

new text begin (b) The commissioner shall conduct community engagement, provide technical assistance,
and establish a collaborative learning community related to the grants available under this
section and shall work with the commissioner of management and budget and the
commissioner of the Department of Administration to mitigate barriers in accessing grant
money.
new text end

new text begin (c) The commissioner shall limit expenditures under this subdivision to the amount
appropriated for this purpose.
new text end

new text begin (d) The commissioner shall give priority to organizations that provide culturally specific
and culturally responsive services or that serve historically underserved communities
throughout the state.
new text end

new text begin An eligible applicant for the capacity grants under subdivision 1 is
an organization or provider that serves, or will serve, rural or underserved communities
and:
new text end

new text begin (1) provides, or will provide, home and community-based services in the state; or
new text end

new text begin (2) serves, or will serve, as a connector for communities to available home and
community-based services.
new text end

new text begin Grants under this section must be used by recipients
for the following activities:
new text end

new text begin (1) expanding existing services;
new text end

new text begin (2) increasing access in rural or underserved areas;
new text end

new text begin (3) creating new home and community-based organizations;
new text end

new text begin (4) connecting underserved communities to benefits and available services; or
new text end

new text begin (5) building new or expanded infrastructure to access medical assistance reimbursement.
new text end

new text begin For the purposes of this section, "new American" means an
individual born abroad and the individual's children, irrespective of immigration status.
new text end

new text begin The commissioner of human services shall
establish a grant program for organizations that support immigrants, refugees, and new
Americans interested in entering the long-term care workforce.
new text end

new text begin (a) The commissioner shall select projects for funding under this
section. An eligible applicant for the grant program in subdivision 1 is an:
new text end

new text begin (1) organization or provider that is experienced in working with immigrants, refugees,
and people born outside of the United States and that demonstrates cultural competency;
or
new text end

new text begin (2) organization or provider with the expertise and capacity to provide training, peer
mentoring, supportive services, and workforce development or other services to develop
and implement strategies for recruiting and retaining qualified employees.
new text end

new text begin (b) The commissioner shall prioritize applications from joint labor management programs.
new text end

new text begin (a) Money allocated under this section must be
used to:
new text end

new text begin (1) support immigrants, refugees, or new Americans to obtain or maintain employment
in the long-term care workforce;
new text end

new text begin (2) develop connections to employment with long-term care employers and potential
employees;
new text end

new text begin (3) provide recruitment, training, guidance, mentorship, and other support services
necessary to encourage employment, employee retention, and successful community
integration;
new text end

new text begin (4) provide career education, wraparound support services, and job skills training in
high-demand health care and long-term care fields;
new text end

new text begin (5) pay for program expenses, including but not limited to hiring instructors and
navigators, space rentals, and supportive services to help participants attend classes.
Allowable uses for supportive services include but are not limited to:
new text end

new text begin (i) course fees;
new text end

new text begin (ii) child care costs;
new text end

new text begin (iii) transportation costs;
new text end

new text begin (iv) tuition fees;
new text end

new text begin (v) financial coaching fees; or
new text end

new text begin (vi) mental health supports and uniforms costs incurred as a direct result of participating
in classroom instruction or training; or
new text end

new text begin (6) repay student loan debt directly incurred as a result of pursuing a qualifying course
of study or training.
new text end

Minnesota Statutes 2022, section 256B.0911, subdivision 13, is amended to read:

(a) The
commissioner shall develop and implement a curriculum and an assessor certification
process.

(b) MnCHOICES certified assessors must:

(1) either have a bachelor's degree in social work, nursing with a public health nursing
certificate, or other closely related field deleted text begin with at least one year of home and community-based
experiencedeleted text end or be a registered nurse with at least two years of home and community-based
experience; and

(2) have received training and certification specific to assessment and consultation for
long-term care services in the state.

(c) Certified assessors shall demonstrate best practices in assessment and support
planning, including person-centered planning principles, and have a common set of skills
that ensures consistency and equitable access to services statewide.

(d) Certified assessors must be recertified every three years.

Minnesota Statutes 2022, section 256B.0913, subdivision 4, is amended to read:

(a)
Funding for services under the alternative care program is available to persons who meet
the following criteria:

(1) the person is a citizen of the United States or a United States national;

(2) the person has been determined by a community assessment under section 256B.0911
to be a person who would require the level of care provided in a nursing facility, as
determined under section 256B.0911, subdivision 26, but for the provision of services under
the alternative care program;

(3) the person is age 65 or older;

(4) the person would be eligible for medical assistance within 135 days of admission to
a nursing facility;

(5) the person is not ineligible for the payment of long-term care services by the medical
assistance program due to an asset transfer penalty under section 256B.0595 or equity
interest in the home exceeding $500,000 as stated in section 256B.056;

(6) the person needs long-term care services that are not funded through other state or
federal funding, or other health insurance or other third-party insurance such as long-term
care insurance;

(7) except for individuals described in clause (8), the monthly cost of the alternative
care services funded by the program for this person does not exceed 75 percent of the
monthly limit described under section 256S.18. This monthly limit does not prohibit the
alternative care client from payment for additional services, but in no case may the cost of
additional services purchased under this section exceed the difference between the client's
monthly service limit defined under section 256S.04, and the alternative care program
monthly service limit defined in this paragraph. If care-related supplies and equipment or
environmental modifications and adaptations are or will be purchased for an alternative
care services recipient, the costs may be prorated on a monthly basis for up to 12 consecutive
months beginning with the month of purchase. If the monthly cost of a recipient's other
alternative care services exceeds the monthly limit established in this paragraph, the annual
cost of the alternative care services shall be determined. In this event, the annual cost of
alternative care services shall not exceed 12 times the monthly limit described in this
paragraph;

(8) for individuals assigned a case mix classification A as described under section
256S.18, with (i) no dependencies in activities of daily living, or (ii) up to two dependencies
in bathing, dressing, grooming, walking, and eating when the dependency score in eating
is three or greater as determined by an assessment performed under section 256B.0911, the
monthly cost of alternative care services funded by the program cannot exceed $593 per
month for all new participants enrolled in the program on or after July 1, 2011. This monthly
limit shall be applied to all other participants who meet this criteria at reassessment. This
monthly limit shall be increased annually as described in section 256S.18. This monthly
limit does not prohibit the alternative care client from payment for additional services, but
in no case may the cost of additional services purchased exceed the difference between the
client's monthly service limit defined in this clause and the limit described in clause (7) for
case mix classification A; deleted text begin and
deleted text end

(9) the person is making timely payments of the assessed monthly fee. A person is
ineligible if payment of the fee is over 60 days past due, unless the person agrees to:

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

(iii) the establishment of greater family involvement in the financial management of
payments; or

(iv) another method acceptable to the lead agency to ensure prompt fee paymentsdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (10) for a person participating in consumer-directed community supports, the person's
monthly service limit must be equal to the monthly service limits in clause (7), except that
a person assigned a case mix classification L must receive the monthly service limit for
case mix classification A.
new text end

(b) The lead agency may extend the client's eligibility as necessary while making
arrangements to facilitate payment of past-due amounts and future premium payments.
Following disenrollment due to nonpayment of a monthly fee, eligibility shall not be
reinstated for a period of 30 days.

(c) Alternative care funding under this subdivision is not available for a person who is
a medical assistance recipient or who would be eligible for medical assistance without a
spenddown or waiver obligation. A person whose initial application for medical assistance
and the elderly waiver program is being processed may be served under the alternative care
program for a period up to 60 days. If the individual is found to be eligible for medical
assistance, medical assistance must be billed for services payable under the federally
approved elderly waiver plan and delivered from the date the individual was found eligible
for the federally approved elderly waiver plan. Notwithstanding this provision, alternative
care funds may not be used to pay for any service the cost of which: (i) is payable by medical
assistance; (ii) is used by a recipient to meet a waiver obligation; or (iii) is used to pay a
medical assistance income spenddown for a person who is eligible to participate in the
federally approved elderly waiver program under the special income standard provision.

(d) Alternative care funding is not available for a person who resides in a licensed nursing
home, certified boarding care home, hospital, or intermediate care facility, except for case
management services which are provided in support of the discharge planning process for
a nursing home resident or certified boarding care home resident to assist with a relocation
process to a community-based setting.

(e) Alternative care funding is not available for a person whose income is greater than
the maintenance needs allowance under section 256S.05, but equal to or less than 120 percent
of the federal poverty guideline effective July 1 in the fiscal year for which alternative care
eligibility is determined, who would be eligible for the elderly waiver with a waiver
obligation.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256B.0913, subdivision 5, is amended to read:

Alternative care funding may be
used for payment of costs of:

(1) adult day services and adult day services bath;

(2) home care;

(3) homemaker services;

(4) personal care;

(5) case management and conversion case management;

(6) respite care;

(7) specialized supplies and equipment;

(8) home-delivered meals;

(9) nonmedical transportation;

(10) nursing services;

(11) chore services;

(12) companion services;

(13) nutrition services;

(14) family caregiver training and education;

(15) coaching and counseling;

(16) telehome care to provide services in their own homes in conjunction with in-home
visits;

(17) consumer-directed community supports deleted text begin under the alternative care programs which
are available statewide and limited to the average monthly expenditures representative of
all alternative care program participants for the same case mix resident class assigned in
the most recent fiscal year for which complete expenditure data is availabledeleted text end ;

(18) environmental accessibility and adaptations; and

(19) discretionary services, for which lead agencies may make payment from their
alternative care program allocation for services not otherwise defined in this section or
section 256B.0625, following approval by the commissioner.

Total annual payments for discretionary services for all clients served by a lead agency
must not exceed 25 percent of that lead agency's annual alternative care program base
allocation, except that when alternative care services receive federal financial participation
under the 1115 waiver demonstration, funding shall be allocated in accordance with
subdivision 17.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256B.092, subdivision 1a, is amended to read:

(a) Each recipient of a home and community-based
waiver shall be provided case management services by qualified vendors as described in
the federally approved waiver application.

(b) Case management service activities provided to or arranged for a person include:

(1) development of the person-centered support plan under subdivision 1b;

(2) informing the individual or the individual's legal guardian or conservator, or parent
if the person is a minor, of service options, including all service options available under the
waiver plan;

(3) consulting with relevant medical experts or service providers;

(4) assisting the person in the identification of potential providers of chosen services,
including:

(i) providers of services provided in a non-disability-specific setting;

(ii) employment service providers;

(iii) providers of services provided in settings that are not controlled by a provider; and

(iv) providers of financial management services;

(5) assisting the person to access services and assisting in appeals under section 256.045;

(6) coordination of services, if coordination is not provided by another service provider;

(7) evaluation and monitoring of the services identified in the support plan, which must
incorporate at least one annual face-to-face visit by the case manager with each person; and

(8) reviewing support plans and providing the lead agency with recommendations for
service authorization based upon the individual's needs identified in the support plan.

(c) Case management service activities that are provided to the person with a
developmental disability shall be provided directly by county agencies or under contract.
If a county agency contracts for case management services, the county agency must provide
each recipient of home and community-based services who is receiving contracted case
management services with the contact information the recipient may use to file a grievance
with the county agency about the quality of the contracted services the recipient is receiving
from a county-contracted case manager. Case management services must be provided by a
public or private agency that is enrolled as a medical assistance provider determined by the
commissioner to meet all of the requirements in the approved federal waiver plans. Case
management services must not be provided to a recipient by a private agency that has a
financial interest in the provision of any other services included in the recipient's support
plan. For purposes of this section, "private agency" means any agency that is not identified
as a lead agency under section 256B.0911, subdivision 10.

(d) Case managers are responsible for service provisions listed in paragraphs (a) and
(b). Case managers shall collaborate with consumers, families, legal representatives, and
relevant medical experts and service providers in the development and annual review of the
person-centered support plan and habilitation plan.

(e) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

If adequate progress is not being made, the case manager shall consult with the person's
expanded support team to identify needed modifications and whether additional professional
support is required to provide consultation.

(f) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than deleted text begin tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , employment planning, community living planning, self-direction
options, and use of technology supportsnew text end . For the purposes of this section, "person-centered
planning" or "person-centered" has the meaning given in section 256B.0911, subdivision
10.new text begin Case managers must document completion of training in a system identified by the
commissioner of human services.
new text end

Minnesota Statutes 2022, section 256B.0949, subdivision 15, is amended to read:

(a) A QSP must be employed by an agency
and be:

(1) a licensed mental health professional who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
ASD diagnostics, ASD developmental and behavioral treatment strategies, and typical child
development; or

(2) a developmental or behavioral pediatrician who has at least 2,000 hours of supervised
clinical experience or training in examining or treating people with ASD or a related condition
or equivalent documented coursework at the graduate level by an accredited university in
the areas of ASD diagnostics, ASD developmental and behavioral treatment strategies, and
typical child development.

(b) A level I treatment provider must be employed by an agency and:

(1) have at least 2,000 hours of supervised clinical experience or training in examining
or treating people with ASD or a related condition or equivalent documented coursework
at the graduate level by an accredited university in ASD diagnostics, ASD developmental
and behavioral treatment strategies, and typical child development or an equivalent
combination of documented coursework or hours of experience; and

(2) have or be at least one of the following:

(i) a master's degree in behavioral health or child development or related fields including,
but not limited to, mental health, special education, social work, psychology, speech
pathology, or occupational therapy from an accredited college or university;

(ii) a bachelor's degree in a behavioral health, child development, or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy, from an accredited college or university, and
advanced certification in a treatment modality recognized by the department;

(iii) a board-certified behavior analyst; or

(iv) a board-certified assistant behavior analyst with 4,000 hours of supervised clinical
experience that meets all registration, supervision, and continuing education requirements
of the certification.

(1) a person who has a bachelor's degree from an accredited college or university in a
behavioral or child development science or related field including, but not limited to, mental
health, special education, social work, psychology, speech pathology, or occupational
therapy; and meets at least one of the following:

(i) has at least 1,000 hours of supervised clinical experience or training in examining or
treating people with ASD or a related condition or equivalent documented coursework at
the graduate level by an accredited university in ASD diagnostics, ASD developmental and
behavioral treatment strategies, and typical child development or a combination of
coursework or hours of experience;

(ii) has certification as a board-certified assistant behavior analyst from the Behavior
Analyst Certification Board;

(iii) is a registered behavior technician as defined by the Behavior Analyst Certification
Board; or

(iv) is certified in one of the other treatment modalities recognized by the department;
or

(2) a person who has:

(i) an associate's degree in a behavioral or child development science or related field
including, but not limited to, mental health, special education, social work, psychology,
speech pathology, or occupational therapy from an accredited college or university; and

(ii) at least 2,000 hours of supervised clinical experience in delivering treatment to people
with ASD or a related condition. Hours worked as a mental health behavioral aide or level
III treatment provider may be included in the required hours of experience; or

(3) a person who has at least 4,000 hours of supervised clinical experience in delivering
treatment to people with ASD or a related condition. Hours worked as a mental health
behavioral aide or level III treatment provider may be included in the required hours of
experience; or

(4) a person who is a graduate student in a behavioral science, child development science,
or related field and is receiving clinical supervision by a QSP affiliated with an agency to
meet the clinical training requirements for experience and training with people with ASD
or a related condition; or

(5) a person who is at least 18 years of age and who:

(i) is fluent in a non-English languagenew text begin or is an individual certified by a Tribal nationnew text end ;

(ii) completed the level III EIDBI training requirements; and

(iii) receives observation and direction from a QSP or level I treatment provider at least
once a week until the person meets 1,000 hours of supervised clinical experience.

(d) A level III treatment provider must be employed by an agency, have completed the
level III training requirement, be at least 18 years of age, and have at least one of the
following:

(1) a high school diploma or commissioner of education-selected high school equivalency
certification;

(2) fluency in a non-English languagenew text begin or Tribal nation certificationnew text end ;

(3) one year of experience as a primary personal care assistant, community health worker,
waiver service provider, or special education assistant to a person with ASD or a related
condition within the previous five years; or

(4) completion of all required EIDBI training within six months of employment.

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 256B.49, subdivision 13, is amended to read:

(a) Each recipient of a home and community-based waiver
shall be provided case management services by qualified vendors as described in the federally
approved waiver application. The case management service activities provided must include:

(1) finalizing the person-centered written support plan within the timelines established
by the commissioner and section 256B.0911, subdivision 29;

(2) informing the recipient or the recipient's legal guardian or conservator of service
options, including all service options available under the waiver plans;

(3) assisting the recipient in the identification of potential service providers of chosen
services, including:

(i) available options for case management service and providers;

(ii) providers of services provided in a non-disability-specific setting;

(iii) employment service providers;

(iv) providers of services provided in settings that are not community residential settings;
and

(v) providers of financial management services;

(4) assisting the recipient to access services and assisting with appeals under section
256.045; and

(5) coordinating, evaluating, and monitoring of the services identified in the service
plan.

(b) The case manager may delegate certain aspects of the case management service
activities to another individual provided there is oversight by the case manager. The case
manager may not delegate those aspects which require professional judgment including:

(1) finalizing the person-centered support plan;

(2) ongoing assessment and monitoring of the person's needs and adequacy of the
approved person-centered support plan; and

(3) adjustments to the person-centered support plan.

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. Case management services must not
be provided to a recipient by a private agency that has any financial interest in the provision
of any other services included in the recipient's support plan. For purposes of this section,
"private agency" means any agency that is not identified as a lead agency under section
256B.0911, subdivision 10.

(d) For persons who need a positive support transition plan as required in chapter 245D,
the case manager shall participate in the development and ongoing evaluation of the plan
with the expanded support team. At least quarterly, the case manager, in consultation with
the expanded support team, shall evaluate the effectiveness of the plan based on progress
evaluation data submitted by the licensed provider to the case manager. The evaluation must
identify whether the plan has been developed and implemented in a manner to achieve the
following within the required timelines:

(1) phasing out the use of prohibited procedures;

(2) acquisition of skills needed to eliminate the prohibited procedures within the plan's
timeline; and

(3) accomplishment of identified outcomes.

(e) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than deleted text begin tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , employment planning, community living planning, self-direction
options, and use of technology supportsnew text end . For the purposes of this section, "person-centered
planning" or "person-centered" has the meaning given in section 256B.0911, subdivision
10.new text begin Case managers shall document completion of training in a system identified by the
commissioner of human services.
new text end

Minnesota Statutes 2022, section 256B.4905, subdivision 4a, is amended to read:

It is the policy of this state that
working-age individuals who have disabilities:

(1) can work and achieve competitive integrated employment with appropriate services
and supports, as needed;

(2) make informed choices about their postsecondary education, work, and career goals;
deleted text begin and
deleted text end

(3) will be offered the opportunity to make an informed choice, at least annually, to
pursue postsecondary education or to work and earn a competitive wagedeleted text begin .deleted text end new text begin ; and
new text end

new text begin (4) will be offered benefits planning assistance and supports to understand available
work incentive programs and to understand the impact of work on benefits.
new text end

Minnesota Statutes 2022, section 256B.4905, subdivision 5a, is amended to read:

new text begin (a) new text end The
commissioner of human services shall ensure that:

(1) the disability waivers under sections 256B.092 and 256B.49 support the presumption
that all working-age Minnesotans with disabilities can work and achieve competitive
integrated employment with appropriate services and supports, as needed; and

(2) each waiver recipient of working age be offered, after an informed decision-making
process and during a person-centered planning process, the opportunity to work and earn a
competitive wage before being offered exclusively day services as defined in section
245D.03, subdivision 1, paragraph (c), clause (4), or successor provisions.

new text begin (b) By August 1, 2024, all case managers must complete an employment support planning
training course identified by the commissioner. For case managers hired by a lead agency
after August 1, 2024, this training must be completed within the first 120 days of providing
case management services. Lead agencies must document completion of the training for all
case managers in a tracking system identified by the commissioner.
new text end

new text begin (a) A provider of home and
community-based services for people with developmental disabilities under section 256B.092
or home and community-based services for people with disabilities under section 256B.49
that holds a credential listed in clause (1) or (2) as of August 1, 2023, must submit data on
individuals who are currently being paid subminimum wages or were being paid subminimum
wages by the provider organization as of August 1, 2023, to the commissioner:
new text end

new text begin (1) a certificate through the United States Department of Labor under United States
Code, title 29, section 214(c), of the Fair Labor Standards Act authorizing the payment of
subminimum wages to workers with disabilities; or
new text end

new text begin (2) a permit by the Minnesota Department of Labor and Industry under section 177.28.
new text end

new text begin (b) The following data must be submitted about each individual required under paragraph
(a):
new text end

new text begin (1) name;
new text end

new text begin (2) date of birth;
new text end

new text begin (3) identified race and ethnicity;
new text end

new text begin (4) disability type;
new text end

new text begin (5) key employment status measures as determined by the commissioner; and
new text end

new text begin (6) key community-life engagement measures as determined by the commissioner.
new text end

new text begin (c) The information in paragraph (b) must be submitted in a format determined by the
commissioner of human services.
new text end

new text begin (d) A provider must submit the data required under this section annually on a date
specified by the commissioner. The commissioner must give a provider at least 30 calendar
days to submit the data following notice of the due date. If a provider fails to submit the
requested data by the date specified by the commissioner, the commissioner may delay
medical assistance reimbursement until the requested data is submitted.
new text end

new text begin (e) Individually identifiable data submitted to the commissioner under this section are
considered private data on individuals as defined by section 13.02, subdivision 12.
new text end

new text begin (f) The commissioner must analyze data annually for tracking employment and
community-life engagement outcomes.
new text end

new text begin Providers of home and community-based
services are prohibited from paying a person with a disability wages below the state minimum
wage pursuant to section 177.24, or below the prevailing local minimum wage on the basis
of the person's disability. A special certificate authorizing the payment of less than the
minimum wage to a person with a disability issued pursuant to a law of this state or to a
federal law is without effect as of August 1, 2028.
new text end

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:

new text begin (a) The commissioner
shall develop and administer a survey of direct care staff who work for organizations that
provide services under the following programs:
new text end

new text begin (1) home and community-based services for seniors under chapter 256S and section
256B.0913, home and community-based services for people with developmental disabilities
under section 256B.092, and home and community-based services for people with disabilities
under section 256B.49;
new text end

new text begin (2) personal care assistance services under section 256B.0625, subdivision 19a;
community first services and supports under section 256B.85; nursing services and home
health services under section 256B.0625, subdivision 6a; home care nursing services under
section 256B.0625, subdivision 7; and
new text end

new text begin (3) financial management services for participants who directly employ direct-care staff
through consumer support grants under section 256.476; the personal care assistance choice
program under section 256B.0659, subdivisions 18 to 20; community first services and
supports under section 256B.85; and the consumer-directed community supports option
available under the alternative care program, the brain injury waiver, the community
alternative care waiver, the community access for disability inclusion waiver, the
developmental disabilities waiver, the elderly waiver, and the Minnesota senior health
option, except financial management services providers are not required to submit the data
listed in subdivision 1a, clauses (7) to (11).
new text end

new text begin (b) The survey must collect information about the individual experience of the direct-care
staff and any other information necessary to assess the overall economic viability and
well-being of the workforce.
new text end

new text begin (c) For purposes of this subdivision, "direct-care staff" means employees, including
self-employed individuals and individuals directly employed by a participant in a
consumer-directed service delivery option, providing direct service to participants under
this section. Direct-care staff does not include executive, managerial, or administrative staff.
new text end

new text begin (d) Individually identifiable data submitted to the commissioner under this section are
considered private data on individuals as defined by section 13.02, subdivision 12.
new text end

new text begin (e) The commissioner shall analyze data submitted under this section annually to assess
the overall economic viability and well-being of the workforce and the impact of the state
of workforce on access to services.
new text end

Minnesota Statutes 2022, section 256B.4912, is amended by adding a subdivision
to read:

new text begin The commissioner shall publish annual reports
on provider and state-level labor market data, including but not limited to the data outlined
in subdivisions 1a and 1b.
new text end

Minnesota Statutes 2022, section 256B.4914, subdivision 3, is amended to read:

Applicable services are those authorized under the state's
home and community-based services waivers under sections 256B.092 and 256B.49,
including the following, as defined in the federally approved home and community-based
services plan:

(1) 24-hour customized living;

(2) adult day services;

(3) adult day services bath;

(4) community residential services;

(5) customized living;

(6) day support services;

(7) employment development services;

(8) employment exploration services;

(9) employment support services;

(10) family residential services;

(11) individualized home supports;

(12) individualized home supports with family training;

(13) individualized home supports with training;

(14) integrated community supports;

new text begin (15) life sharing;
new text end

deleted text begin (15)deleted text end new text begin (16)new text end night supervision;

deleted text begin (16)deleted text end new text begin (17)new text end positive support services;

deleted text begin (17)deleted text end new text begin (18)new text end prevocational services;

deleted text begin (18)deleted text end new text begin (19)new text end residential support services;

deleted text begin (19)deleted text end new text begin (20)new text end respite services;

deleted text begin (20)deleted text end new text begin (21)new text end transportation services; and

deleted text begin (21)deleted text end new text begin (22)new text end other services as approved by the federal government in the state home and
community-based services waiver plan.

Minnesota Statutes 2022, section 256B.4914, subdivision 5, is amended to read:

(a) The base wage index is
established to determine staffing costs associated with providing services to individuals
receiving home and community-based services. For purposes of calculating the base wage,
Minnesota-specific wages taken from job descriptions and standard occupational
classification (SOC) codes from the Bureau of Labor Statistics as defined in the Occupational
Handbook must be used.

(b) The commissioner shall update the base wage index in subdivision 5a, publish these
updated values, and load them into the rate management system as follows:

(1) on January 1, 2022, based on wage data by SOC from the Bureau of Labor Statistics
available as of December 31, 2019;

(2) on deleted text begin Novemberdeleted text end new text begin Januarynew text end 1, 2024, based on wage data by SOC from the Bureau of Labor
Statistics available as of December 31, 2021; and

(3) on deleted text begin July 1, 2026deleted text end new text begin January 1, 2025new text end , and every two years thereafter, based on wage data
by SOC from the Bureau of Labor Statistics available 30 months and one day prior to the
scheduled update.

Minnesota Statutes 2022, section 256B.4914, subdivision 5a, is amended to read:

The base wage index must be calculated as
follows:

(1) for supervisory staff, 100 percent of the median wage for community and social
services specialist (SOC code 21-1099), with the exception of the supervisor of positive
supports professional, positive supports analyst, and positive supports specialist, which is
100 percent of the median wage for clinical counseling and school psychologist (SOC code
19-3031);

(2) for registered nurse staff, 100 percent of the median wage for registered nurses (SOC
code 29-1141);

(3) for licensed practical nurse staff, 100 percent of the median wage for licensed practical
nurses (SOC code 29-2061);

(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employersdeleted text begin , with the exception of asleep-overnight staff for family residential services, which
is 36 percent of the minimum wage in Minnesota for large employersdeleted text end ;

(5) for residential direct care staff, the sum of:

(i) 15 percent of the subtotal of 50 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 30 percent of the median wage for nursing assistant
(SOC code 31-1131); and 20 percent of the median wage for social and human services
aide (SOC code 21-1093); and

(ii) 85 percent of the subtotal of 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1014); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093);

(6) for adult day services staff, 70 percent of the median wage for nursing assistant (SOC
code 31-1131); and 30 percent of the median wage for home health and personal care aide
(SOC code 31-1120);

(7) for day support services staff and prevocational services staff, 20 percent of the
median wage for nursing assistant (SOC code 31-1131); 20 percent of the median wage for
psychiatric technician (SOC code 29-2053); and 60 percent of the median wage for social
and human services aide (SOC code 21-1093);

(8) for positive supports analyst staff, 100 percent of the median wage for deleted text begin substance
abuse, behavioral disorder, and mental health counselordeleted text end new text begin clinical, counseling, and school
psychologistsnew text end (SOC code deleted text begin 21-1018deleted text end new text begin 19-3031new text end );

(9) for positive supports professional staff, 100 percent of the median wage for deleted text begin clinical
counseling and schooldeleted text end psychologistnew text begin , all othernew text end (SOC code deleted text begin 19-3031deleted text end new text begin 19-3039new text end );

(10) for positive supports specialist staff, 100 percent of the median wage for deleted text begin psychiatric
techniciansdeleted text end new text begin occupational therapistnew text end (SOC code deleted text begin 29-2053deleted text end new text begin 29-1122new text end );

(11) for individualized home supports with family training staff, 20 percent of the median
wage for nursing aide (SOC code 31-1131); 30 percent of the median wage for community
social service specialist (SOC code 21-1099); 40 percent of the median wage for social and
human services aide (SOC code 21-1093); and ten percent of the median wage for psychiatric
technician (SOC code 29-2053);

(12) for individualized home supports with training services staff, 40 percent of the
median wage for community social service specialist (SOC code 21-1099); 50 percent of
the median wage for social and human services aide (SOC code 21-1093); and ten percent
of the median wage for psychiatric technician (SOC code 29-2053);

(13) for employment support services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(14) for employment exploration services staff, 50 percent of the median wage for
rehabilitation counselor (SOC code 21-1015); and 50 percent of the median wage for
community and social services specialist (SOC code 21-1099);

(15) for employment development services staff, 50 percent of the median wage for
education, guidance, school, and vocational counselors (SOC code 21-1012); and 50 percent
of the median wage for community and social services specialist (SOC code 21-1099);

(16) for individualized home support without training staff, 50 percent of the median
wage for home health and personal care aide (SOC code 31-1120); and 50 percent of the
median wage for nursing assistant (SOC code 31-1131);

(17) for night supervision staff, 40 percent of the median wage for home health and
personal care aide (SOC code 31-1120); 20 percent of the median wage for nursing assistant
(SOC code 31-1131); 20 percent of the median wage for psychiatric technician (SOC code
29-2053); and 20 percent of the median wage for social and human services aide (SOC code
21-1093); and

(18) for respite staff, 50 percent of the median wage for home health and personal care
aide (SOC code 31-1131); and 50 percent of the median wage for nursing assistant (SOC
code 31-1014).

new text begin The amendments to clauses (8), (9), and (10) are effective January
1, 2024, or upon federal approval, whichever is later. The amendment to clause (4) is
effective January 1, 2026, or upon federal approval, whichever is later. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 256B.4914, subdivision 5b, is amended to read:

The commissioner shall update
the client and programming support, transportation, and program facility cost component
values as required in subdivisions 6 to 9anew text begin and the rates identified in subdivision 19new text end for
changes in the Consumer Price Index. The commissioner shall adjust these values higher
or lower, publish these updated values, and load them into the rate management system as
follows:

(1) on January 1, 2022, by the percentage change in the CPI-U from the date of the
previous update to the data available on December 31, 2019;

(2) on deleted text begin Novemberdeleted text end new text begin Januarynew text end 1, 2024, by the percentage change in the CPI-U from the date
of the previous update to the data available as of December 31, 2021; and

(3) on deleted text begin July 1, 2026deleted text end new text begin January 1, 2025new text end , and every two years thereafter, by the percentage
change in the CPI-U from the date of the previous update to the data available 30 months
and one day prior to the scheduled update.

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later, except that the amendments to clauses (2) and (3), are effective January
1, 2024, or upon federal approval, whichever is later. The commissioner of human services
shall notify the revisor of statutes when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision
to read:

new text begin Beginning January
1, 2025, and every two years thereafter, the commissioner shall update the competitive
workforce factor in subdivisions 8, 9, and 9a. The value of the competitive workforce factor
must be the value determined in the most recent report under subdivision 10c.
new text end

Minnesota Statutes 2022, section 256B.4914, subdivision 6, is amended to read:

(a) For purposes of this section,
residential support services includes 24-hour customized living services, community
residential services, customized living services, deleted text begin family residential services,deleted text end and integrated
community supports.

(b) A unit of service for residential support services is a day. Any portion of any calendar
day, within allowable Medicaid rules, where an individual spends time in a residential setting
is billable as a day. The number of days authorized for all individuals enrolling in residential
support services must include every day that services start and end.

(c) When the available shared staffing hours in a residential setting are insufficient to
meet the needs of an individual who enrolled in residential support services after January
1, 2014, then individual staffing hours shall be used.

Minnesota Statutes 2022, section 256B.4914, subdivision 8, is amended to read:

(a) For the purpose of this section, unit-based services with programming
include employment exploration services, employment development services, employment
support services, individualized home supports with family training, individualized home
supports with training, and positive support services provided to an individual outside of
any service plan for a day program or residential support service.

(b) Component values for unit-based services with programming are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 8.4new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 15.5 percent;

(6) client programming and support ratio: 4.7 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 6.1 percent; and

(9) absence and utilization factor ratio: 3.9 percent.

(d) Payments for unit-based services with programming must be calculated as follows,
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

(1) determine the number of units of service to meet a recipient's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language
accessibility under subdivision 12, add the customization rate provided in subdivision 12
to the result of clause (3);

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) this is the subtotal rate;

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;

(14) for services provided in a shared manner, divide the total payment in clause (13)
as follows:

(i) for employment exploration services, divide by the number of service recipients, not
to exceed five;

(ii) for employment support services, divide by the number of service recipients, not to
exceed six; and

(iii) for individualized home supports with training and individualized home supports
with family training, divide by the number of service recipients, not to exceed two; and

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

Minnesota Statutes 2022, section 256B.4914, subdivision 9, is amended to read:

(a) For the purposes of this section, unit-based services
without programming include individualized home supports without training and night
supervision provided to an individual outside of any service plan for a day program or
residential support service. Unit-based services without programming do not include respite.

(b) Component values for unit-based services without programming are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 8.4new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) program plan support ratio: 7.0 percent;

(6) client programming and support ratio: 2.3 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 2.9 percent; and

(9) absence and utilization factor ratio: 3.9 percent.

(d) Payments for unit-based services without programming must be calculated as follows
unless the services are reimbursed separately as part of a residential support services or day
program payment rate:

(1) determine the number of units of service to meet a recipient's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 to 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for program plan support, multiply the result of clause (7) by one plus the program
plan support ratio;

(9) for employee-related expenses, multiply the result of clause (8) by one plus the
employee-related cost ratio;

(10) for client programming and supports, multiply the result of clause (9) by one plus
the client programming and support ratio;

(11) this is the subtotal rate;

(12) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the
total payment amount;

(14) for individualized home supports without training provided in a shared manner,
divide the total payment amount in clause (13) by the number of service recipients, not to
exceed two; and

(15) adjust the result of clause (14) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

Minnesota Statutes 2022, section 256B.4914, subdivision 9a, is amended to read:

(a)
For the purposes of this section, respite services include respite services provided to an
individual outside of any service plan for a day program or residential support service.

(b) Component values for respite services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 8.4new text end percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 2.9 percent; and

(7) absence and utilization factor ratio: 3.9 percent.

(d) Payments for respite services must be calculated as follows unless the service is
reimbursed separately as part of a residential support services or day program payment rate:

(1) determine the number of units of service to meet an individual's needs;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as
provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the
product of one plus the competitive workforce factor;

(4) for a recipient requiring deaf and hard-of-hearing customization under subdivision
12, add the customization rate provided in subdivision 12 to the result of clause (3);

(5) multiply the number of direct staffing hours by the appropriate staff wage;

(6) multiply the number of direct staffing hours by the product of the supervisory span
of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), and multiply the result by one plus the
employee vacation, sick, and training allowance ratio. This is defined as the direct staffing
rate;

(8) for employee-related expenses, multiply the result of clause (7) by one plus the
employee-related cost ratio;

(9) this is the subtotal rate;

(10) sum the standard general administrative support ratio, the program-related expense
ratio, and the absence and utilization factor ratio;

(11) divide the result of clause (9) by one minus the result of clause (10). This is the
total payment amount;

(12) for respite services provided in a shared manner, divide the total payment amount
in clause (11) by the number of service recipients, not to exceed three; and

(13) adjust the result of clause (12) by a factor to be determined by the commissioner
to adjust for regional differences in the cost of providing services.

Minnesota Statutes 2022, section 256B.4914, subdivision 14, is amended to read:

(a) In a format prescribed by the commissioner, lead agencies
must identify individuals with exceptional needs that cannot be met under the disability
waiver rate system. The commissioner shall use that information to evaluate and, if necessary,
approve an alternative payment rate for those individuals. Whether granted, denied, or
modified, the commissioner shall respond to all exception requests in writing. The
commissioner shall include in the written response the basis for the action and provide
notification of the right to appeal under paragraph (h).

(b) Lead agencies must act on an exception request within 30 days and notify the initiator
of the request of their recommendation in writing. A lead agency shall submit all exception
requests along with its recommendation to the commissioner.

(1) an individual has service needs that cannot be met through additional units of service;

(2) an individual's rate determined under subdivisions 6 to 9a is so insufficient that it
has resulted in an individual receiving a notice of discharge from the individual's provider;
or

(3) an individual's service needs, including behavioral changes, require a level of service
which necessitates a change in provider or which requires the current provider to propose
service changes beyond those currently authorized.

(d) Exception requests must include the following information:

(1) the service needs required by each individual that are not accounted for in subdivisions
6 to 9a;

(2) the service rate requested and the difference from the rate determined in subdivisions
6 to 9a;

(3) a basis for the underlying costs used for the rate exception and any accompanying
documentation; and

(4) any contingencies for approval.

(e) Approved rate exceptions shall be managed within lead agency allocations under
sections 256B.092 and 256B.49.

(f) Individual disability waiver recipients, an interested party, or the license holder that
would receive the rate exception increase may request that a lead agency submit an exception
request. A lead agency that denies such a request shall notify the individual waiver recipient,
interested party, or license holder of its decision and the reasons for denying the request in
writing no later than 30 days after the request has been made and shall submit its denial to
the commissioner in accordance with paragraph (b). The reasons for the denial must be
based on the failure to meet the criteria in paragraph (c).

(g) The commissioner shall determine whether to approve or deny an exception request
no more than 30 days after receiving the request. If the commissioner denies the request,
the commissioner shall notify the lead agency and the individual disability waiver recipient,
the interested party, and the license holder in writing of the reasons for the denial.

(h) The individual disability waiver recipient may appeal any denial of an exception
request by either the lead agency or the commissioner, pursuant to sections 256.045 and
256.0451. When the denial of an exception request results in the proposed demission of a
waiver recipient from a residential or day habilitation program, the commissioner shall issue
a temporary stay of demission, when requested by the disability waiver recipient, consistent
with the provisions of section 256.045, subdivisions 4a and 6, paragraph (c). The temporary
stay shall remain in effect until the lead agency can provide an informed choice of
appropriate, alternative services to the disability waiver.

(i) Providers may petition lead agencies to update values that were entered incorrectly
or erroneously into the rate management system, based on past service level discussions
and determination in subdivision 4, without applying for a rate exception.

(j) The starting date for the rate exception will be the later of the date of the recipient's
change in support or the date of the request to the lead agency for an exception.

(k) The commissioner shall track all exception requests received and their dispositions.
The commissioner shall issue quarterly public exceptions statistical reports, including the
number of exception requests received and the numbers granted, denied, withdrawn, and
pending. The report shall include the average amount of time required to process exceptions.

(l) Approved rate exceptions remain in effect in all cases until an individual's needs
change as defined in paragraph (c).

new text begin (m) Rates determined under subdivision 19 are ineligible for rate exceptions.
new text end

Minnesota Statutes 2022, section 256B.4914, is amended by adding a subdivision
to read:

new text begin The commissioner
shall establish rates for family residential services and life sharing services based on a
person's assessed need, as described in the federally-approved waiver plans. Rates for life
sharing services must be ten percent higher than the corresponding family residential services
rate.
new text end

Minnesota Statutes 2022, section 256B.5012, is amended by adding a subdivision
to read:

new text begin (a) Effective January 1, 2024, the minimum daily
operating rate for intermediate care facilities for persons with developmental disabilities is
$260.00.
new text end

new text begin (b) Beginning January 1, 2026, and every two years thereafter, the rate in paragraph (a)
must be updated for the percentage change in the Consumer Price Index (CPI-U) from the
date of the previous CPI-U update to the data available 12 months and one day prior to the
scheduled update.
new text end

Minnesota Statutes 2022, section 256B.85, is amended by adding a subdivision
to read:

new text begin (a) This subdivision applies to
services and supports described in subdivision 7, clause (8).
new text end

new text begin (b) If multiple parents are support workers providing CFSS services to their minor child
or children, each parent may provide up to 40 hours of medical assistance home and
community-based services in any seven-day period, regardless of the number of children
served. The total number of hours of medical assistance home and community-based services
and alternative care provided by all of the parents must not exceed 80 hours in a seven-day
period, regardless of the number of children served.
new text end

new text begin (c) If only one parent is a support worker providing CFSS services to the parent's minor
child or children, the parent may provide up to 60 hours of medical assistance home and
community-based services in a seven-day period, regardless of the number of children
served.
new text end

new text begin (d) If a participant's spouse is a support worker providing CFSS services, the participant's
spouse may provide up to 60 hours of medical assistance home and community-based
services in a seven-day period.
new text end

new text begin (e) Paragraphs (b) to (d) must not be construed to permit an increase in either the total
authorized service budget for an individual or the total number of authorized service units.
new text end

new text begin (f) A participant's parent or spouse must not receive a wage that exceeds the current rate
for a CFSS support worker, including the wage, benefits, and payroll taxes.
new text end

Minnesota Statutes 2022, section 256B.851, subdivision 5, is amended to read:

(a) The commissioner must use the
following component values:

(1) employee vacation, sick, and training factor, 8.71 percent;

(2) employer taxes and workers' compensation factor, 11.56 percent;

(3) employee benefits factor, 12.04 percent;

(4) client programming and supports factor, 2.30 percent;

(5) program plan support factor, 7.00 percent;

(6) general business and administrative expenses factor, 13.25 percent;

(7) program administration expenses factor, 2.90 percent; and

(8) absence and utilization factor, 3.90 percent.

(b) For purposes of implementation, the commissioner shall use the following
implementation components:

(1) deleted text begin personal care assistance services and CFSS: 75.45 percent;deleted text end new text begin beginning January 1,
2024: 88.19 percent; and
new text end

(2) deleted text begin enhanced rate personal care assistance services and enhanced rate CFSS: 75.45
percent; anddeleted text end new text begin beginning January 1, 2025: 92.10 percent.
new text end

deleted text begin (3) qualified professional services and CFSS worker training and development: 75.45
percent.
deleted text end

new text begin (c) Beginning January 1, 2025, the commissioner shall use the following worker retention
components:
new text end

new text begin (1) for workers who have provided fewer than 1,001 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 1.0 percent;
new text end

new text begin (2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 1.0217 percent;
new text end

new text begin (3) for workers who have provided between 2,001 and 6,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 1.0436 percent;
new text end

new text begin (4) for workers who have provided between 6,001 and 10,000 cumulative hours in
personal care assistance services or CFSS, the worker retention component is 1.0735 percent;
and
new text end

new text begin (5) for workers who have provided more than 10,000 hours in personal care assistance
services or CFSS, the worker retention component is 1.1081 percent.
new text end

new text begin (d) The commissioner shall define the appropriate worker retention component based
on the total number of units billed for services rendered by the individual provider since
July 1, 2017. The worker retention component must be determined by the commissioner
for each individual provider and is not subject to appeal.
new text end

new text begin The amendments to paragraph (b) are effective January 1, 2024,
or ninety days after federal approval, whichever is later. Paragraphs (c) and (d) are effective
January 1, 2025, or ninety days after federal approval, whichever is later. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 256B.851, subdivision 6, is amended to read:

(a) The commissioner must determine
the rate for personal care assistance services, CFSS, extended personal care assistance
services, extended CFSS, enhanced rate personal care assistance services, enhanced rate
CFSS, qualified professional services, and CFSS worker training and development as
follows:

(1) multiply the appropriate total wage component value calculated in subdivision 4 by
one plus the employee vacation, sick, and training factor in subdivision 5;

(2) for program plan support, multiply the result of clause (1) by one plus the program
plan support factor in subdivision 5;

(3) for employee-related expenses, add the employer taxes and workers' compensation
factor in subdivision 5 and the employee benefits factor in subdivision 5. The sum is
employee-related expenses. Multiply the product of clause (2) by one plus the value for
employee-related expenses;

(4) for client programming and supports, multiply the product of clause (3) by one plus
the client programming and supports factor in subdivision 5;

(5) for administrative expenses, add the general business and administrative expenses
factor in subdivision 5, the program administration expenses factor in subdivision 5, and
the absence and utilization factor in subdivision 5;

(6) divide the result of clause (4) by one minus the result of clause (5). The quotient is
the hourly rate;

(7) multiply the hourly rate by the appropriate implementation component under
subdivision 5. This is the adjusted hourly rate; deleted text begin and
deleted text end

(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment
ratedeleted text begin .deleted text end new text begin ; and
new text end

new text begin (9) multiply the total adjusted payment rate by the appropriate staff retention component
under subdivision 5, paragraph (b). This is the final payment rate.
new text end

(b) The commissioner must publish the total deleted text begin adjusteddeleted text end new text begin finalnew text end payment rates.

new text begin This section is effective January 1, 2025, or ninety days after
federal approval, whichever is later. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 256D.425, subdivision 1, is amended to read:

A person who is aged, blind, or 18 years
of age or older and disabled and who is receiving supplemental security benefits under Title
XVI on the basis of age, blindness, or disability (or would be eligible for such benefits
except for excess income) is eligible for a payment under the Minnesota supplemental aid
program, if the person's net income is less than the standards in section 256D.44. new text begin A person
who is receiving benefits under the Minnesota supplemental aid program in the month prior
to becoming eligible under section 1619(b) of the Social Security Act is eligible for a
payment under the Minnesota supplemental aid program while they remain in section 1619(b)
status. new text end Persons who are not receiving Supplemental Security Income benefits under Title
XVI of the Social Security Act or disability insurance benefits under Title II of the Social
Security Act due to exhausting time limited benefits are not eligible to receive benefits
under the MSA program. Persons who are not receiving Social Security or other maintenance
benefits for failure to meet or comply with the Social Security or other maintenance program
requirements are not eligible to receive benefits under the MSA program. Persons who are
found ineligible for Supplemental Security Income because of excess income, but whose
income is within the limits of the Minnesota supplemental aid program, must have blindness
or disability determined by the state medical review team.

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

Minnesota Statutes 2022, section 256R.25, is amended to read:

(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to (o).

(b) For a facility licensed as a nursing home, the portion related to the provider surcharge
under section 256.9657 is equal to $8.86 per resident day. For a facility licensed as both a
nursing home and a boarding care home, the portion related to the provider surcharge under
section 256.9657 is equal to $8.86 per resident day multiplied by the result of its number
of nursing home beds divided by its total number of licensed beds.

(c) The portion related to the licensure fee under section 144.122, paragraph (d), is the
amount of the fee divided by the sum of the facility's resident days.

(d) The portion related to development and education of resident and family advisory
councils under section 144A.33 is $5 per resident day divided by 365.

(e) The portion related to scholarships is determined under section 256R.37.

(f) The portion related to planned closure rate adjustments is as determined under section
256R.40, subdivision 5, and Minnesota Statutes 2010, section 256B.436.

(g) The portion related to consolidation rate adjustments shall be as determined under
section 144A.071, subdivisions 4c, paragraph (a), clauses (5) and (6), and 4d.

(h) The portion related to single-bed room incentives is as determined under section
256R.41.

(i) The portions related to real estate taxes, special assessments, and payments made in
lieu of real estate taxes directly identified or allocated to the nursing facility are the allowable
amounts divided by the sum of the facility's resident days. Allowable costs under this
paragraph for payments made by a nonprofit nursing facility that are in lieu of real estate
taxes shall not exceed the amount which the nursing facility would have paid to a city or
township and county for fire, police, sanitation services, and road maintenance costs had
real estate taxes been levied on that property for those purposes.

(j) The portion related to employer health insurance costs is the allowable costs divided
by the sum of the facility's resident days.

(k) The portion related to the Public Employees Retirement Association is the allowable
costs divided by the sum of the facility's resident days.

(l) The portion related to quality improvement incentive payment rate adjustments is
the amount determined under section 256R.39.

(m) The portion related to performance-based incentive payments is the amount
determined under section 256R.38.

(n) The portion related to special dietary needs is the amount determined under section
256R.51.

(o) The portion related to the rate adjustments for border city facilities is the amount
determined under section 256R.481.

new text begin (p) The portion related to the rate adjustment for critical access nursing facilities is the
amount determined under section 256R.47.
new text end

Minnesota Statutes 2022, section 256R.47, is amended to read:

(a) The commissioner, in consultation with the commissioner of health, may designate
certain nursing facilities as critical access nursing facilities. The designation shall be granted
on a competitive basis, within the limits of funds appropriated for this purpose.

(b) The commissioner shall request proposals from nursing facilities every two years.
Proposals must be submitted in the form and according to the timelines established by the
commissioner. In selecting applicants to designate, the commissioner, in consultation with
the commissioner of health, and with input from stakeholders, shall develop criteria designed
to preserve access to nursing facility services in isolated areas, rebalance long-term care,
and improve quality. To the extent practicable, the commissioner shall ensure an even
distribution of designations across the state.

(c) deleted text begin The commissioner shall allow the benefits in clauses (1) to (5)deleted text end For nursing facilities
designated as critical access nursing facilitiesdeleted text begin :deleted text end new text begin , the commissioner shall allow a supplemental
payment above a facility's operating payment rate as determined to be necessary by the
commissioner to maintain access to nursing facilities services in isolated areas identified
in paragraph (b). The commissioner must approve the amounts of supplemental payments
through a memorandum of understanding. Supplemental payments to facilities under this
section must be in the form of time-limited rate adjustments included in the external fixed
payment rate under section 256R.25.
new text end

deleted text begin (1) partial rebasing, with the commissioner allowing a designated facility operating
payment rates being the sum of up to 60 percent of the operating payment rate determined
in accordance with section 256R.21, subdivision 3, and at least 40 percent, with the sum of
the two portions being equal to 100 percent, of the operating payment rate that would have
been allowed had the facility not been designated. The commissioner may adjust these
percentages by up to 20 percent and may approve a request for less than the amount allowed;
deleted text end

deleted text begin (2) enhanced payments for leave days. Notwithstanding section 256R.43, upon
designation as a critical access nursing facility, the commissioner shall limit payment for
leave days to 60 percent of that nursing facility's total payment rate for the involved resident,
and shall allow this payment only when the occupancy of the nursing facility, inclusive of
bed hold days, is equal to or greater than 90 percent;
deleted text end

deleted text begin (3) two designated critical access nursing facilities, with up to 100 beds in active service,
may jointly apply to the commissioner of health for a waiver of Minnesota Rules, part
4658.0500, subpart 2, in order to jointly employ a director of nursing. The commissioner
of health shall consider each waiver request independently based on the criteria under
Minnesota Rules, part 4658.0040;
deleted text end

deleted text begin (4) the minimum threshold under section 256B.431, subdivision 15, paragraph (e), shall
be 40 percent of the amount that would otherwise apply; and
deleted text end

deleted text begin (5) the quality-based rate limits under section 256R.23, subdivisions 5 to 7, apply to
designated critical access nursing facilities.
deleted text end

(d) Designation of a critical access nursing facility is for a new text begin maximum new text end period of new text begin up to
new text end two years, after which the deleted text begin benefitsdeleted text end new text begin benefitnew text end allowed under paragraph (c) shall be removed.
Designated facilities may apply for continued designation.

deleted text begin (e) This section is suspended and no state or federal funding shall be appropriated or
allocated for the purposes of this section from January 1, 2016, to December 31, 2019.
deleted text end

new text begin (e) The memorandum of understanding required by paragraph (c), clause (1), must state
that the designation of a critical access nursing facility must be removed if the facility
undergoes a change of ownership as defined in section 144A.06, subdivision 2.
new text end

Minnesota Statutes 2022, section 256S.15, subdivision 2, is amended to read:

The elderly waiver payment for the foster care service in
combination with the payment for all other elderly waiver services, including case
management, must not exceed the monthly case mix budget cap for the participant as
specified in sections 256S.18, subdivision 3, and 256S.19, deleted text begin subdivisionsdeleted text end new text begin subdivisionnew text end 3 deleted text begin and
4deleted text end .

Minnesota Statutes 2022, section 256S.18, is amended by adding a subdivision
to read:

new text begin The monthly case mix budget caps for each case mix classification for
consumer-directed community supports must be equal to the monthly case mix budget caps
in subdivision 3.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.19, subdivision 3, is amended to read:

(a) The elderly waiver monthly conversion budget cap for the
cost of elderly waiver services deleted text begin without consumer-directed community supportsdeleted text end must be
based on the nursing facility case mix adjusted total payment rate of the nursing facility
where the elderly waiver applicant currently resides for the applicant's case mix classification
as determined according to section 256R.17.

(b) The elderly waiver monthly conversion budget cap for the cost of elderly waiver
services deleted text begin without consumer-directed community supports shalldeleted text end new text begin mustnew text end be calculated by
multiplying the applicable nursing facility case mix adjusted total payment rate by 365,
dividing by 12, and subtracting the participant's maintenance needs allowance.

(c) A participant's initially approved monthly conversion budget cap for elderly waiver
services deleted text begin without consumer-directed community supports shalldeleted text end new text begin mustnew text end be adjusted at least
annually as described in section 256S.18, subdivision 5.

new text begin (d) Conversion budget caps for individuals participating in consumer-directed community
supports must be set as described in paragraphs (a) to (c).
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.203, subdivision 1, is amended to read:

The commissioner must adjust the elderly waiver
capitation payment rates for managed care organizations paid to reflect the monthly service
rate limits for customized living services and 24-hour customized living services established
under section 256S.202 deleted text begin anddeleted text end new text begin ,new text end the rate adjustments for disproportionate share facilities under
section 256S.205new text begin , and the assisted living facility closure payments under section 256S.206new text end .

Minnesota Statutes 2022, section 256S.203, subdivision 2, is amended to read:

Medical assistance rates paid to customized living
providers by managed care organizations under this chapter must not exceed the monthly
service rate limits and component rates as determined by the commissioner under sections
256S.15 and 256S.20 to 256S.202, plus any rate adjustment new text begin or special payment new text end under section
256S.205new text begin or 256S.206new text end .

new text begin The commissioner
of human services shall establish a special payment program to support licensed assisted
living facilities who serve waiver participants under section 256B.49 and chapter 256S
when the assisted living facility is acting to close the facility as outlined in section 144G.57.
The payments must support the facility to meet the health and safety needs of residents
during facility occupancy and revenue decline.
new text end

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

new text begin (b) "Closure period" means the number of days in the approved closure plan for the
eligible facility as determined by the commissioner of health under section 144G.57, not to
exceed 60 calendar days.
new text end

new text begin (c) "Eligible claim" means a claim for customized living services and 24-hour customized
living services provided to waiver participants under section 256B.49 and chapter 256S
during the eligible facility's closure period.
new text end

new text begin (d) "Eligible facility" means a licensed assisted living facility that has an approved
closure plan, as determined by the commissioner of health under section 144G.57, that is
acting to close the facility and no longer serve residents in that setting. A facility where a
provider is relinquishing an assisted living facility license to transition to a different license
type is not an eligible facility.
new text end

new text begin (a) An eligible facility may apply to the commissioner of human
services for assisted living closure transition payments in the manner prescribed by the
commissioner.
new text end

new text begin (b) The commissioner shall notify the facility within 14 calendars days of the facility's
application about the result of the application, including whether the facility meets the
definition of an eligible facility.
new text end

new text begin (a) The commissioner must increase the payment
for eligible claims by 50 percent during the eligible facility's closure period.
new text end

new text begin (b) The commissioner must direct managed care organizations to increase the payment
for eligible claims by 50 percent during the eligible facility's closure period for eligible
claims submitted to managed care organizations.
new text end

new text begin The commissioner of human services must
coordinate the activities under this section with any impacted state agencies and lead agencies.
new text end

new text begin This section is effective July 1, 2024, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 256S.21, is amended to read:

The payment methodologies in sections
256S.2101 to 256S.215 apply tonew text begin :
new text end

new text begin (1)new text end elderly waiver, elderly waiver customized living, and elderly waiver foster care under
this chapter;

new text begin (2)new text end alternative care under section 256B.0913;

new text begin (3)new text end essential community supports under section 256B.0922; and

new text begin (4)new text end community access for disability inclusion customized living and brain injury
customized living under section 256B.49.

new text begin (a) Beginning January 1, 2024, and every two years
thereafter, the commissioner, in consultation with stakeholders, shall use all available data
and resources to evaluate the following rate setting elements:
new text end

new text begin (1) the base wage index;
new text end

new text begin (2) the factors and supervision wage components; and
new text end

new text begin (3) the formulas to calculate adjusted base wages and rates.
new text end

new text begin (b) Beginning January 15, 2026, and every two years thereafter, the commissioner shall
report to the chairs and ranking minority members of the legislative committees and divisions
with jurisdiction over health and human services finance and policy with a full report on
the information and data gathered under paragraph (a).
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.2101, is amended to read:

All rates and
rate components for community access for disability inclusion customized living and brain
injury customized living under section 256B.4914 shall be the sum of deleted text begin tendeleted text end new text begin sixnew text end percent of the
rates calculated under sections 256S.211 to 256S.215 and deleted text begin 90deleted text end new text begin 94new text end percent of the rates calculated
using the rate methodology in effect as of June 30, 2017.

Except for home-delivered meals deleted text begin as
described in section 256S.215, subdivision 15deleted text end , all rates and rate components for elderly
waiver, elderly waiver customized living, and elderly waiver foster care under this chapter;
alternative care under section 256B.0913; and essential community supports under section
256B.0922 shall benew text begin :
new text end

new text begin (1) beginning January 1, 2024,new text end the sum of deleted text begin 18.8deleted text end new text begin 27.8new text end percent of the rates calculated under
sections 256S.211 to 256S.215, and deleted text begin 81.2deleted text end new text begin 72.2new text end percent of the rates calculated using the rate
methodology in effect as of June 30, 2017deleted text begin . The rate for home-delivered meals shall be the
sum of the service rate in effect as of January 1, 2019, and the increases described in section
256S.215, subdivision 15.deleted text end new text begin ; and
new text end

new text begin (2) beginning January 1, 2026, the sum of 25 percent of the rates calculated under sections
256S.211 to 256S.215, and 75 percent of the rates calculated using the rate methodology
in effect as of June 30, 2017.
new text end

new text begin (a) Except for community access for disability
inclusion customized living and brain injury customized living under section 256B.49, at
least 80 percent of the marginal increase in revenue from the implementation of any
adjustments to the phase-in in subdivision 2, or any updates to services rates directed under
section 256S.211, subdivision 3, must be used to increase compensation-related costs for
employees directly employed by the provider.
new text end

new text begin (b) For the purposes of this subdivision, compensation-related costs include:
new text end

new text begin (1) wages and salaries;
new text end

new text begin (2) the employer's share of FICA taxes, Medicare taxes, state and federal unemployment
taxes, workers' compensation, and mileage reimbursement;
new text end

new text begin (3) the employer's paid share of health and dental insurance, life insurance, disability
insurance, long-term care insurance, uniform allowance, pensions, and contributions to
employee retirement accounts; and
new text end

new text begin (4) benefits that address direct support professional workforce needs above and beyond
what employees were offered prior to the implementation of the adjusted phase-in in
subdivision 2, including any concurrent or subsequent adjustments to the base wage indices.
new text end

new text begin (c) Compensation-related costs for persons employed in the central office of a corporation
or entity that has an ownership interest in the provider or exercises control over the provider,
or for persons paid by the provider under a management contract, do not count toward the
80 percent requirement under this subdivision.
new text end

new text begin (d) A provider agency or individual provider that receives additional revenue subject to
the requirements of this subdivision shall prepare, and upon request submit to the
commissioner, a distribution plan that specifies the amount of money the provider expects
to receive that is subject to the requirements of this subdivision, including how that money
was or will be distributed to increase compensation-related costs for employees. Within 60
days of final implementation of the new phase-in proportion or adjustment to the base wage
indices subject to the requirements of this subdivision, the provider must post the distribution
plan and leave it posted for a period of at least six months in an area of the provider's
operation to which all direct support professionals have access. The posted distribution plan
must include instructions regarding how to contact the commissioner, or the commissioner's
representative, if an employee has not received the compensation-related increase described
in the plan.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.211, is amended by adding a subdivision
to read:

new text begin On January 1, 2024, and every two years thereafter,
the commissioner shall recalculate rates for services as directed in section 256S.215. Prior
to recalculating the rates, the commissioner shall:
new text end

new text begin (1) update the base wage index for services in section 256S.212 based on the most
recently available Bureau of Labor Statistics Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA data;
new text end

new text begin (2) update the payroll taxes and benefits factor in section 256S.213, subdivision 1, based
on the most recently available nursing facility cost report data;
new text end

new text begin (3) update the supervision wage components in section 256S.213, subdivisions 4 and 5,
based on the most recently available Bureau of Labor Statistics Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA data; and
new text end

new text begin (4) update the adjusted base wage for services as directed in section 256S.214.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.211, is amended by adding a subdivision
to read:

new text begin On January 1 of each year, the
commissioner shall update the home-delivered meals rate in section 256S.215, subdivision
15, by the percent increase in the nursing facility dietary per diem using the two most recently
available nursing facility cost reports.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.212, is amended to read:

If any of the SOC codes and positions used in
this section are no longer available, the commissioner shall, in consultation with stakeholders,
select a new SOC code and position that is the closest match to the previously used SOC
position.

For customized livingdeleted text begin ,deleted text end new text begin
andnew text end foster caredeleted text begin , and residential caredeleted text end component services, the home management and support
services base wage equals 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for new text begin home health and new text end personal deleted text begin and homedeleted text end care aide (SOC code deleted text begin 39-9021deleted text end new text begin
31-1120new text end ); 33.33 percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
wage for food preparation workers (SOC code 35-2021); and 33.34 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for maids and
housekeeping cleaners (SOC code 37-2012).

For customized livingdeleted text begin ,deleted text end new text begin andnew text end foster caredeleted text begin , and
residential caredeleted text end component services, the home care aide base wage equals deleted text begin 50deleted text end new text begin 75new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home healthnew text begin
and personal carenew text end aides (SOC code deleted text begin 31-1011deleted text end new text begin 31-1120new text end ); and 50 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
deleted text begin 31-1014deleted text end new text begin 31-1131new text end ).

For customized livingdeleted text begin ,deleted text end new text begin andnew text end foster caredeleted text begin , and
residential caredeleted text end component services, the home health aide base wage equals deleted text begin 20deleted text end new text begin 33.33new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed
practical and licensed vocational nurses (SOC code 29-2061); deleted text begin and 80deleted text end new text begin 33.33new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end )new text begin ; and 33.34 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for home health and personal care aides (SOC code
31-1120)new text end .

For customized livingdeleted text begin ,deleted text end new text begin andnew text end
foster caredeleted text begin , and residential caredeleted text end component services, the medication setups by licensed nurse
base wage equals deleted text begin tendeleted text end new text begin 25new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for licensed practical and licensed vocational nurses (SOC code 29-2061);
and deleted text begin 90deleted text end new text begin 75new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average
wage for registered nurses (SOC code 29-1141).

The chore services base wage equals deleted text begin 100deleted text end new text begin 50new text end percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for landscaping
and groundskeeping workers (SOC code 37-3011)new text begin ; and 50 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for maids and housekeeping cleaners
(SOC code 37-2012)new text end .

The companion services base wage equals
deleted text begin 50deleted text end new text begin 80new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage
for new text begin home health and new text end personal deleted text begin and homedeleted text end care aides (SOC code deleted text begin 39-9021deleted text end new text begin 31-1120new text end ); and deleted text begin 50deleted text end new text begin
20new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
maids and housekeeping cleaners (SOC code 37-2012).

The
homemaker deleted text begin services anddeleted text end assistance with personal care base wage equals deleted text begin 60deleted text end new text begin 50new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for new text begin home health
and new text end personal deleted text begin and homedeleted text end care deleted text begin aidedeleted text end new text begin aidesnew text end (SOC code deleted text begin 39-9021deleted text end new text begin 31-1120new text end ); deleted text begin 20deleted text end new text begin and 50new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end )deleted text begin ; and 20 percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012)deleted text end .

The homemaker deleted text begin services anddeleted text end
cleaning base wage equals deleted text begin 60 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for personal and home care aide (SOC code 39-9021); 20 percent
of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing
assistants (SOC code 31-1014); and 20deleted text end new text begin 100new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012).

The homemaker
deleted text begin services anddeleted text end home management base wage equals deleted text begin 60deleted text end new text begin 50new text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for new text begin home health and new text end personal deleted text begin and homedeleted text end
care deleted text begin aidedeleted text end new text begin aidesnew text end (SOC code deleted text begin 39-9021deleted text end new text begin 31-1120new text end ); deleted text begin 20deleted text end new text begin and 50new text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
deleted text begin 31-1014deleted text end new text begin 31-1131new text end )deleted text begin ; and 20 percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for maids and housekeeping cleaners (SOC code 37-2012)deleted text end .

The in-home respite care services
base wage equals deleted text begin fivedeleted text end new text begin 15new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA
average wage for registered nurses (SOC code 29-1141); 75 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistantsdeleted text end new text begin home health and
personal care aidesnew text end (SOC code deleted text begin 31-1014deleted text end new text begin 31-1120new text end ); and deleted text begin 20deleted text end new text begin tennew text end percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for licensed practical and licensed
vocational nurses (SOC code 29-2061).

The out-of-home respite care
services base wage equals deleted text begin fivedeleted text end new text begin 15new text end percent of the Minneapolis-St. Paul-Bloomington, MN-WI
MetroSA average wage for registered nurses (SOC code 29-1141); 75 percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin nursing assistantsdeleted text end new text begin
home health and personal care aidesnew text end (SOC code deleted text begin 31-1014deleted text end new text begin 31-1120new text end ); and deleted text begin 20deleted text end new text begin tennew text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for licensed practical
and licensed vocational nurses (SOC code 29-2061).

The individual community
living support base wage equals deleted text begin 20deleted text end new text begin 60new text end percent of the Minneapolis-St. Paul-Bloomington,
MN-WI MetroSA average wage for deleted text begin licensed practical and licensed vocational nursesdeleted text end new text begin social
and human services assistantsnew text end (SOC code deleted text begin 29-2061deleted text end new text begin 21-1093new text end ); and deleted text begin 80deleted text end new text begin 40new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end ).

The registered nurse base wage equals 100
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for
registered nurses (SOC code 29-1141).

The deleted text begin social workerdeleted text end new text begin
unlicensed supervisornew text end base wage equals 100 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for deleted text begin medical and public health socialdeleted text end new text begin
first-line supervisors of personal servicenew text end workers (SOC code deleted text begin 21-1022deleted text end new text begin 39-1022new text end ).

new text begin The adult day services base wage equals 75
percent of the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home
health and personal care aides (SOC code 31-1120); and 25 percent of the Minneapolis-St.
Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants (SOC code
31-1131).
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.213, is amended to read:

The payroll taxes and benefits factor
is the sum of net payroll taxes and benefits, divided by the sum of all salaries for all nursing
facilities on the most recent and available cost report.

The general and administrative factor is
deleted text begin the difference of net general and administrative expenses and administrative salaries, divided
by total operating expenses for all nursing facilities on the most recent and available cost
reportdeleted text end new text begin 14.4 percentnew text end .

new text begin (a) new text end The program plan support factor is deleted text begin 12.8deleted text end new text begin tennew text end
percent new text begin for the following services new text end to cover the cost of direct service staff needed to provide
support for deleted text begin home and community-baseddeleted text end new text begin thenew text end service when not engaged in direct contact with
participantsdeleted text begin .deleted text end new text begin :
new text end

new text begin (1) adult day services;
new text end

new text begin (2) customized living; and
new text end

new text begin (3) foster care.
new text end

new text begin (b) The program plan support factor is 15.5 percent for the following services to cover
the cost of direct service staff needed to provide support for the service when not engaged
in direct contact with participants:
new text end

new text begin (1) chore services;
new text end

new text begin (2) companion services;
new text end

new text begin (3) homemaker assistance with personal care;
new text end

new text begin (4) homemaker cleaning;
new text end

new text begin (5) homemaker home management;
new text end

new text begin (6) in-home respite care;
new text end

new text begin (7) individual community living support; and
new text end

new text begin (8) out-of-home respite care.
new text end

The
registered nurse management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end equals 15 percent of
the registered nurse adjusted base wage as defined in section 256S.214.

The deleted text begin social workerdeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end
equals 15 percent of the deleted text begin social workerdeleted text end new text begin unlicensed supervisornew text end adjusted base wage as defined
in section 256S.214.

new text begin The facility and equipment factor for adult
day services is 16.2 percent.
new text end

new text begin The food, supplies, and
transportation factor for adult day services is 24 percent.
new text end

new text begin The supplies and transportation factor
for the following services is 1.56 percent:
new text end

new text begin (1) chore services;
new text end

new text begin (2) companion services;
new text end

new text begin (3) homemaker assistance with personal care;
new text end

new text begin (4) homemaker cleaning;
new text end

new text begin (5) homemaker home management;
new text end

new text begin (6) in-home respite care;
new text end

new text begin (7) individual community support services; and
new text end

new text begin (8) out-of-home respite care.
new text end

new text begin The absence factor for the following services is 4.5 percent:
new text end

new text begin (1) adult day services;
new text end

new text begin (2) chore services;
new text end

new text begin (3) companion services;
new text end

new text begin (4) homemaker assistance with personal care;
new text end

new text begin (5) homemaker cleaning;
new text end

new text begin (6) homemaker home management;
new text end

new text begin (7) in-home respite care;
new text end

new text begin (8) individual community living support; and
new text end

new text begin (9) out-of-home respite care.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.214, is amended to read:

For the purposes of section 256S.215, the adjusted base wage for each position equals
the position's base wage under section 256S.212 plus:

(1) the position's base wage multiplied by the payroll taxes and benefits factor under
section 256S.213, subdivision 1;

deleted text begin (2) the position's base wage multiplied by the general and administrative factor under
section 256S.213, subdivision 2; and
deleted text end

deleted text begin (3)deleted text end new text begin (2)new text end the position's base wage multiplied by the new text begin applicable new text end program plan support factor
under section 256S.213, subdivision 3deleted text begin .deleted text end new text begin ; and
new text end

new text begin (3) the position's base wage multiplied by the absence factor under section 256S.213,
subdivision 9, if applicable.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 2, is amended to read:

The component
rate for home management and support services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home management and support services adjusted base wage deleted text begin plusdeleted text end new text begin andnew text end the
registered nurse management and supervision deleted text begin factor.deleted text end new text begin wage component;
new text end

new text begin (2) multiply the result of clause (1) by the general and administrative factor; and
new text end

new text begin (3) sum the results of clauses (1) and (2).
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 3, is amended to read:

The component rate for home care
aide services is new text begin calculated as follows:
new text end

new text begin (1) sum new text end the home health aide services adjusted base wage deleted text begin plusdeleted text end new text begin andnew text end the registered nurse
management and supervision deleted text begin factor.deleted text end new text begin wage component;
new text end

new text begin (2) multiply the result of clause (1) by the general and administrative factor; and
new text end

new text begin (3) sum the results of clauses (1) and (2).
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 4, is amended to read:

The component rate for home
health aide services is new text begin calculated as follows:
new text end

new text begin (2) multiply the result of clause (1) by the general and administrative factor; and
new text end

new text begin (3) sum the results of clauses (1) and (2).
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 7, is amended to read:

The 15-minute unit rate for chore services is calculated
as follows:

(1) sum the chore services adjusted base wage and the deleted text begin social workerdeleted text end new text begin unlicensed supervisornew text end
supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 8, is amended to read:

The 15-minute unit rate for companion services is
calculated as follows:

(1) sum the companion services adjusted base wage and the deleted text begin social workerdeleted text end new text begin unlicensed
supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 9, is amended to read:

The 15-minute
unit rate for homemaker deleted text begin services anddeleted text end assistance with personal care is calculated as follows:

(1) sum the homemaker deleted text begin services anddeleted text end assistance with personal care adjusted base wage
and the deleted text begin registered nurse management anddeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage
componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 10, is amended to read:

The 15-minute unit rate for
homemaker deleted text begin services anddeleted text end cleaning is calculated as follows:

(1) sum the homemaker deleted text begin services anddeleted text end cleaning adjusted base wage and the deleted text begin registered
nurse management anddeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 11, is amended to read:

The 15-minute unit rate
for homemaker deleted text begin services anddeleted text end home management is calculated as follows:

(1) sum the homemaker deleted text begin services anddeleted text end home management adjusted base wage and thedeleted text begin
registered nurse management anddeleted text end new text begin unlicensed supervisornew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ;
deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 12, is amended to read:

(a) The 15-minute unit rate for in-home
respite care services is calculated as follows:

(1) sum the in-home respite care services adjusted base wage and the registered nurse
management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

(b) The in-home respite care services daily rate equals the in-home respite care services
15-minute unit rate multiplied by 18.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 13, is amended to read:

(a) The 15-minute unit rate for
out-of-home respite care is calculated as follows:

(1) sum the out-of-home respite care services adjusted base wage and the registered
nurse management and supervision deleted text begin factordeleted text end new text begin wage componentnew text end ; deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

(b) The out-of-home respite care services daily rate equals the 15-minute unit rate for
out-of-home respite care services multiplied by 18.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 14, is amended to read:

The individual community living
support rate is calculated as follows:

(1) sum the deleted text begin home care aidedeleted text end new text begin individual community living supportnew text end adjusted base wage
and the deleted text begin social workerdeleted text end new text begin registered nurse management andnew text end supervision deleted text begin factordeleted text end new text begin wage componentnew text end ;
deleted text begin and
deleted text end

(2) new text begin multiply the result of clause (1) by the general and administrative factor;
new text end

new text begin (3) multiply the result of clause (1) by the supplies and transportation factor; and
new text end

new text begin (4) sum the results of clauses (1) to (3) and new text end divide the result deleted text begin of clause (1)deleted text end by four.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 15, is amended to read:

new text begin Effective January 1, 2024, new text end the home-delivered
meals rate deleted text begin equals $9.30deleted text end new text begin is $8.17, updated as directed in section 256S.211, subdivision 4new text end .
deleted text begin The commissioner shall increase the home delivered meals rate every July 1 by the percent
increase in the nursing facility dietary per diem using the two most recent and available
nursing facility cost reports.
deleted text end

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

Minnesota Statutes 2022, section 256S.215, subdivision 16, is amended to read:

The 15-minute unit rate for adult day servicesdeleted text begin , with
an assumed staffing ratio of one staff person to four participants, is the sum ofdeleted text end new text begin is calculated
as followsnew text end :

(1) deleted text begin one-sixteenth of the home care aidedeleted text end new text begin divide the adult daynew text end services adjusted base wagedeleted text begin ,
except that the general and administrative factor used to determine the home care aide
services adjusted base wage is 20 percentdeleted text end new text begin by five to reflect an assumed staffing ratio of one
to fivenew text end ;

(2) deleted text begin one-fourth of the registered nurse management and supervision factordeleted text end new text begin sum the result
of clause (1) and the registered nurse management and supervision wage componentnew text end ; deleted text begin and
deleted text end

(3) deleted text begin $0.63 to cover the cost of meals.deleted text end new text begin multiply the result of clause (2) by the general and
administrative factor;
new text end

new text begin (4) multiply the result of clause (2) by the facility and equipment factor;
new text end

new text begin (5) multiply the result of clause (2) by the food, supplies, and transportation factor; and
new text end

new text begin (6) sum the results of clauses (2) to (5) and divide the result by four.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256S.215, subdivision 17, is amended to read:

The 15-minute unit rate for adult day services
bath is deleted text begin the sum ofdeleted text end new text begin calculated as followsnew text end :

(1) deleted text begin one-fourth of the home care aidedeleted text end new text begin sum the adult daynew text end services adjusted base wagedeleted text begin ,
except that the general and administrative factor used to determine the home care aide
services adjusted base wage is 20 percentdeleted text end new text begin and the nurse management and supervision wage
componentnew text end ;

(2) deleted text begin one-fourth of the registered nurse management and supervisiondeleted text end new text begin multiply the result
of clause (1) by the general and administrativenew text end factor; deleted text begin and
deleted text end

(3) deleted text begin $0.63 to cover the cost of meals.deleted text end new text begin multiply the result of clause (1) by the facility and
equipment factor;
new text end

new text begin (4) multiply the result of clause (1) by the food, supplies, and transportation factor; and
new text end

new text begin (5) sum the results of clauses (1) to (4) and divide the result by four.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 268.19, subdivision 1, is amended to read:

(a) Except as provided by this section, data gathered from
any person under the administration of the Minnesota Unemployment Insurance Law are
private data on individuals or nonpublic data not on individuals as defined in section 13.02,
subdivisions 9 and 12, and may not be disclosed except according to a district court order
or section 13.05. A subpoena is not considered a district court order. These data may be
disseminated to and used by the following agencies without the consent of the subject of
the data:

(1) state and federal agencies specifically authorized access to the data by state or federal
law;

(2) any agency of any other state or any federal agency charged with the administration
of an unemployment insurance program;

(3) any agency responsible for the maintenance of a system of public employment offices
for the purpose of assisting individuals in obtaining employment;

(4) the public authority responsible for child support in Minnesota or any other state in
accordance with section 256.978;

(5) human rights agencies within Minnesota that have enforcement powers;

(6) the Department of Revenue to the extent necessary for its duties under Minnesota
laws;

(7) public and private agencies responsible for administering publicly financed assistance
programs for the purpose of monitoring the eligibility of the program's recipients;

(8) the Department of Labor and Industry and the Commerce Fraud Bureau in the
Department of Commerce for uses consistent with the administration of their duties under
Minnesota law;

(9) the Department of Human Services and the Office of Inspector General and its agents
within the Department of Human Services, including county fraud investigators, for
investigations related to recipient or provider fraud and employees of providers when the
provider is suspected of committing public assistance fraud;

new text begin (10) the Department of Human Services for the purpose of evaluating medical assistance
services and supporting program improvement;
new text end

deleted text begin (10)deleted text end new text begin (11)new text end local and state welfare agencies for monitoring the eligibility of the data subject
for assistance programs, or for any employment or training program administered by those
agencies, whether alone, in combination with another welfare agency, or in conjunction
with the department or to monitor and evaluate the statewide Minnesota family investment
program and other cash assistance programs, the Supplemental Nutrition Assistance Program,
and the Supplemental Nutrition Assistance Program Employment and Training program by
providing data on recipients and former recipients of Supplemental Nutrition Assistance
Program (SNAP) benefits, cash assistance under chapter 256, 256D, 256J, or 256K, child
care assistance under chapter 119B, or medical programs under chapter 256B or 256L or
formerly codified under chapter 256D;

deleted text begin (11)deleted text end new text begin (12)new text end local and state welfare agencies for the purpose of identifying employment,
wages, and other information to assist in the collection of an overpayment debt in an
assistance program;

deleted text begin (12)deleted text end new text begin (13)new text end local, state, and federal law enforcement agencies for the purpose of ascertaining
the last known address and employment location of an individual who is the subject of a
criminal investigation;

deleted text begin (13)deleted text end new text begin (14)new text end the United States Immigration and Customs Enforcement has access to data
on specific individuals and specific employers provided the specific individual or specific
employer is the subject of an investigation by that agency;

deleted text begin (14)deleted text end new text begin (15)new text end the Department of Health for the purposes of epidemiologic investigations;

deleted text begin (15)deleted text end new text begin (16)new text end the Department of Corrections for the purposes of case planning and internal
research for preprobation, probation, and postprobation employment tracking of offenders
sentenced to probation and preconfinement and postconfinement employment tracking of
committed offenders;

deleted text begin (16)deleted text end new text begin (17)new text end the state auditor to the extent necessary to conduct audits of job opportunity
building zones as required under section 469.3201; and

deleted text begin (17)deleted text end new text begin (18)new text end the Office of Higher Education for purposes of supporting program
improvement, system evaluation, and research initiatives including the Statewide
Longitudinal Education Data System.

(b) Data on individuals and employers that are collected, maintained, or used by the
department in an investigation under section 268.182 are confidential as to data on individuals
and protected nonpublic data not on individuals as defined in section 13.02, subdivisions 3
and 13, and must not be disclosed except under statute or district court order or to a party
named in a criminal proceeding, administrative or judicial, for preparation of a defense.

(c) Data gathered by the department in the administration of the Minnesota unemployment
insurance program must not be made the subject or the basis for any suit in any civil
proceedings, administrative or judicial, unless the action is initiated by the department.

Laws 2021, chapter 30, article 12, section 5, as amended by Laws 2021, First
Special Session chapter 7, article 17, section 2, is amended to read:

The Governor's Council on an Age-Friendly Minnesota, established in Executive Order
19-38, shall: (1) work to advance age-friendly policies; and (2) coordinate state, local, and
private partners' collaborative work on emergency preparedness, with a focus on older
adults, communities, and persons in zip codes most impacted by the COVID-19 pandemic.
The Governor's Council on an Age-Friendly Minnesota is extended and expires June 30,
deleted text begin 2024deleted text end new text begin 2027new text end .

Laws 2021, First Special Session chapter 7, article 17, section 8, is amended to
read:

(a) This act includes $0 in fiscal year
2022 and $875,000 in fiscal year 2023 for age-friendly community grants. The commissioner
of human services, in collaboration with the Minnesota Board on Aging and the Governor's
Council on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop
the age-friendly community grant program to help communities, including cities, counties,
other municipalities, tribes, and collaborative efforts, to become age-friendly communities,
with an emphasis on structures, services, and community features necessary to support older
adult residents over the next decade, including but not limited to:

(1) coordination of health and social services;

(2) transportation access;

(3) safe, affordable places to live;

(4) reducing social isolation and improving wellness;

(5) combating ageism and racism against older adults;

(6) accessible outdoor space and buildings;

(7) communication and information technology access; and

(8) opportunities to stay engaged and economically productive.

The general fund base in this act for this purpose is $875,000 in fiscal year 2024 deleted text begin and $0deleted text end new text begin ,
$875,000new text end in fiscal year 2025new text begin , $875,000 in fiscal year 2025, $875,000 in fiscal year 2026,
$875,000 in fiscal year 2027, and $0 in fiscal year 2028new text end .

(b) All grant activities must be completed by March 31, deleted text begin 2024deleted text end new text begin 2027new text end .

(a) This act includes $0 in fiscal year 2022 and
$575,000 in fiscal year 2023 for technical assistance grants. The commissioner of human
services, in collaboration with the Minnesota Board on Aging and the Governor's Council
on an Age-Friendly Minnesota, established in Executive Order 19-38, shall develop the
age-friendly technical assistance grant program. The general fund base in this act for this
purpose is $575,000 in fiscal year 2024 deleted text begin and $0deleted text end new text begin , $575,000new text end in fiscal year 2025new text begin , $575,000 in
fiscal year 2026, $575,000 in fiscal year 2027, and $0 in fiscal year 2028new text end .

(b) All grant activities must be completed by March 31, deleted text begin 2024deleted text end new text begin 2027new text end .

Laws 2021, First Special Session chapter 7, article 17, section 16, is amended to
read:

new text begin (a) new text end This act includes $400,000 in fiscal year 2022 and $300,000 in fiscal year 2023 for
an actuarial research study of public and private financing options for long-term services
and supports reform to increase access across the state. new text begin Any unexpended amount in fiscal
year 2023 is available through June 30, 2024. new text end The commissioner of human services must
conduct the study. Of this amount, the commissioner may transfer up to $100,000 to the
commissioner of commerce for costs related to the requirements of the study. The general
fund base included in this act for this purpose is $0 in fiscal year 2024 and $0 in fiscal year
2025.

new text begin (b) All activities must be completed by June 30, 2024.
new text end

new text begin (a) The commissioner of human services must review the medical assistance early
intensive developmental and behavioral intervention (EIDBI) service and evaluate the need
for licensure or other regulatory modifications. At a minimum, the evaluation must include:
new text end

new text begin (1) an examination of current Department of Human Services-licensed programs that
are similar to EIDBI;
new text end

new text begin (2) an environmental scan of licensure requirements for Medicaid autism programs in
other states; and
new text end

new text begin (3) health and safety needs for populations with autism and related conditions.
new text end

new text begin (b) The commissioner must consult with interested stakeholders, including self-advocates
who use EIDBI services, EIDBI providers, parents of youth who use EIDBI services, and
advocacy organizations. The commissioner must convene stakeholder meetings to obtain
feedback on licensure or regulatory recommendations.
new text end

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

new text begin The commissioner, in consultation with stakeholders, must evaluate options to expand
services authorized under Minnesota's federally approved home and community-based
waivers, including positive support, crisis respite, respite, and specialist services. The
evaluation may include options to authorize services under Minnesota's medical assistance
state plan and strategies to decrease the number of people who remain in hospitals, jails,
and other acute or crisis settings when they no longer meet medical or other necessity criteria.
new text end

new text begin The labor agreement between the state of Minnesota and the Service Employees
International Union Healthcare Minnesota and Iowa, submitted to the Legislative
Coordinating Commissioner on March ..., 2023, is ratified.
new text end

new text begin Upon federal approval, the commissioner must increase the annual limit for specialized
equipment and supplies under Minnesota's federally approved home and community-based
service waiver plans, alternative care, and essential community supports to $10,000.
new text end

new text begin The commissioner must establish a temporary grant for customized living providers that
serve six or fewer people in a single-family home and that are transitioning to a community
residential services licensure or integrated community supports licensure. Allowable uses
of grant money include physical plant updates required for community residential services
or integrated community supports licensure, technical assistance to adapt business models
and meet policy and regulatory guidance, and other uses approved by the commissioner.
License holders of eligible settings must apply for grant money using an application process
holders of eligible settings must apply for grant money using an application process
determined by the commissioner. Grant money approved by the commissioner is a one-time
award of up to $20,000 per eligible setting. To be considered for grant money, eligible
license holders must submit a grant application by June 30, 2024. The commissioner may
approve grant applications on a rolling basis.
new text end

new text begin The commissioners of human services, employment and economic development, and
education must conduct an interagency alignment study on employment supports for people
with disabilities. The study must evaluate:
new text end

new text begin (1) service rates;
new text end

new text begin (2) provider enrollment and monitoring standards; and
new text end

new text begin (3) eligibility processes and people's lived experience transitioning between employment
programs.
new text end

new text begin By January 15, 2025, the Departments of Human Services, Employment and Economic
Development, and Education must provide the chairs and ranking minority members of the
legislative committees with jurisdiction over health, human services, and labor with a plan
for tracking employment outcomes for people with disabilities served by programs
administered by the agencies. This plan must include any needed changes to state law to
track supports received and outcomes across programs.
new text end

new text begin The commissioner must seek all necessary amendments to Minnesota's federally approved
disability waiver plans to require that people receiving prevocational or employment support
services are compensated at or above the state minimum wage or at or above the prevailing
local minimum wage no later than August 1, 2028.
new text end

new text begin (a) The commissioner must study presumptive functional eligibility for people with
disabilities and older adults in the following programs:
new text end

new text begin (1) medical assistance, alternative care, and essential community supports; and
new text end

new text begin (2) home and community-based services and essential community supports.
new text end

new text begin (b) The commissioner must evaluate the following in the study of presumptive eligibility
within the programs listed in paragraph (a):
new text end

new text begin (1) current eligibility processes;
new text end

new text begin (2) barriers to timely eligibility determinations; and
new text end

new text begin (3) strategies to enhance access to home and community-based services in the least
restrictive setting.
new text end

new text begin (c) By January 1, 2025, the commissioner must report recommendations and draft
legislation to the chairs and ranking minority members of the legislative committees with
jurisdiction over health and human services finance and policy.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2022, section 256B.4914, subdivision 6b, new text end new text begin is repealed.
new text end

new text begin (b) new text end new text begin Minnesota Statutes 2022, section 256S.19, subdivision 4, new text end new text begin is repealed.
new text end

new text begin Paragraph (a) is effective January 1, 2026, or upon federal
approval, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained. Paragraph (b) is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 245A.10, subdivision 3, is amended to read:

(a) For fees required under
subdivision 1, an applicant for an initial license or certification issued by the commissioner
shall submit a $500 application fee with each new application required under this subdivision.
new text begin If the applicant is an organization applying for an initial license to provide services under
chapter 245D, the applicant shall submit a $4,200 application fee. new text end An applicant for an initial
day services facility license under chapter 245D shall submit a $250 application fee with
each new application. The application fee shall not be prorated, is nonrefundable, and is in
lieu of the annual license or certification fee that expires on December 31. The commissioner
shall not process an application until the application fee is paid.

(b) Except as provided in clauses (1) to (3), an applicant shall apply for a license to
provide services at a specific location.

(1) For a license to provide home and community-based services to persons with
disabilities or age 65 and older under chapter 245D, an applicant shall submit an application
to provide services statewide. deleted text begin Notwithstanding paragraph (a), applications received by the
commissioner between July 1, 2013, and December 31, 2013, for licensure of services
provided under chapter 245D must include an application fee that is equal to the annual
license renewal fee under subdivision 4, paragraph (b), or $500, whichever is less.
Applications received by the commissioner after January 1, 2014, must include the application
fee required under paragraph (a). Applicants who meet the modified application criteria
identified in section 245A.042, subdivision 2, are exempt from paying an application fee.
deleted text end

(2) For a license to provide independent living assistance for youth under section 245A.22,
an applicant shall submit a single application to provide services statewide.

(3) For a license for a private agency to provide foster care or adoption services under
Minnesota Rules, parts 9545.0755 to 9545.0845, an applicant shall submit a single application
to provide services statewide.

(c) The initial application fee charged under this subdivision does not include the
temporary license surcharge under section 16E.22.

Minnesota Statutes 2022, section 256B.056, subdivision 3, is amended to read:

(a) To be eligible for medical
assistance, a person must not individually own more than $3,000 in assets, or if a member
of a household with two family members, husband and wife, or parent and child, the
household must not own more than $6,000 in assets, plus $200 for each additional legal
dependent. In addition to these maximum amounts, an eligible individual or family may
accrue interest on these amounts, but they must be reduced to the maximum at the time of
an eligibility redetermination. The accumulation of the clothing and personal needs allowance
according to section 256B.35 must also be reduced to the maximum at the time of the
eligibility redetermination. The value of assets that are not considered in determining
eligibility for medical assistance is the value of those assets excluded under the Supplemental
Security Income program for aged, blind, and disabled persons, with the following
exceptions:

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

(2) capital and operating assets of a trade or business that the local agency determines
are necessary to the person's ability to earn an income are not considered;

(3) motor vehicles are excluded to the same extent excluded by the Supplemental Security
Income program;

(4) assets designated as burial expenses are excluded to the same extent excluded by the
Supplemental Security Income program. Burial expenses funded by annuity contracts or
life insurance policies must irrevocably designate the individual's estate as contingent
beneficiary to the extent proceeds are not used for payment of selected burial expenses;

(5) for a person who no longer qualifies as an employed person with a disability due to
loss of earnings, assets allowed while eligible for medical assistance under section 256B.057,
subdivision 9, are not considered for 12 months, beginning with the first month of ineligibility
as an employed person with a disability, to the extent that the person's total assets remain
within the allowed limits of section 256B.057, subdivision 9, paragraph (d);

(6) a designated employment incentives asset account is disregarded when determining
eligibility for medical assistance for a person age 65 years or older under section 256B.055,
subdivision 7. An employment incentives asset account must only be designated by a person
who has been enrolled in medical assistance under section 256B.057, subdivision 9, for a
24-consecutive-month period. A designated employment incentives asset account contains
qualified assets owned by the person deleted text begin and the person's spousedeleted text end in the last month of enrollment
in medical assistance under section 256B.057, subdivision 9. Qualified assets include
retirement and pension accounts, medical expense accounts, and up to $17,000 of the person's
other nonexcluded new text begin liquid new text end assets. An employment incentives asset account is no longer
designated when a person loses medical assistance eligibility for a calendar month or more
before turning age 65. A person who loses medical assistance eligibility before age 65 can
establish a new designated employment incentives asset account by establishing a new
24-consecutive-month period of enrollment under section 256B.057, subdivision 9. deleted text begin The
deleted text end deleted text begin income of a spouse of a person enrolled in medical assistance under section 256B.057,
subdivision 9, during each of the 24 consecutive months before the person's 65th birthday
must be disregarded when determining eligibility for medical assistance under section
256B.055, subdivision 7.deleted text end Persons eligible under this clause are not subject to the provisions
in section 256B.059; and

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

(b) No asset limit shall apply to persons eligible under section 256B.055, subdivision
15.

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

Minnesota Statutes 2022, section 256B.057, subdivision 9, is amended to read:

(a) Medical assistance may be paid for
a person who is employed and who:

(1) but for excess earnings or assets, meets the definition of disabled under the
Supplemental Security Income program;

(2) meets the asset limits in paragraph (d); and

(3) pays a premium and other obligations under paragraph (e).

(b) For purposes of eligibility, there is a $65 earned income disregard. To be eligible
for medical assistance under this subdivision, a person must have more than $65 of earned
income. Earned income must have Medicare, Social Security, and applicable state and
federal taxes withheld. The person must document earned income tax withholding. Any
spousal income or assets shall be disregarded for purposes of eligibility and premium
determinations.

(1) is temporarily unable to work and without receipt of earned income due to a medical
condition, as verified by a physician, advanced practice registered nurse, or physician
assistant; or

(2) loses employment for reasons not attributable to the enrollee, and is without receipt
of earned income may retain eligibility for up to four consecutive months after the month
of job loss. To receive a four-month extension, enrollees must verify the medical condition
or provide notification of job loss. All other eligibility requirements must be met and the
enrollee must pay all calculated premium costs for continued eligibility.

(d) For purposes of determining eligibility under this subdivision, a person's assets must
not exceed $20,000, excluding:

(1) all assets excluded under section 256B.056;

(2) retirement accounts, including individual accounts, 401(k) plans, 403(b) plans, Keogh
plans, and pension plans;

(3) medical expense accounts set up through the person's employer; and

(4) spousal assets, including spouse's share of jointly held assets.

(e) All enrollees must pay a premium to be eligible for medical assistance under this
subdivision, except as provided under clause (5).

(1) An enrollee must pay the greater of a $35 premium or the premium calculated based
on the person's gross earned and unearned income and the applicable family size using a
sliding fee scale established by the commissioner, which begins at one percent of income
at 100 percent of the federal poverty guidelines and increases to 7.5 percent of income for
those with incomes at or above 300 percent of the federal poverty guidelines.

(2) Annual adjustments in the premium schedule based upon changes in the federal
poverty guidelines shall be effective for premiums due in July of each year.

(3) All enrollees who receive unearned income must pay one-half of one percent of
unearned income in addition to the premium amount, except as provided under clause (5).

(4) Increases in benefits under title II of the Social Security Act shall not be counted as
income for purposes of this subdivision until July 1 of each year.

(5) Effective July 1, 2009, American Indians are exempt from paying premiums as
required by section 5006 of the American Recovery and Reinvestment Act of 2009, Public
Law 111-5. For purposes of this clause, an American Indian is any person who meets the
definition of Indian according to Code of Federal Regulations, title 42, section 447.50.

(f) A person's eligibility and premium shall be determined by the local county agency.
Premiums must be paid to the commissioner. All premiums are dedicated to the
commissioner.

(g) Any required premium shall be determined at application and redetermined at the
enrollee's six-month income review or when a change in income or household size is reported.
Enrollees must report any change in income or household size within ten days of when the
change occurs. A decreased premium resulting from a reported change in income or
household size shall be effective the first day of the next available billing month after the
change is reported. Except for changes occurring from annual cost-of-living increases, a
change resulting in an increased premium shall not affect the premium amount until the
next six-month review.

(h) Premium payment is due upon notification from the commissioner of the premium
amount required. Premiums may be paid in installments at the discretion of the commissioner.

(i) Nonpayment of the premium shall result in denial or termination of medical assistance
unless the person demonstrates good cause for nonpayment. "Good cause" means an excuse
for the enrollee's failure to pay the required premium when due because the circumstances
were beyond the enrollee's control or not reasonably foreseeable. The commissioner shall
determine whether good cause exists based on the weight of the supporting evidence
submitted by the enrollee to demonstrate good cause. Except when an installment agreement
is accepted by the commissioner, all persons disenrolled for nonpayment of a premium must
pay any past due premiums as well as current premiums due prior to being reenrolled.
Nonpayment shall include payment with a returned, refused, or dishonored instrument. The
commissioner may require a guaranteed form of payment as the only means to replace a
returned, refused, or dishonored instrument.

new text begin (j) The commissioner is authorized to determine that a premium amount was calculated
or billed in error, make corrections to financial records and billing systems, and refund
premiums collected in error.
new text end

deleted text begin (j)deleted text end new text begin (k)new text end For enrollees whose income does not exceed 200 percent of the federal poverty
guidelines and who are also enrolled in Medicare, the commissioner shall reimburse the
enrollee for Medicare part B premiums under section 256B.0625, subdivision 15, paragraph
(a).

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

Minnesota Statutes 2022, section 256B.0625, subdivision 17, is amended to read:

(a) "Nonemergency medical transportation service"
means motor vehicle transportation provided by a public or private person that serves
Minnesota health care program beneficiaries who do not require emergency ambulance
service, as defined in section 144E.001, subdivision 3, to obtain covered medical services.

(b) Medical assistance covers medical transportation costs incurred solely for obtaining
emergency medical care or transportation costs incurred by eligible persons in obtaining
emergency or nonemergency medical care when paid directly to an ambulance company,
nonemergency medical transportation company, or other recognized providers of
transportation services. Medical transportation must be provided by:

(1) nonemergency medical transportation providers who meet the requirements of this
subdivision;

(2) ambulances, as defined in section 144E.001, subdivision 2;

(3) taxicabs that meet the requirements of this subdivision;

(4) public transit, as defined in section 174.22, subdivision 7; or

(5) not-for-hire vehicles, including volunteer drivers, as defined in section 65B.472,
subdivision 1, paragraph (h).

(c) Medical assistance covers nonemergency medical transportation provided by
nonemergency medical transportation providers enrolled in the Minnesota health care
programs. All nonemergency medical transportation providers must comply with the
operating standards for special transportation service as defined in sections 174.29 to 174.30
and Minnesota Rules, chapter 8840, and all drivers must be individually enrolled with the
commissioner and reported on the claim as the individual who provided the service. All
nonemergency medical transportation providers shall bill for nonemergency medical
transportation services in accordance with Minnesota health care programs criteria. Publicly
operated transit systems, volunteers, and not-for-hire vehicles are exempt from the
requirements outlined in this paragraph.

(d) An organization may be terminated, denied, or suspended from enrollment if:

(1) the provider has not initiated background studies on the individuals specified in
section 174.30, subdivision 10, paragraph (a), clauses (1) to (3); or

(2) the provider has initiated background studies on the individuals specified in section
174.30, subdivision 10, paragraph (a), clauses (1) to (3), and:

(i) the commissioner has sent the provider a notice that the individual has been
disqualified under section 245C.14; and

(ii) the individual has not received a disqualification set-aside specific to the special
transportation services provider under sections 245C.22 and 245C.23.

(e) The administrative agency of nonemergency medical transportation must:

(1) adhere to the policies defined by the commissioner;

(2) pay nonemergency medical transportation providers for services provided to
Minnesota health care programs beneficiaries to obtain covered medical services;

(3) provide data monthly to the commissioner on appeals, complaints, no-shows, canceled
trips, and number of trips by mode; and

(4) by July 1, 2016, in accordance with subdivision 18e, utilize a web-based single
administrative structure assessment tool that meets the technical requirements established
by the commissioner, reconciles trip information with claims being submitted by providers,
and ensures prompt payment for nonemergency medical transportation services.

(f) Until the commissioner implements the single administrative structure and delivery
system under subdivision 18e, clients shall obtain their level-of-service certificate from the
commissioner or an entity approved by the commissioner that does not dispatch rides for
clients using modes of transportation under paragraph (i), clauses (4), (5), (6), and (7).

(g) The commissioner may use an order by the recipient's attending physician, advanced
practice registered nurse, physician assistant, or a medical or mental health professional to
certify that the recipient requires nonemergency medical transportation services.
Nonemergency medical transportation providers shall perform driver-assisted services for
eligible individuals, when appropriate. Driver-assisted service includes passenger pickup
at and return to the individual's residence or place of business, assistance with admittance
of the individual to the medical facility, and assistance in passenger securement or in securing
of wheelchairs, child seats, or stretchers in the vehicle.

Nonemergency medical transportation providers must take clients to the health care
provider using the most direct route, and must not exceed 30 miles for a trip to a primary
care provider or 60 miles for a trip to a specialty care provider, unless the client receives
authorization from the local agency.

Nonemergency medical transportation providers may not bill for separate base rates for
the continuation of a trip beyond the original destination. Nonemergency medical
transportation providers must maintain trip logs, which include pickup and drop-off times,
signed by the medical provider or client, whichever is deemed most appropriate, attesting
to mileage traveled to obtain covered medical services. Clients requesting client mileage
reimbursement must sign the trip log attesting mileage traveled to obtain covered medical
services.

(h) The administrative agency shall use the level of service process established by the
commissioner to determine the client's most appropriate mode of transportation. If public
transit or a certified transportation provider is not available to provide the appropriate service
mode for the client, the client may receive a onetime service upgrade.

(i) The covered modes of transportation are:

(1) client reimbursement, which includes client mileage reimbursement provided to
clients who have their own transportation, or to family or an acquaintance who provides
transportation to the client;

(2) volunteer transport, which includes transportation by volunteers using their own
vehicle;

(3) unassisted transport, which includes transportation provided to a client by a taxicab
or public transit. If a taxicab or public transit is not available, the client can receive
transportation from another nonemergency medical transportation provider;

(4) assisted transport, which includes transport provided to clients who require assistance
by a nonemergency medical transportation provider;

(5) lift-equipped/ramp transport, which includes transport provided to a client who is
dependent on a device and requires a nonemergency medical transportation provider with
a vehicle containing a lift or ramp;

(6) protected transport, which includes transport provided to a client who has received
a prescreening that has deemed other forms of transportation inappropriate and who requires
a provider: (i) with a protected vehicle that is not an ambulance or police car and has safety
locks, a video recorder, and a transparent thermoplastic partition between the passenger and
the vehicle driver; and (ii) who is certified as a protected transport provider; and

(7) stretcher transport, which includes transport for a client in a prone or supine position
and requires a nonemergency medical transportation provider with a vehicle that can transport
a client in a prone or supine position.

(j) The local agency shall be the single administrative agency and shall administer and
reimburse for modes defined in paragraph (i) according to paragraphs (m) and (n) when the
commissioner has developed, made available, and funded the web-based single administrative
structure, assessment tool, and level of need assessment under subdivision 18e. The local
agency's financial obligation is limited to funds provided by the state or federal government.

(k) The commissioner shall:

(1) verify that the mode and use of nonemergency medical transportation is appropriate;

(2) verify that the client is going to an approved medical appointment; and

(3) investigate all complaints and appeals.

(l) The administrative agency shall pay for the services provided in this subdivision and
seek reimbursement from the commissioner, if appropriate. As vendors of medical care,
local agencies are subject to the provisions in section 256B.041, the sanctions and monetary
recovery actions in section 256B.064, and Minnesota Rules, parts 9505.2160 to 9505.2245.

(m) Payments for nonemergency medical transportation must be paid based on the client's
assessed mode under paragraph (h), not the type of vehicle used to provide the service. The
medical assistance reimbursement rates for nonemergency medical transportation services
that are payable by or on behalf of the commissioner for nonemergency medical
transportation services are:

(1) $0.22 per mile for client reimbursement;

(2) up to 100 percent of the Internal Revenue Service business deduction rate for volunteer
transport;

(3) equivalent to the standard fare for unassisted transport when provided by public
transit, and deleted text begin $11deleted text end new text begin $13.20new text end for the base rate and deleted text begin $1.30deleted text end new text begin $1.56new text end per mile when provided by a
nonemergency medical transportation provider;

(4) deleted text begin $13deleted text end new text begin $15.60new text end for the base rate and deleted text begin $1.30deleted text end new text begin $1.56new text end per mile for assisted transport;

(5) deleted text begin $18deleted text end new text begin $21.60 new text end for the base rate and deleted text begin $1.55deleted text end new text begin $1.86new text end per mile for lift-equipped/ramp transport;

(6) $75 for the base rate and $2.40 per mile for protected transport; and

(7) $60 for the base rate and $2.40 per mile for stretcher transport, and $9 per trip for
an additional attendant if deemed medically necessary.

(n) The base rate for nonemergency medical transportation services in areas defined
under RUCA to be super rural is equal to 111.3 percent of the respective base rate in
paragraph (m), clauses (1) to (7). The mileage rate for nonemergency medical transportation
services in areas defined under RUCA to be rural or super rural areas is:

(1) for a trip equal to 17 miles or less, equal to 125 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7); and

(2) for a trip between 18 and 50 miles, equal to 112.5 percent of the respective mileage
rate in paragraph (m), clauses (1) to (7).

(o) For purposes of reimbursement rates for nonemergency medical transportation
services under paragraphs (m) and (n), the zip code of the recipient's place of residence
shall determine whether the urban, rural, or super rural reimbursement rate applies.

(p) For purposes of this subdivision, "rural urban commuting area" or "RUCA" means
a census-tract based classification system under which a geographical area is determined
to be urban, rural, or super rural.

(q) The commissioner, when determining reimbursement rates for nonemergency medical
transportation under paragraphs (m) and (n), shall exempt all modes of transportation listed
under paragraph (i) from Minnesota Rules, part 9505.0445, item R, subitem (2).

new text begin (r) Effective for the first day of each calendar quarter in which the price of gasoline, as
posted publicly by the United States Energy Information Administration, exceeds $3.00 per
gallon, the commissioner shall adjust the rate paid per mile in paragraph (m) up or down
by one percent for every increase or decrease of ten cents in the price of gasoline. The
increase or decrease must be calculated using a base gasoline price of $3.00. The percentage
increase or decrease must be calculated using the average of the most recently available
price of all grades of gasoline for Minnesota, as posted publicly by the United States Energy
Information Administration.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256B.0625, subdivision 17b, is amended to read:

(a) As a condition for payment, nonemergency
medical transportation providers must document each occurrence of a service provided to
a recipient according to this subdivision. Providers must maintain deleted text begin odometer and otherdeleted text end records
sufficient to distinguish individual trips with specific vehicles and drivers. The documentation
may be collected and maintained using electronic systems or software or in paper form but
must be made available and produced upon request. Program funds paid for transportation
that is not documented according to this subdivision deleted text begin shall be recovered by the departmentdeleted text end new text begin
may be subject to recovery by the commissioner pursuant to section 256B.064new text end .

(b) A nonemergency medical transportation provider must compile transportation new text begin trip
new text end recordsnew text begin that are written in English and legible according to the standard of a reasonable
person andnew text end that deleted text begin meetdeleted text end new text begin include each ofnew text end the following deleted text begin requirementsdeleted text end new text begin elementsnew text end :

deleted text begin (1) the record must be in English and must be legible according to the standard of a
reasonable person;
deleted text end

deleted text begin (2)deleted text end new text begin (1)new text end the recipient's name deleted text begin must be on each page of the recorddeleted text end ; deleted text begin and
deleted text end

deleted text begin (3) each entry in the record must document:
deleted text end

deleted text begin (i) the date on which the entry is made;
deleted text end

deleted text begin (ii)deleted text end new text begin (2)new text end the date or dates the service is providednew text begin , if different than the date the entry was
madenew text end ;

deleted text begin (iii)deleted text end new text begin (3)new text end the printed deleted text begin last name, first name, and middle initialdeleted text end new text begin name new text end of the drivernew text begin sufficient
to distinguish the driver of service or the driver's provider numbernew text end ;

deleted text begin (iv)deleted text end new text begin (4) the date andnew text end the signature of the driver attesting deleted text begin to the following: "I certify that
I have accurately reported in this record the trip miles I actually drove and the dates and
times I actually drove them. I understand that misreporting the miles driven and hours
worked is fraud for which I could face criminal prosecution or civil proceedings."deleted text end new text begin that the
record accurately represents the services provided and the actual miles driven, and
acknowledging that misreporting information that results in ineligible or excessive payments
may result in civil or criminal actionnew text end ;

deleted text begin (v)deleted text end new text begin (5) the date andnew text end the signature of the recipient or authorized party attesting deleted text begin to the
following: "I certify that I received the reported transportation service.", or the signature of
the provider of medical services certifying that the recipient was delivered to the providerdeleted text end new text begin
that transportation services were provided as indicated on the transportation trip record, or
the signature of the medical services provider certifying that the recipient was transported
to the provider destination. In the event that both the medical services provider and the
recipient or authorized party refuse or are unable to provide signatures, the driver must
document on the transportation trip record that signatures were requested and not providednew text end ;

deleted text begin (vi)deleted text end new text begin (6)new text end the address, or the description if the address is not available, of both the origin
and destination, and the mileage for the most direct route from the origin to the destination;

deleted text begin (vii)deleted text end new text begin (7)new text end the new text begin name or number of the new text end mode of transportation in which the service is
provided;

deleted text begin (viii)deleted text end new text begin (8)new text end the license plate number of the vehicle used to transport the recipient;

deleted text begin (ix) whether the service was ambulatory or nonambulatory;
deleted text end

deleted text begin (x)deleted text end new text begin (9)new text end the time of the new text begin recipient new text end pickupnew text begin ;
new text end

deleted text begin anddeleted text end new text begin (10)new text end the time of the new text begin recipient new text end drop-off deleted text begin with "a.m." and "p.m." designationsdeleted text end ;

new text begin (11) the odometer reading of the vehicle used to transport the recipient taken at the time
of pickup;
new text end

new text begin (12) the odometer reading of the vehicle used to transport the recipient taken at the time
of drop-off;
new text end

deleted text begin (xi)deleted text end new text begin (13)new text end the name of the extra attendant when an extra attendant is used to provide
special transportation service; and

deleted text begin (xii)deleted text end new text begin (14)new text end the deleted text begin electronic sourcedeleted text end documentationnew text begin indicating the method that wasnew text end used to
deleted text begin calculate driving directions and mileagedeleted text end new text begin determine the most direct routenew text end .

new text begin (c) In determining whether the commissioner will seek recovery, the documentation
requirements in this section apply retroactively to audit findings beginning January 1, 2020,
and to all audit findings thereafter.
new text end

Minnesota Statutes 2022, section 256B.0625, subdivision 18a, is amended to read:

(a) Medical assistance reimbursement for meals
for persons traveling to receive medical care may not exceed deleted text begin $5.50 for breakfast, $6.50 for
lunch, or $8 for dinnerdeleted text end new text begin reimbursement amounts provided in state collective bargaining
agreementsnew text end .

(b) Medical assistance reimbursement for lodging for persons traveling to receive medical
care may not exceed deleted text begin $50deleted text end new text begin $98new text end per day unless prior authorized by the local agency.

(c) Regardless of the number of employees that an enrolled health care provider may
have, medical assistance covers sign and oral language interpreter services when provided
by an enrolled health care provider during the course of providing a direct, person-to-person
covered health care service to an enrolled recipient with limited English proficiency or who
has a hearing loss and uses interpreting services. Coverage for face-to-face oral language
interpreter services shall be provided only if the oral language interpreter used by the enrolled
health care provider is listed in the registry or roster established under section 144.058.

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256B.0625, subdivision 18h, is amended to read:

(a) The following new text begin nonemergency medical transportation (NEMT) new text end subdivisions apply
to managed care plans and county-based purchasing plans:

(1) subdivision 17, paragraphs (a), (b), (i), and (n);

(2) subdivision 18; and

(3) subdivision 18a.

(b) A nonemergency medical transportation provider must comply with the operating
standards for special transportation service specified in sections 174.29 to 174.30 and
Minnesota Rules, chapter 8840. Publicly operated transit systems, volunteers, and not-for-hire
vehicles are exempt from the requirements in this paragraph.

new text begin (c) Managed care plans and county-based purchasing plans must provide a fuel adjustment
for NEMT rates when fuel exceeds $3 per gallon. If, for any contract year, federal approval
is not received for this paragraph, the commissioner must adjust the capitation rates paid to
managed care plans and county-based purchasing plans for that contract year to reflect the
removal of this provision. Contracts between managed care plans and county-based
purchasing plans and providers to whom this paragraph applies must allow recovery of
payments from those providers if capitation rates are adjusted in accordance with this
paragraph. Payment recoveries must not exceed the amount equal to any increase in rates
that results from this paragraph. This paragraph expires if federal approval is not received
for this paragraph at any time.
new text end

new text begin This section is effective January 1, 2024.
new text end

Minnesota Statutes 2022, section 256M.42, is amended to read:

(a) The commissioner shall allocate state money appropriated
under this section new text begin on an annual basis new text end to each county board deleted text begin and tribal government approved
by the commissioner to assume county agency dutiesdeleted text end for adult deleted text begin protective services or as a
lead investigative agencydeleted text end new text begin protectionnew text end under section 626.557 deleted text begin on an annual basis in an amount
determineddeleted text end new text begin and to Tribal Nations that have voluntarily chosen by resolution of Tribal
government to participate in vulnerable adult protection programsnew text end according to the following
formulanew text begin after the award of the amounts in paragraph (c)new text end :

(1) 25 percent must be allocated new text begin to the responsible agency new text end on the basis of the number
of reports of suspected vulnerable adult maltreatment under sections 626.557 and 626.5572,
deleted text begin when the county or tribe is responsibledeleted text end as determined by the most recent data of the
commissioner; and

(2) 75 percent must be allocated new text begin to the responsible agency new text end on the basis of the number
of screened-in reports for adult protective services or vulnerable adult maltreatment
investigations under sections 626.557 and 626.5572, deleted text begin when the county or tribe is responsibledeleted text end
as determined by the most recent data of the commissioner.

(b) deleted text begin The commissioner is precluded from changing the formula under this subdivision
or recommending a change to the legislature without public review and input.deleted text end new text begin
Notwithstanding this subdivision, no county must be awarded less than a minimum allocation
established by the commissioner.
new text end

new text begin (c) To receive money under this subdivision, a participating Tribal Nation must apply
to the commissioner. Of the amount appropriated for purposes of this section, the
commissioner must award $100,000 to each federally recognized Tribal Nation with a Tribal
resolution establishing a vulnerable adult protection program. Money received by a Tribal
Nation under this section must be used for its vulnerable adult protection program.
new text end

The commissioner shall make allocations for the state fiscal year
starting July 1, deleted text begin 2019deleted text end new text begin 2023new text end , and to each county board or tribal government on or before
October 10, deleted text begin 2019deleted text end new text begin 2023new text end . The commissioner shall make allocations under subdivision 1 to
each county board or tribal government each year thereafter on or before July 10.

Money
received under this section must be used for staffing for protection of vulnerable adults or
to expand adult protective servicesnew text begin for adults referred by the common entry point for adult
protective servicesnew text end . deleted text begin Money must not be used to supplant current county or tribe expenditures
for these purposes.
deleted text end

new text begin State funds must be used to expand, not supplant, the
base of county expenditures for adult protection programs, service interventions, or
multidisciplinary teams.
new text end

new text begin The commissioner must
set vulnerable adult protection measures and standards for money received under this section.
The standards must include but not be limited to a target percentage of adults referred who
are accepted by the county for protective services and goals for reducing disparities in
service outcomes for adults referred to counties for protective services under section 626.557.
The commissioner must require an underperforming county to demonstrate that the county
designated money allocated under this section for the purpose required and implemented a
reasonable strategy to improve adult protection performance, including the provision of a
performance improvement plan and additional remedies identified by the commissioner.
The commissioner may redirect up to 20 percent of a county's money under this section
toward the performance improvement plan.
new text end

new text begin Tribal Nations shall establish vulnerable
adult protection measures and standards and report annually to the commissioner on these
outcomes and the number of adults served.
new text end

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

Minnesota Statutes 2022, section 256R.17, subdivision 2, is amended to read:

(a) The commissioner shall assign a case mix index to each
case mix classification deleted text begin based on the Centers for Medicare and Medicaid Services staff time
measurement studydeleted text end new text begin as determined by the commissioner of health under section 144.0724new text end .

(b) An index maximization approach shall be used to classify residents. "Index
maximization" has the meaning given in section 144.0724, subdivision 2, paragraph (c).

Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision
to read:

new text begin "American Society of Addiction Medicine criteria" or "ASAM criteria" has the
meaning provided in section 254B.01, subdivision 2a.
new text end

Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
read:

new text begin "Protective factors" means the actions or efforts a person
can take to reduce the negative impact of certain issues, such as substance use disorders,
mental health disorders, and risk of suicide. Protective factors include connecting to positive
supports in the community, a good diet, exercise, attending counseling or 12-step groups,
and taking medications.
new text end

Minnesota Statutes 2022, section 245G.05, subdivision 1, is amended to read:

deleted text begin (a)deleted text end A comprehensive assessment of the
client's substance use disorder must be administered face-to-face by an alcohol and drug
counselor within deleted text begin threedeleted text end new text begin fivenew text end calendar days from the day of service initiation for a residential
program or deleted text begin within three calendar days on which a treatment session has been provided of
the day of service initiation for a clientdeleted text end new text begin by the end of the fifth day on which a treatment
service is providednew text end in a nonresidential program. new text begin The number of days to complete the
comprehensive assessment excludes the day of service initiation. new text end If the comprehensive
assessment is not completed within the required time frame, the person-centered reason for
the delay and the planned completion date must be documented in the client's file. The
comprehensive assessment is complete upon a qualified staff member's dated signature. If
the client received a comprehensive assessment that authorized the treatment service, an
alcohol and drug counselor may use the comprehensive assessment for requirements of this
subdivision but must document a review of the comprehensive assessment and update the
comprehensive assessment as clinically necessary to ensure compliance with this subdivision
within applicable timelines. deleted text begin The comprehensive assessment must include sufficient
information to complete the assessment summary according to subdivision 2 and the
individual treatment plan according to section 245G.06. The comprehensive assessment
must include information about the client's needs that relate to substance use and personal
strengths that support recovery, including:
deleted text end

deleted text begin (1) age, sex, cultural background, sexual orientation, living situation, economic status,
and level of education;
deleted text end

deleted text begin (2) a description of the circumstances on the day of service initiation;
deleted text end

deleted text begin (3) a list of previous attempts at treatment for substance misuse or substance use disorder,
compulsive gambling, or mental illness;
deleted text end

deleted text begin (4) a list of substance use history including amounts and types of substances used,
frequency and duration of use, periods of abstinence, and circumstances of relapse, if any.
For each substance used within the previous 30 days, the information must include the date
of the most recent use and address the absence or presence of previous withdrawal symptoms;
deleted text end

deleted text begin (5) specific problem behaviors exhibited by the client when under the influence of
substances;
deleted text end

deleted text begin (6) the client's desire for family involvement in the treatment program, family history
of substance use and misuse, history or presence of physical or sexual abuse, and level of
family support;
deleted text end

deleted text begin (7) physical and medical concerns or diagnoses, current medical treatment needed or
being received related to the diagnoses, and whether the concerns need to be referred to an
appropriate health care professional;
deleted text end

deleted text begin (8) mental health history, including symptoms and the effect on the client's ability to
function; current mental health treatment; and psychotropic medication needed to maintain
stability. The assessment must utilize screening tools approved by the commissioner pursuant
to section 245.4863 to identify whether the client screens positive for co-occurring disorders;
deleted text end

deleted text begin (9) arrests and legal interventions related to substance use;
deleted text end

deleted text begin (10) a description of how the client's use affected the client's ability to function
appropriately in work and educational settings;
deleted text end

deleted text begin (11) ability to understand written treatment materials, including rules and the client's
rights;
deleted text end

deleted text begin (12) a description of any risk-taking behavior, including behavior that puts the client at
risk of exposure to blood-borne or sexually transmitted diseases;
deleted text end

deleted text begin (13) social network in relation to expected support for recovery;
deleted text end

deleted text begin (14) leisure time activities that are associated with substance use;
deleted text end

deleted text begin (15) whether the client is pregnant and, if so, the health of the unborn child and the
client's current involvement in prenatal care;
deleted text end

deleted text begin (16) whether the client recognizes needs related to substance use and is willing to follow
treatment recommendations; and
deleted text end

deleted text begin (17) information from a collateral contact may be included, but is not required.
deleted text end

deleted text begin (b) If the client is identified as having opioid use disorder or seeking treatment for opioid
use disorder, the program must provide educational information to the client concerning:
deleted text end

deleted text begin (1) risks for opioid use disorder and dependence;
deleted text end

deleted text begin (2) treatment options, including the use of a medication for opioid use disorder;
deleted text end

deleted text begin (3) the risk of and recognizing opioid overdose; and
deleted text end

deleted text begin (4) the use, availability, and administration of naloxone to respond to opioid overdose.
deleted text end

deleted text begin (c) The commissioner shall develop educational materials that are supported by research
and updated periodically. The license holder must use the educational materials that are
approved by the commissioner to comply with this requirement.
deleted text end

deleted text begin (d) If the comprehensive assessment is completed to authorize treatment service for the
client, at the earliest opportunity during the assessment interview the assessor shall determine
if:
deleted text end

deleted text begin (1) the client is in severe withdrawal and likely to be a danger to self or others;
deleted text end

deleted text begin (2) the client has severe medical problems that require immediate attention; or
deleted text end

deleted text begin (3) the client has severe emotional or behavioral symptoms that place the client or others
at risk of harm.
deleted text end

deleted text begin If one or more of the conditions in clauses (1) to (3) are present, the assessor must end the
assessment interview and follow the procedures in the program's medical services plan
under section 245G.08, subdivision 2, to help the client obtain the appropriate services. The
assessment interview may resume when the condition is resolved. deleted text end new text begin An alcohol and drug
counselor must sign and date the comprehensive assessment review and update.
new text end

Minnesota Statutes 2022, section 245G.05, is amended by adding a subdivision to
read:

new text begin (a) A comprehensive assessment
must meet the requirements under section 245I.10, subdivision 6, paragraphs (b) and (c).
It must include:
new text end

new text begin (1) a diagnosis of a substance use disorder or a finding that the client does not meet the
criteria for a substance use disorder;
new text end

new text begin (2) a determination of whether the individual screens positive for co-occurring mental
health disorders using a screening tool approved by the commissioner pursuant to section
245.4863; and
new text end

new text begin (3) a recommendation for the ASAM level of care; for programs receiving payment
under chapter 254B, the ASAM level of care must be identified in section 254B.19,
subdivision 1.
new text end

new text begin (b) If the individual is assessed for opioid use disorder, the program must provide
educational material to the client within 24 hours of service initiation on:
new text end

new text begin (1) risks for opioid use disorder and dependence;
new text end

new text begin (2) treatment options, including the use of a medication for opioid use disorder;
new text end

new text begin (3) the risk of and recognizing opioid overdose; and
new text end

new text begin (4) the use, availability, and administration of naloxone to respond to opioid overdose.
new text end

new text begin If the client is identified as having opioid use disorder at a later point, the education must
be provided at that point. The license holder must use the educational materials that are
approved by the commissioner to comply with this requirement.
new text end

Minnesota Statutes 2022, section 245G.06, subdivision 1, is amended to read:

Each client must have a person-centered individual treatment
plan developed by an alcohol and drug counselor within ten days from the day of service
initiation for a residential program and within five calendar days new text begin by the end of the tenth day
new text end on which a treatment session has been provided from the day of service initiation for a client
in a nonresidential programnew text begin , not to exceed 30 daysnew text end . Opioid treatment programs must complete
the individual treatment plan within 21 days from the day of service initiation.new text begin For the
purposes of these time frames, the day services are initiated is excluded when calculating
the number of days.new text end The individual treatment plan must be signed by the client and the
alcohol and drug counselor and document the client's involvement in the development of
the plan. The individual treatment plan is developed upon the qualified staff member's dated
signature. Treatment planning must include ongoing assessment of client needs. An individual
treatment plan must be updated based on new information gathered about the client's
condition, the client's level of participation, and on whether methods identified have the
intended effect. A change to the plan must be signed by the client and the alcohol and drug
counselor. If the client chooses to have family or others involved in treatment services, the
client's individual treatment plan must include how the family or others will be involved in
the client's treatment. If a client is receiving treatment services or an assessment via telehealth
and the alcohol and drug counselor documents the reason the client's signature cannot be
obtained, the alcohol and drug counselor may document the client's verbal approval or
electronic written approval of the treatment plan or change to the treatment plan in lieu of
the client's signature.

Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision to
read:

new text begin (a) After completing an
individual's comprehensive assessment, the license holder must complete an individual
treatment plan. The license holder must:
new text end

new text begin (1) base the client's individual treatment plan on the client's comprehensive assessment;
new text end

new text begin (2) use a person-centered, culturally appropriate planning process that allows the client's
family and other natural supports to observe and participate in the client's individual treatment
services, assessments, and treatment planning;
new text end

new text begin (3) identify the client's treatment goals;
new text end

new text begin (4) identify the number of hours of skilled treatment services as defined in section
254B.01 the program plans to provide to the client each week or, if services will be provided
less frequently than weekly, the number of hours of treatment services the program plans
to provide to the client each month;
new text end

new text begin (5) identify the participants involved in the client's treatment planning. The client must
be a participant in the client's treatment planning. If applicable, the license holder must
document the reasons that the license holder did not involve the client's family or other
natural supports in the client's treatment planning;
new text end

new text begin (6) identify resources to refer the client to when the client's needs are to be addressed
concurrently by another provider; and
new text end

new text begin (7) identify maintenance strategy goals and methods designed to address relapse
prevention and to strengthen the client's protective factors.
new text end

Minnesota Statutes 2022, section 245G.06, subdivision 3, is amended to read:

A treatment plan review must be deleted text begin entered in a client's
file weekly or after each treatment service, whichever is less frequent,deleted text end new text begin completednew text end by the
alcohol and drug counselor responsible for the client's treatment plan. The review must
indicate the span of time covered by the review deleted text begin and each of the six dimensions listed in
section 245G.05, subdivision 2, paragraph (c)deleted text end . The review must:

(1) deleted text begin address each goal in thedeleted text end new text begin document client goals addressed since the lastnew text end treatment
plan new text begin review new text end and whether the new text begin identified new text end methods deleted text begin to address the goals aredeleted text end new text begin continue to be
new text end effective;

(2) deleted text begin includedeleted text end new text begin documentnew text end monitoring of any physical and mental health problemsnew text begin and include
toxicology results for alcohol and substance use, when availablenew text end ;

(3) document the participation of othersnew text begin involved in the individual's treatment planning,
including when services are offered to the client's family or significant othersnew text end ;

(4) new text begin if changes to the treatment plan are determined to be necessary, new text end document staff
recommendations for changes in the methods identified in the treatment plan and whether
the client agrees with the change; deleted text begin and
deleted text end

(5) include a review and evaluation of the individual abuse prevention plan according
to section 245A.65deleted text begin .deleted text end new text begin ; and
new text end

new text begin (6) document any referrals made since the previous treatment plan review.
new text end

Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision to
read:

new text begin (a) A license holder must ensure that
a treatment plan review is completed, meets the requirements of subdivision 3, and is entered
in each client's file by the alcohol and drug counselor responsible for the client's treatment
plan according the frequencies in this subdivision.
new text end

new text begin (b) For a client in a residential program, a treatment plan review must be completed and
entered once every 14 days.
new text end

new text begin (c) For a client in a nonresidential program, a treatment plan review must be completed
and entered once every 14 days unless the treatment plan clearly indicates services will be
provided to the client less frequently, according to paragraphs (d) and (e).
new text end

new text begin (d) For clients in a nonresidential program with a treatment plan that clearly indicates
less than 20 hours of skilled treatment services will be provided to the client each week or
less frequently than weekly, a treatment plan review must be completed and entered once
every 30 days.
new text end

new text begin (e) For clients in a nonresidential program with a treatment plan that clearly indicates
less than 5 hours of skilled treatment services will be provided to the client each month or
less frequently than monthly, a treatment plan review must be completed and entered once
every 90 days.
new text end

new text begin (f) Notwithstanding this subdivision, opioid treatment programs licensed according to
section 245G.22 must complete treatment plan reviews according to the frequencies in
section 245G.22, subdivision 15, paragraph (c), clause (3).
new text end

Minnesota Statutes 2022, section 245G.07, subdivision 2, is amended to read:

A license holder may provide or arrange the
following additional treatment service as a part of the client's individual treatment plan:

(1) relationship counseling provided by a qualified professional to help the client identify
the impact of the client's substance use disorder on others and to help the client and persons
in the client's support structure identify and change behaviors that contribute to the client's
substance use disorder;

(2) therapeutic recreation to allow the client to participate in recreational activities
without the use of mood-altering chemicals and to plan and select leisure activities that do
not involve the inappropriate use of chemicals;

(3) stress management and physical well-being to help the client reach and maintain an
appropriate level of health, physical fitness, and well-being;

(4) living skills development to help the client learn basic skills necessary for independent
living;

(5) employment or educational services to help the client become financially independent;

(6) socialization skills development to help the client live and interact with others in a
positive and productive manner;

(7) room, board, and supervision at the treatment site to provide the client with a safe
and appropriate environment to gain and practice new skills; and

(8) peer recovery support services provided one-to-one by an individual in recovery
qualified according to section deleted text begin 245G.11, subdivision 8deleted text end new text begin 245I.04, subdivision 18new text end . Peer support
services include education; advocacy; mentoring through self-disclosure of personal recovery
experiences; attending recovery and other support groups with a client; accompanying the
client to appointments that support recovery; assistance accessing resources to obtain housing,
employment, education, and advocacy services; and nonclinical recovery support to assist
the transition from treatment into the recovery community.

new text begin This section is effective upon federal approval. The commissioner
of human services shall notify the revisor of statutes when federal approval is obtained.
new text end

Minnesota Statutes 2022, section 245G.22, subdivision 15, is amended to read:

(a) The program must
deleted text begin offer at least 50 consecutive minutes of individual or group therapy treatment services as
defined in section 245G.07, subdivision 1, paragraph (a), clause (1), per week, for the first
ten weeks following the day of service initiation, and at least 50 consecutive minutes per
month thereafter. As clinically appropriate, the program may offer these services cumulatively
and not consecutively in increments of no less than 15 minutes over the required time period,
and for a total of 60 minutes of treatment services over the time period, and must document
the reason for providing services cumulatively in the client's record. The program may offer
additional levels of service when deemed clinically necessarydeleted text end new text begin meet the requirements in
section 245G.07, subdivision 1, paragraph (a), and must document each time the client was
offered an individual or group counseling service. If the individual or group counseling
service was offered but not provided to the client, the license holder must document the
reason the service was not provided. If the service was provided, the license holder must
ensure that the staff member who provided the treatment service documents in the client
record the date, type, and amount of the treatment service and the client's response to the
treatment service within seven days of providing the treatment servicenew text end .

(b) Notwithstanding the requirements of comprehensive assessments in section 245G.05,
the assessment must be completed within 21 days from the day of service initiation.

(1) treatment plan contents for a maintenance client are not required to include goals
the client must reach to complete treatment and have services terminated;

(2) treatment plans for a client in a taper or detox status must include goals the client
must reach to complete treatment and have services terminated; and

(3) for the ten weeks following the day of service initiation for all new admissions,
readmissions, and transfers, a weekly treatment plan review must be documented once the
treatment plan is completed. Subsequently, the counselor must document treatment plan
reviews deleted text begin in the six dimensionsdeleted text end at least once monthly or, when clinical need warrants, more
frequently.

Minnesota Statutes 2022, section 245I.04, subdivision 10, is amended to read:

A mental health
certified peer specialist must:

(1) have been diagnosed with a mental illness;

(2) be a current or former mental health services client; and

(3) deleted text begin have a valid certification as a mental health certified peer specialist under section
256B.0615deleted text end new text begin hold a current credential from the Minnesota Certification Board that demonstrates
skills and training in ethics and boundaries, advocacy, mentoring and education, and mental
health recovery and wellness supportnew text end .

Minnesota Statutes 2022, section 245I.04, is amended by adding a subdivision
to read:

new text begin (a) A recovery peer must:
new text end

new text begin (1) have a minimum of one year in recovery from substance use disorder; and
new text end

new text begin (2) hold a current credential from the Minnesota Certification Board, the Upper Midwest
Indian Council on Addictive Disorders, or the National Association for Alcoholism and
Drug Abuse Counselors that demonstrates skills and training in the domains of ethics and
boundaries, advocacy, mentoring and education, and recovery and wellness support.
new text end

new text begin (b) A recovery peer who receives a credential from a Tribal Nation when providing peer
recovery support services in a tribally licensed program satisfies the requirement in paragraph
(a), clause (2).
new text end

Minnesota Statutes 2022, section 245I.04, is amended by adding a subdivision
to read:

new text begin A recovery peer, under the supervision of
an alcohol and drug counselor, must:
new text end

new text begin (1) provide individualized peer support to each client;
new text end

new text begin (2) promote a client's recovery goals, self-sufficiency, self-advocacy, and development
of natural supports; and
new text end

new text begin (3) support a client's maintenance of skills that the client has learned from other services.
new text end

Minnesota Statutes 2022, section 245I.10, subdivision 6, is amended to read:

(a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context.new text begin An alcohol and drug counselor
may gather and document the information in paragraphs (b) and (c) when completing a
comprehensive assessment according to section 245G.05.
new text end

(b) When completing a standard diagnostic assessment of a client, the assessor must
gather and document information about the client's current life situation, including the
following information:

(1) the client's age;

(2) the client's current living situation, including the client's housing status and household
members;

(3) the status of the client's basic needs;

(4) the client's education level and employment status;

(5) the client's current medications;

(6) any immediate risks to the client's health and safetynew text begin , specifically withdrawal, medical
conditions, and behavioral and emotional symptomsnew text end ;

(7) the client's perceptions of the client's condition;

(8) the client's description of the client's symptoms, including the reason for the client's
referral;

(9) the client's history of mental healthnew text begin and substance use disordernew text end treatment; deleted text begin and
deleted text end

(10) cultural influences on the clientdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (11) substance use history, if applicable, including:
new text end

new text begin (i) amounts and types of substances, frequency and duration, route of administration,
periods of abstinence, and circumstances of relapse; and
new text end

new text begin (ii) the impact to functioning when under the influence of substances, including legal
interventions.
new text end

(c) If the assessor cannot obtain the information that this paragraph requires without
retraumatizing the client or harming the client's willingness to engage in treatment, the
assessor must identify which topics will require further assessment during the course of the
client's treatment. The assessor must gather and document information related to the following
topics:

(1) the client's relationship with the client's family and other significant personal
relationships, including the client's evaluation of the quality of each relationship;

(2) the client's strengths and resources, including the extent and quality of the client's
social networks;

(3) important developmental incidents in the client's life;

(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;

(5) the client's history of or exposure to alcohol and drug usage and treatment; and

(6) the client's health history and the client's family health history, including the client's
physical, chemical, and mental health history.

(d) When completing a standard diagnostic assessment of a client, an assessor must use
a recognized diagnostic framework.

(1) When completing a standard diagnostic assessment of a client who is five years of
age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
Classification of Mental Health and Development Disorders of Infancy and Early Childhood
published by Zero to Three.

(2) When completing a standard diagnostic assessment of a client who is six years of
age or older, the assessor must use the current edition of the Diagnostic and Statistical
Manual of Mental Disorders published by the American Psychiatric Association.

(3) When completing a standard diagnostic assessment of a client who is five years of
age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
(ECSII) to the client and include the results in the client's assessment.

(4) When completing a standard diagnostic assessment of a client who is six to 17 years
of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
(CASII) to the client and include the results in the client's assessment.

(5) When completing a standard diagnostic assessment of a client who is 18 years of
age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the criteria
in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders
published by the American Psychiatric Association to screen and assess the client for a
substance use disorder.

(e) When completing a standard diagnostic assessment of a client, the assessor must
include and document the following components of the assessment:

(1) the client's mental status examination;

(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
vulnerabilities; safety needs, including client information that supports the assessor's findings
after applying a recognized diagnostic framework from paragraph (d); and any differential
diagnosis of the client;new text begin and
new text end

(3) an explanation of: (i) how the assessor diagnosed the client using the information
from the client's interview, assessment, psychological testing, and collateral information
about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
and (v) the client's responsivity factors.

(f) When completing a standard diagnostic assessment of a client, the assessor must
consult the client and the client's family about which services that the client and the family
prefer to treat the client. The assessor must make referrals for the client as to services required
by law.

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

new text begin "American Society of Addiction Medicine criteria" or "ASAM" means the clinical
guidelines for purposes of the assessment, treatment, placement, and transfer or discharge
of individuals with substance use disorders. The ASAM criteria are contained in the current
edition of the ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and
Co-Occurring Conditions.
new text end

Minnesota Statutes 2022, section 254B.01, subdivision 8, is amended to read:

"Recovery community organization"
means an independentnew text begin , nonprofitnew text end organization led and governed by representatives of local
communities of recovery. A recovery community organization mobilizes resources within
and outside of the recovery community to increase the prevalence and quality of long-term
recovery from deleted text begin alcohol and other drug addictiondeleted text end new text begin substance use disordernew text end . Recovery community
organizations provide peer-based recovery support activities such as training of recovery
peers. Recovery community organizations provide mentorship and ongoing support to
individuals dealing with a substance use disorder and connect them with the resources that
can support each person's recovery. A recovery community organization also promotes a
recovery-focused orientation in community education and outreach programming, and
organize recovery-focused policy advocacy activities to foster healthy communities and
reduce the stigma of substance use disorder.

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

new text begin "Skilled treatment services" has the meaning given
for the "treatment services" described in section 245G.07, subdivisions 1, paragraph (a),
clauses (1) to (4), and 2, clauses (1) to (6). Skilled treatment services must be provided by
qualified professionals as identified in section 245G.07, subdivision 3.
new text end

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

new text begin Sober home is a cooperative living residence, a room and board
residence, an apartment, or any other living accommodation that:
new text end

new text begin (1) provides temporary housing to persons with a substance use disorder;
new text end

new text begin (2) stipulates residents must abstain from using alcohol or other illicit substances not
prescribed by a physician and meet other requirements as a condition of living in the home;
new text end

new text begin (3) charges a fee for living there;
new text end

new text begin (4) does not provide counseling or treatment services to residents; and
new text end

new text begin (5) promotes sustained recovery from substance use disorders.
new text end

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

new text begin "Comprehensive assessment" means a
person-centered, trauma-informed assessment that:
new text end

new text begin (1) is completed for a substance use disorder diagnosis, treatment planning, and
determination of client eligibility for substance use disorder treatment services;
new text end

new text begin (2) meets the requirements in section 245G.05; and
new text end

new text begin (3) is completed by an alcohol and drug counselor qualified according to section 245G.11,
subdivision 5.
new text end

Minnesota Statutes 2022, section 254B.05, subdivision 1, is amended to read:

(a) Programs licensed by the commissioner are
eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
notwithstanding the provisions of section 245A.03. American Indian programs that provide
substance use disorder treatment, extended care, transitional residence, or outpatient treatment
services, and are licensed by tribal government are eligible vendors.

(b) A licensed professional in private practice as defined in section 245G.01, subdivision
17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible
vendor of a comprehensive assessment and assessment summary provided according to
section 245G.05, and treatment services provided according to sections 245G.06 and
245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses
(1) to (6).

(c) A county is an eligible vendor for a comprehensive assessment and assessment
summary when provided by an individual who meets the staffing credentials of section
245G.11, subdivisions 1 and 5, and completed according to the requirements of section
245G.05. A county is an eligible vendor of care coordination services when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and
provided according to the requirements of section 245G.07, subdivision 1, paragraph (a),
clause (5).new text begin A county is an eligible vendor of peer recovery services when the services are
provided by an individual who meets the requirements of section 245I.04, subdivision 18.
new text end

(d) A recovery community organization that meets deleted text begin certificationdeleted text end new text begin thenew text end requirements deleted text begin identified
by the commissionerdeleted text end new text begin of clauses (1) to (10) and meets membership or accreditation
requirements of the Association of Recovery Community Organizations, the Council on
Accreditation of Peer Recovery Support Services, or a Minnesota statewide recovery
community organization identified by the commissionernew text end is an eligible vendor of peer support
services.new text begin Eligible vendors under this paragraph must be:
new text end

new text begin (1) nonprofit organizations;
new text end

new text begin (2) led and governed by the recovery community with more than 50 percent of the board
of directors or advisory boards self-identifying as people in personal recovery from their
own substance use disorders;
new text end

new text begin (3) primarily focused on recovery from substance use disorders, with missions and
visions that support this primary focus;
new text end

new text begin (4) grassroots and reflective of and engaged with the community served;
new text end

new text begin (5) accountable to the recovery community through processes that promote involvement,
engagement, and consultation of people in recovery and their families, friends, and recovery
allies;
new text end

new text begin (6) providers of nonclinical, peer recovery support services, including but not limited
to recovery support groups, recovery coaching, telephone recovery support, skill-building
groups, and harm-reduction activities;
new text end

new text begin (7) supportive, allowing for opportunities for all paths toward recovery and refraining
from excluding anyone based on their chosen path, which may include but is not limited to
harm reduction paths, faith-based paths, and nonfaith-based paths;
new text end

new text begin (8) purposeful in meeting the diverse needs of Black, Indigenous, and people of color
communities, including board and staff development activities, organizational practices,
service offerings, advocacy efforts, and culturally informed outreach and service plans;
new text end

new text begin (9) stewards of recovery-friendly language that is supportive of and promotes recovery
across diverse geographical and cultural contexts and reduces stigma; and
new text end

new text begin (10) maintaining an employee and volunteer code of ethics and easily accessible grievance
procedures either posted in physical spaces, on websites, or on program policies or forms.
new text end

new text begin (e) A recovery community organization that is aggrieved by an accreditation or
membership determination and believes it meets the requirements under section 254B.05,
subdivision 1, paragraph (d), clauses (1) to (10), may appeal under section 256.045,
subdivision 3, clause (15), for reconsideration as an eligible vendor.
new text end

deleted text begin (e)deleted text end new text begin (f)new text end Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, are not eligible vendors. Programs that are not licensed as a residential or
nonresidential substance use disorder treatment or withdrawal management program by the
commissioner or by tribal government or do not meet the requirements of subdivisions 1a
and 1b are not eligible vendors.

Minnesota Statutes 2022, section 254B.05, subdivision 1a, is amended to read:

(a) deleted text begin Effective January 1, 2000,deleted text end
Vendors of room and board are eligible for behavioral health fund payment if the vendor:

(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;

(2) is determined to meet applicable health and safety requirements;

(3) is not a jail or prison;

(4) is not concurrently receiving funds under chapter 256I for the recipient;

(5) admits individuals who are 18 years of age or older;

(6) is registered as a board and lodging or lodging establishment according to section
157.17;

(7) has awake staff on site 24 hours per day;

(8) has staff who are at least 18 years of age and meet the requirements of section
245G.11, subdivision 1, paragraph (b);

(9) has emergency behavioral procedures that meet the requirements of section 245G.16;

(10) meets the requirements of section 245G.08, subdivision 5, if administering
medications to clients;

(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;

(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;

(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;

(14) has a grievance procedure that meets the requirements of section 245G.15,
subdivision 2; and

(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.

(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).

(c) Programs providing children's mental health crisis admissions and stabilization under
section 245.4882, subdivision 6, are eligible vendors of room and board.

new text begin (d) Programs providing children's residential services under section 245.4882, except
services for individuals who have a placement under chapter 260C or 260D, are eligible
vendors of room and board.
new text end

deleted text begin (d)deleted text end new text begin (e)new text end Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
of room and board and are exempt from paragraph (a), clauses (6) to (15).

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

Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

(1) deleted text begin outpatient treatment services that are licensed according to sections 245G.01 to
245G.17, or applicable tribal license;deleted text end new text begin those licensed, as applicable, according to chapter
245G or applicable Tribal license and provided by the following ASAM levels of care:
new text end

new text begin (i) ASAM level 0.5 early intervention services provided according to section 254B.19,
subdivision 1, clause (1);
new text end

new text begin (ii) ASAM level 1.0 outpatient services provided according to section 254B.19,
subdivision 1, clause (2);
new text end

new text begin (iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19,
subdivision 1, clause (3);
new text end

new text begin (iv) ASAM level 2.5 partial hospitalization services provided according to section
254B.19, subdivision 1, clause (4);
new text end

new text begin (v) ASAM level 3.1 clinically managed low-intensity residential services provided
according to section 254B.19, subdivision 1, clause (5);
new text end

new text begin (vi) ASAM level 3.3 clinically managed population-specific high-intensity residential
services provided according to section 254B.19, subdivision 1, clause (6); and
new text end

new text begin (vii) ASAM level 3.5 clinically managed high-intensity residential services provided
according to section 254B.19, subdivision 1, clause (7);
new text end

(2) comprehensive assessments provided according to sections 245.4863, paragraph (a),
and 245G.05;

(3) deleted text begin caredeleted text end new text begin treatmentnew text end coordination services provided according to section 245G.07,
subdivision 1, paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) deleted text begin on July 1, 2019, or upon federal approval, whichever is later,deleted text end withdrawal management
services provided according to chapter 245F;

(6) substance use disorder treatment services with medications for opioid use disorder
deleted text begin that aredeleted text end new text begin provided in an opioid treatment programnew text end licensed according to sections 245G.01
to 245G.17 and 245G.22, or applicable tribal license;

deleted text begin (7) substance use disorder treatment with medications for opioid use disorder plus
enhanced treatment services that meet the requirements of clause (6) and provide nine hours
of clinical services each week;
deleted text end

deleted text begin (8) high, medium, and low intensity residential treatment services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable tribal license which
provide, respectively, 30, 15, and five hours of clinical services each week;
deleted text end

deleted text begin (9)deleted text end new text begin (7)new text end hospital-based treatment services that are licensed according to sections 245G.01
to 245G.17 or applicable tribal license and licensed as a hospital under sections 144.50 to
144.56;

deleted text begin (10)deleted text end new text begin (8)new text end adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable tribal license;

deleted text begin (11) high-intensity residential treatmentdeleted text end new text begin (9) ASAM 3.5 clinically managed high-intensity
residentialnew text end services that are licensed according to sections 245G.01 to 245G.17 and 245G.21
or applicable tribal license, which provide deleted text begin 30 hours of clinical services each weekdeleted text end new text begin ASAM
level of care 3.5 according to section 254B.19, subdivision 1, clause (7), and isnew text end provided
by a state-operated vendor or to clients who have been civilly committed to the commissioner,
present the most complex and difficult care needs, and are a potential threat to the community;
and

deleted text begin (12)deleted text end new text begin (10)new text end room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) meets the licensure exclusion criteria of section 245A.03, subdivision 2, paragraph
(a), clause (6), and meets the requirements under section 245G.19, subdivision 4; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific or culturally responsive programs as defined in section 254B.01,
subdivision 4a;

(3) disability responsive programs as defined in section 254B.01, subdivision 4b;

(4) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; or

(5) programs that offer services to individuals with co-occurring mental health and
substance use disorder problems if:

(i) the program meets the co-occurring requirements in section 245G.20;

(ii) 25 percent of the counseling staff are licensed mental health professionals under
section 245I.04, subdivision 2, or are students or licensing candidates under the supervision
of a licensed alcohol and drug counselor supervisor and mental health professional under
section 245I.04, subdivision 2, except that no more than 50 percent of the mental health
staff may be students or licensing candidates with time documented to be directly related
to provisions of co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance use disorder
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the substance use disorder facility of the child care provider's current licensure to provide
child care services. Programs that provide child care according to paragraph (c), clause (1),
must be deemed in compliance with the licensing requirements in section 245G.19.

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, substance use disorder services that are otherwise covered
as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,
subdivision 3b. The use of telehealth to deliver services must be medically appropriate to
the condition and needs of the person being served. Reimbursement shall be at the same
rates and under the same conditions that would otherwise apply to direct face-to-face services.

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

(h) Payment for outpatient substance use disorder services that are licensed according
to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
prior authorization of a greater number of hours is obtained from the commissioner.

new text begin The commissioner
must establish start-up and capacity-building grants for prospective or new recovery
community organizations serving or intending to serve culturally specific or
population-specific recovery communities. Grants may be used for expenses that are not
reimbursable under Minnesota health care programs, including but not limited to:
new text end

new text begin (1) costs associated with hiring and retaining staff;
new text end

new text begin (2) staff training, purchasing office equipment and supplies;
new text end

new text begin (3) purchasing software and website services;
new text end

new text begin (4) costs associated with establishing nonprofit status;
new text end

new text begin (5) rental and lease costs and community outreach; and
new text end

new text begin (6) education and recovery events.
new text end

new text begin The
commissioner must establish start-up and capacity-building grants for prospective or new
withdrawal management programs that will meet medically monitored or clinically monitored
levels of care. Grants may be used for expenses that are not reimbursable under Minnesota
health care programs, including but not limited to:
new text end

new text begin (1) costs associated with hiring staff;
new text end

new text begin (2) costs associated with staff retention;
new text end

new text begin (3) the purchase of office equipment and supplies;
new text end

new text begin (4) the purchase of software;
new text end

new text begin (5) costs associated with obtaining applicable and required licenses;
new text end

new text begin (6) business formation costs;
new text end

new text begin (7) costs associated with staff training; and
new text end

new text begin (8) the purchase of medical equipment and supplies necessary to meet health and safety
requirements.
new text end

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

new text begin All sober homes must comply with applicable state laws
and regulations and local ordinances related to maximum occupancy, fire safety, and
sanitation. All sober homes must register with the Department of Human Services. In
addition, all sober homes must:
new text end

new text begin (1) maintain a supply of naloxone in the home;
new text end

new text begin (2) have trained staff that can administer naloxone;
new text end

new text begin (3) have written policies regarding access to all prescribed medications;
new text end

new text begin (4) have written policies regarding evictions;
new text end

new text begin (5) have staff training and policies regarding co-occurring mental illnesses;
new text end

new text begin (6) not prohibit prescribed medications taken as directed by a licensed prescriber, such
as pharmacotherapies specifically approved by the Food and Drug Administration (FDA)
for treatment of opioid use disorder as well as other medications with FDA-approved
indications for the treatment of co-occurring disorders; and
new text end

new text begin (7) return all property and medications to a person discharged from the home and retain
the items for a minimum of 60 days if the person did not collect them upon discharge. The
owner must make every effort to contact persons listed as emergency contacts so that the
items are returned.
new text end

new text begin (a) The commissioner shall establish a certification program for
sober homes. The certification is mandatory for sober homes receiving any federal, state,
or local funding. The certification requirements must include:
new text end

new text begin (1) health and safety standards, including separate sleeping and bathroom facilities for
people who identify as men and people who identify as women, written policies on how to
accommodate residents who do not identify as a man or woman, and verification that the
home meets fire and sanitation ordinances;
new text end

new text begin (2) intake admission procedures, including names and contact information in case of an
emergency or upon discharge and notification of a family member or other emergency
contact designated by the resident under certain circumstances, including but not limited to
death due to an overdose;
new text end

new text begin (3) an assessment of potential resident needs and appropriateness of the residence to
meet these needs;
new text end

new text begin (4) a resident bill of rights, including a right to a refund if discharged;
new text end

new text begin (5) policies to address mental health and health emergencies to prevent a person from
hurting themselves or others, including contact information for emergency resources in the
community;
new text end

new text begin (6) policies on staff qualifications and prohibition against fraternization;
new text end

new text begin (7) drug-testing procedures and requirements;
new text end

new text begin (8) policies to mitigate medication misuse, including policies for:
new text end

new text begin (i) securing medication;
new text end

new text begin (ii) house staff providing medication at specified times to residents;
new text end

new text begin (iii) medication counts with staff and residents;
new text end

new text begin (iv) storing and providing prescribed medications and documenting when a person
accesses their prescribed medications; and
new text end

new text begin (v) ensuring that medications cannot be accessed by other residents;
new text end

new text begin (9) a policy on medications for opioid use disorder;
new text end

new text begin (10) having naloxone on site and in a conspicuous location;
new text end

new text begin (11) prohibiting charging exorbitant fees over and above standard costs for lab tests;
new text end

new text begin (12) discharge procedures, including involuntary discharge procedures that ensure at
least a 24-hours notice prior to filing an eviction action. The notice must include why the
resident is being involuntarily discharged and a warning that an eviction action may become
public as soon as it is filed, making finding future housing more difficult;
new text end

new text begin (13) policy on referrals to substance use disorder services, mental health services, peer
support services, and support groups;
new text end

new text begin (14) training for staff on naloxone, mental health crises, de-escalation, person-centered
planning, creating a crisis plan, and becoming a culturally informed and responsive sober
home;
new text end

new text begin (15) fee schedule and refund policy;
new text end

new text begin (16) copies of all forms provided to residents;
new text end

new text begin (17) rules for residents;
new text end

new text begin (18) background checks of staff and administrators;
new text end

new text begin (19) policies that promote recovery by requiring resident participation in treatment,
self-help groups or other recovery supports; and
new text end

new text begin (20) policies requiring abstinence from alcohol and illicit drugs.
new text end

new text begin (b) Certifications must be renewed every three years.
new text end

new text begin The commissioner shall create a registry containing a listing of sober
homes that have met the certification requirements. The registry must include each sober
home city and zip code, maximum resident capacity, and whether the setting serves a specific
population based on race, ethnicity, national origin, sexual orientation, gender identity, or
physical ability.
new text end

new text begin An individual living in a sober home has the right to:
new text end

new text begin (1) access to an environment that supports recovery;
new text end

new text begin (2) access to an environment that is safe and free from alcohol and other illicit substances;
new text end

new text begin (3) be free from physical and verbal abuse, neglect, financial exploitation, and all forms
of maltreatment covered under the Vulnerable Adults Act;
new text end

new text begin (4) be treated with dignity and respect and to have personal property treated with respect;
new text end

new text begin (5) have personal, financial, and medical information kept private and to be advised of
the program's policies and procedures regarding disclosure of such information;
new text end

new text begin (6) access, while living in the residence, to other community-based support services as
needed;
new text end

new text begin (7) be referred to appropriate services upon leaving the residence if necessary;
new text end

new text begin (8) retain personal property that does not jeopardize safety or health;
new text end

new text begin (9) assert these rights personally or have them asserted by the individual's representative
or by anyone on behalf of the individual without retaliation;
new text end

new text begin (10) be provided with the name, address, and telephone number of the ombudsman for
mental health, substance use disorder, and developmental disabilities and information about
the right to file a complaint;
new text end

new text begin (11) be fully informed of these rights and responsibilities, as well as to program policies
and procedures; and
new text end

new text begin (12) not be required to perform services for the residence that are not included in the
usual expectations for all residents.
new text end

new text begin In addition to pursuing other remedies, an individual
may bring an action to recover damages caused by a violation of this section. The court
shall award a resident who prevails in an action under this section double damages, costs,
disbursements, reasonable attorney fees, and any equitable relief the court deems appropriate.
new text end

new text begin For each client assigned an ASAM level
of care, eligible vendors must implement the standards set by the ASAM for the respective
level of care. Additionally, vendors must meet the following requirements.
new text end

new text begin (1) For ASAM level 0.5 early intervention targeting individuals who are at risk of
developing a substance-related problem but may not have a diagnosed substance use disorder,
early intervention services may include individual or group counseling, treatment
coordination, peer recovery support, screening brief intervention, and referral to treatment
provided according to section 254A.03, subdivision 3, paragraph (c).
new text end

new text begin (2) For ASAM level 1.0 outpatient clients, adults must receive up to eight hours per
week of skilled treatment services and adolescents must receive up to five hours per week.
Services must be licensed according to section 245G.20 and meet requirements under section
256B.0759. Peer recovery and treatment coordination may be provided beyond the hourly
skilled treatment service hours allowable per week.
new text end

new text begin (3) For ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours
per week of skilled treatment services and adolescents must receive six or more hours per
week. Vendors must be licensed according to section 245G.20 and must meet requirements
under section 256B.0759. Peer recovery and treatment coordination may be provided beyond
the hourly skilled treatment service hours allowable per week. If clinically indicated on the
client's treatment plan, this service may be provided in conjunction with room and board
according to section 254B.05, subdivision 1a.
new text end

new text begin (4) For ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or
more of skilled treatment services. Services must be licensed according to section 245G.20
and must meet requirements under section 256B.0759. Level 2.5 is for clients who need
daily monitoring in a structured setting as directed by the individual treatment plan and in
accordance with the limitations in section 254B.05, subdivision 5, paragraph (h). If clinically
indicated on the client's treatment plan, this service may be provided in conjunction with
room and board according to section 254B.05, subdivision 1a.
new text end

new text begin (5) For ASAM level 3.1 clinically managed low-intensity residential clients, programs
must provide at least 5 hours of skilled treatment services per week according to each client's
specific treatment schedule as directed by the individual treatment plan. Programs must be
licensed according to section 245G.20 and must meet requirements under section 256B.0759.
new text end

new text begin (6) For ASAM level 3.3 clinically managed population-specific high-intensity residential
clients, programs must be licensed according to section 245G.20 and must meet requirements
under section 256B.0759. Programs must have 24-hour-a-day staffing coverage. Programs
must be enrolled as a disability responsive program as described in section 254B.01,
subdivision 4b, and must specialize in serving persons with a traumatic brain injury or a
cognitive impairment so significant, and the resulting level of impairment so great, that
outpatient or other levels of residential care would not be feasible or effective. Programs
must provide, at minimum, daily skilled treatment services seven days a week according to
each client's specific treatment schedule as directed by the individual treatment plan.
new text end

new text begin (7) For ASAM level 3.5 clinically managed high-intensity residential clients, services
must be licensed according to section 245G.20 and must meet requirements under section
256B.0759. Programs must have 24-hour-a-day staffing coverage and provide, at minimum,
daily skilled treatment services seven days a week according to each client's specific treatment
schedule as directed by the individual treatment plan.
new text end

new text begin (8) For ASAM level withdrawal management 3.2 clinically managed clients, withdrawal
management must be provided according to chapter 245F.
new text end

new text begin (9) For ASAM level withdrawal management 3.7 medically monitored clients, withdrawal
management must be provided according to chapter 245F.
new text end

new text begin The license holder must maintain
documentation of a formal patient referral arrangement agreement for each of the following
levels of care not provided by the license holder:
new text end

new text begin (1) level 1.0 outpatient;
new text end

new text begin (2) level 2.1 intensive outpatient;
new text end

new text begin (3) level 2.5 partial hospitalization;
new text end

new text begin (4) level 3.1 clinically managed low-intensity residential;
new text end

new text begin (5) level 3.3 clinically managed population-specific high-intensity residential;
new text end

new text begin (6) level 3.5 clinically managed high-intensity residential;
new text end

new text begin (7) level withdrawal management 3.2 clinically managed residential withdrawal
management; and
new text end

new text begin (8) level withdrawal management 3.7 medically monitored inpatient withdrawal
management.
new text end

new text begin ASAM levels of care referenced in subdivision 1,
clauses (2) to (7), must have documentation of the evidence-based practices being utilized
that include at least three of the following:
new text end

new text begin (1) 12-step facilitation;
new text end

new text begin (2) brief cognitive behavioral therapy;
new text end

new text begin (3) motivational interviewing; and
new text end

new text begin (4) contingency management.
new text end

new text begin Eligible vendors providing services under ASAM
levels of care referenced in subdivision 1, clauses (2) to (7), must have a program outreach
plan. The treatment director must document a review and update the plan annually. The
program outreach plan must include treatment coordination strategies and processes to
ensure seamless transitions across the continuum of care. The plan must include how the
provider will:
new text end

new text begin (1) increase the awareness of early intervention treatment services, including but not
limited to the services defined in section 254A.03, subdivision 3, paragraph (c);
new text end

new text begin (2) coordinate, as necessary, with certified community behavioral health clinics when
a license holder is located in a geographic region served by a certified community behavioral
health clinic;
new text end

new text begin (3) establish a referral arrangement agreement with a withdrawal management program
licensed under chapter 245F when a license holder is located in a geographic region in which
a withdrawal management program is licensed under chapter 245F. If a withdrawal
management program licensed under chapter 245F is not geographically accessible, the
plan must include how the provider will address the client's need for this level of care;
new text end

new text begin (4) coordinate with inpatient acute-care hospitals, including emergency departments,
hospital outpatient clinics, urgent care centers, residential crisis settings, medical
detoxification inpatient facilities and ambulatory detoxification providers in the area served
by the provider to help transition individuals from emergency department or hospital settings
and minimize the time between assessment and treatment;
new text end

new text begin (5) develop and maintain collaboration with local county and Tribal human services
agencies; and
new text end

new text begin (6) collaborate with primary care and mental health settings.
new text end

Minnesota Statutes 2022, section 256.042, subdivision 2, is amended to read:

(a) The council shall consist of the following deleted text begin 19deleted text end new text begin 30new text end voting
members, appointed by the commissioner of human services except as otherwise specified,
and three nonvoting members:

(1) two members of the house of representatives, appointed in the following sequence:
the first from the majority party appointed by the speaker of the house and the second from
the minority party appointed by the minority leader. Of these two members, one member
must represent a district outside of the seven-county metropolitan area, and one member
must represent a district that includes the seven-county metropolitan area. The appointment
by the minority leader must ensure that this requirement for geographic diversity in
appointments is met;

(2) two members of the senate, appointed in the following sequence: the first from the
majority party appointed by the senate majority leader and the second from the minority
party appointed by the senate minority leader. Of these two members, one member must
represent a district outside of the seven-county metropolitan area and one member must
represent a district that includes the seven-county metropolitan area. The appointment by
the minority leader must ensure that this requirement for geographic diversity in appointments
is met;

(3) one member appointed by the Board of Pharmacy;

(4) one member who is a physician appointed by the Minnesota Medical Association;

(5) one member representing opioid treatment programs, sober living programs, or
substance use disorder programs licensed under chapter 245G;

(6) one member appointed by the Minnesota Society of Addiction Medicine who is an
addiction psychiatrist;

(7) one member representing professionals providing alternative pain management
therapies, including, but not limited to, acupuncture, chiropractic, or massage therapy;

(8) one member representing nonprofit organizations conducting initiatives to address
the opioid epidemic, with the commissioner's initial appointment being a member
representing the Steve Rummler Hope Network, and subsequent appointments representing
this or other organizations;

(9) one member appointed by the Minnesota Ambulance Association who is serving
with an ambulance service as an emergency medical technician, advanced emergency
medical technician, or paramedic;

(10) one member representing the Minnesota courts who is a judge or law enforcement
officer;

(11) one public member who is a Minnesota resident and who is in opioid addiction
recovery;

(12) deleted text begin twodeleted text end new text begin 11new text end members representing Indian tribes, one representing deleted text begin the Ojibwe tribes and
one representing the Dakota tribesdeleted text end new text begin each of Minnesota's Tribal Nationsnew text end ;

new text begin (13) two members representing the urban American Indian population;
new text end

deleted text begin (13)deleted text end new text begin (14)new text end one public member who is a Minnesota resident and who is suffering from
chronic pain, intractable pain, or a rare disease or condition;

deleted text begin (14)deleted text end new text begin (15)new text end one mental health advocate representing persons with mental illness;

deleted text begin (15)deleted text end new text begin (16)new text end one member appointed by the Minnesota Hospital Association;

deleted text begin (16)deleted text end new text begin (17)new text end one member representing a local health department; and

deleted text begin (17)deleted text end new text begin (18)new text end the commissioners of human services, health, and corrections, or their designees,
who shall be ex officio nonvoting members of the council.

(b) The commissioner of human services shall coordinate the commissioner's
appointments to provide geographic, racial, and gender diversity, and shall ensure that at
least deleted text begin one-halfdeleted text end new text begin one-thirdnew text end of council members appointed by the commissioner reside outside
of the seven-county metropolitan area. Of the members appointed by the commissioner, to
the extent practicable, at least one member must represent a community of color
disproportionately affected by the opioid epidemic.

(c) The council is governed by section 15.059, except that members of the council shall
serve three-year terms and shall receive no compensation other than reimbursement for
expenses. Notwithstanding section 15.059, subdivision 6, the council shall not expire.

(d) The chair shall convene the council at least quarterly, and may convene other meetings
as necessary. The chair shall convene meetings at different locations in the state to provide
geographic access, and shall ensure that at least one-half of the meetings are held at locations
outside of the seven-county metropolitan area.

(e) The commissioner of human services shall provide staff and administrative services
for the advisory council.

(f) The council is subject to chapter 13D.

Minnesota Statutes 2022, section 256.042, subdivision 4, is amended to read:

(a) The commissioner of human services shall submit a report of the
grants proposed by the advisory council to be awarded for the upcoming calendar year to
the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services policy and finance, by December 1 of each year, beginning
December 1, 2022. This paragraph expires upon the expiration of the advisory council.

(b) The grants shall be awarded to proposals selected by the advisory council that address
the priorities in subdivision 1, paragraph (a), clauses (1) to (4), unless otherwise appropriated
by the legislature. The advisory council shall determine grant awards and funding amounts
based on the funds appropriated to the commissioner under section 256.043, subdivision 3,
paragraph (h), and subdivision 3a, paragraph (d). The commissioner shall award the grants
from the opiate epidemic response fund and administer the grants in compliance with section
16B.97. No more than ten percent of the grant amount may be used by a grantee for
administration.new text begin The commissioner must award at least 50 percent of grants to projects that
include a focus on addressing the opioid crisis in Black and Indigenous communities and
communities of color.
new text end

Minnesota Statutes 2022, section 256.045, subdivision 3, is amended to read:

(a) State agency hearings are available for the following:

(1) any person applying for, receiving or having received public assistance, medical
care, or a program of social services granted by the state agency or a county agency or the
federal Food and Nutrition Act whose application for assistance is denied, not acted upon
with reasonable promptness, or whose assistance is suspended, reduced, terminated, or
claimed to have been incorrectly paid;

(2) any patient or relative aggrieved by an order of the commissioner under section
252.27;

(3) a party aggrieved by a ruling of a prepaid health plan;

(4) except as provided under chapter 245C, any individual or facility determined by a
lead investigative agency to have maltreated a vulnerable adult under section 626.557 after
they have exercised their right to administrative reconsideration under section 626.557;

(5) any person whose claim for foster care payment according to a placement of the
child resulting from a child protection assessment under chapter 260E is denied or not acted
upon with reasonable promptness, regardless of funding source;

(6) any person to whom a right of appeal according to this section is given by other
provision of law;

(7) an applicant aggrieved by an adverse decision to an application for a hardship waiver
under section 256B.15;

(8) an applicant aggrieved by an adverse decision to an application or redetermination
for a Medicare Part D prescription drug subsidy under section 256B.04, subdivision 4a;

(9) except as provided under chapter 245A, an individual or facility determined to have
maltreated a minor under chapter 260E, after the individual or facility has exercised the
right to administrative reconsideration under chapter 260E;

(10) except as provided under chapter 245C, an individual disqualified under sections
245C.14 and 245C.15, following a reconsideration decision issued under section 245C.23,
on the basis of serious or recurring maltreatment; a preponderance of the evidence that the
individual has committed an act or acts that meet the definition of any of the crimes listed
in section 245C.15, subdivisions 1 to 4; or for failing to make reports required under section
260E.06, subdivision 1, or 626.557, subdivision 3. Hearings regarding a maltreatment
determination under clause (4) or (9) and a disqualification under this clause in which the
basis for a disqualification is serious or recurring maltreatment, shall be consolidated into
a single fair hearing. In such cases, the scope of review by the human services judge shall
include both the maltreatment determination and the disqualification. The failure to exercise
the right to an administrative reconsideration shall not be a bar to a hearing under this section
if federal law provides an individual the right to a hearing to dispute a finding of
maltreatment;

(11) any person with an outstanding debt resulting from receipt of public assistance,
medical care, or the federal Food and Nutrition Act who is contesting a setoff claim by the
Department of Human Services or a county agency. The scope of the appeal is the validity
of the claimant agency's intention to request a setoff of a refund under chapter 270A against
the debt;

(12) a person issued a notice of service termination under section 245D.10, subdivision
3a, by a licensed provider of any residential supports or services listed in section 245D.03,
subdivision 1, paragraphs (b) and (c), that is not otherwise subject to appeal under subdivision
4a;

(13) an individual disability waiver recipient based on a denial of a request for a rate
exception under section 256B.4914; deleted text begin or
deleted text end

(14) a person issued a notice of service termination under section 245A.11, subdivision
11, that is not otherwise subject to appeal under subdivision 4adeleted text begin .deleted text end new text begin ; or
new text end

new text begin (15) a recovery community organization seeking medical assistance vendor eligibility
under section 254B.01, subdivision 8, that is aggrieved by a membership or accreditation
determination and that believes the organization meets the requirements under section
254B.05, subdivision 1, paragraph (d), clauses (1) to (10). The scope of the review by the
human service judge shall be limited to whether the organization meets each of the
requirements under section 254B.05, subdivision 1, paragraph (d), clauses (1) to (10).
new text end

(b) The hearing for an individual or facility under paragraph (a), clause (4), (9), or (10),
is the only administrative appeal to the final agency determination specifically, including
a challenge to the accuracy and completeness of data under section 13.04. Hearings requested
under paragraph (a), clause (4), apply only to incidents of maltreatment that occur on or
after October 1, 1995. Hearings requested by nursing assistants in nursing homes alleged
to have maltreated a resident prior to October 1, 1995, shall be held as a contested case
proceeding under the provisions of chapter 14. Hearings requested under paragraph (a),
clause (9), apply only to incidents of maltreatment that occur on or after July 1, 1997. A
hearing for an individual or facility under paragraph (a), clauses (4), (9), and (10), is only
available when there is no district court action pending. If such action is filed in district
court while an administrative review is pending that arises out of some or all of the events
or circumstances on which the appeal is based, the administrative review must be suspended
until the judicial actions are completed. If the district court proceedings are completed,
dismissed, or overturned, the matter may be considered in an administrative hearing.

(d) The scope of hearings involving claims to foster care payments under paragraph (a),
clause (5), shall be limited to the issue of whether the county is legally responsible for a
child's placement under court order or voluntary placement agreement and, if so, the correct
amount of foster care payment to be made on the child's behalf and shall not include review
of the propriety of the county's child protection determination or child placement decision.

(e) The scope of hearings under paragraph (a), clauses (12) and (14), shall be limited to
whether the proposed termination of services is authorized under section 245D.10,
subdivision 3a, paragraph (b), or 245A.11, subdivision 11, and whether the requirements
of section 245D.10, subdivision 3a, paragraphs (c) to (e), or 245A.11, subdivision 2a,
paragraphs (d) to (f), were met. If the appeal includes a request for a temporary stay of
termination of services, the scope of the hearing shall also include whether the case
management provider has finalized arrangements for a residential facility, a program, or
services that will meet the assessed needs of the recipient by the effective date of the service
termination.

(f) A vendor of medical care as defined in section 256B.02, subdivision 7, or a vendor
under contract with a county agency to provide social services is not a party and may not
request a hearing under this section, except if assisting a recipient as provided in subdivision
4.

(g) An applicant or recipient is not entitled to receive social services beyond the services
prescribed under chapter 256M or other social services the person is eligible for under state
law.

(h) The commissioner may summarily affirm the county or state agency's proposed
action without a hearing when the sole issue is an automatic change due to a change in state
or federal law.

(i) Unless federal or Minnesota law specifies a different time frame in which to file an
appeal, an individual or organization specified in this section may contest the specified
action, decision, or final disposition before the state agency by submitting a written request
for a hearing to the state agency within 30 days after receiving written notice of the action,
decision, or final disposition, or within 90 days of such written notice if the applicant,
recipient, patient, or relative shows good cause, as defined in section 256.0451, subdivision
13, why the request was not submitted within the 30-day time limit. The individual filing
the appeal has the burden of proving good cause by a preponderance of the evidence.

Minnesota Statutes 2022, section 256.478, subdivision 2, is amended to read:

An individual is eligible for the transition to community initiative
if the individual does not meet eligibility criteria for the medical assistance program under
section 256B.056 or 256B.057, but who meets at least one of the following criteria:

(1) the person otherwise meets the criteria under section 256B.092, subdivision 13, or
256B.49, subdivision 24;

(2) the person has met treatment objectives and no longer requires a hospital-level care
or a secure treatment setting, but the person's discharge from the Anoka Metro Regional
Treatment Center, the Minnesota deleted text begin Security Hospitaldeleted text end new text begin Forensic Mental Health Program, the
Child Adolescent Behavioral Health Hospital program, a psychiatric residential treatment
facility under section 256B.0941, intensive residential treatment services under section
256B.0622, children's residential services under section 245.4882new text end , or a deleted text begin community behavioral
healthdeleted text end hospital would be substantially delayed without additional resources available through
the transitions to community initiative;new text begin or
new text end

deleted text begin (3) the person is in a community hospital, but alternative community living options
would be appropriate for the person, and the person has received approval from the
commissioner; or
deleted text end

deleted text begin (4) (i)deleted text end new text begin (3)new text end the person new text begin (i) new text end is receiving customized living services reimbursed under section
256B.4914, 24-hour customized living services reimbursed under section 256B.4914, or
community residential services reimbursed under section 256B.4914; (ii) deleted text begin the persondeleted text end expresses
a desire to move; and (iii) deleted text begin the persondeleted text end has received approval from the commissioner.

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

Minnesota Statutes 2022, section 256B.0615, subdivision 1, is amended to read:

Medical assistance covers mental health certified peer specialist
services, as established in subdivision 2, deleted text begin subject to federal approval,deleted text end if provided to recipients
who are eligible for services under sections 256B.0622, 256B.0623, and 256B.0624 and
are provided by a mental health certified peer specialist who has completed the training
under subdivision 5 and is qualified according to section 245I.04, subdivision 10.

Minnesota Statutes 2022, section 256B.0615, subdivision 5, is amended to read:

deleted text begin The commissioner of
human services shall develop a training and certification process for certified peer specialists.
The candidates must have had a primary diagnosis of mental illness, be a current or former
consumer of mental health services, and must demonstrate leadership and advocacy skills
and a strong dedication to recovery. The training curriculum must teach participating
consumers specific skills relevant to providing peer support to other consumers. In addition
to initial training and certification, the commissioner shall develop ongoing continuing
educational workshops on pertinent issues related to peer support counseling. deleted text end new text begin A certified
peer specialist is qualified as a mental health peer specialist as defined in section 245I.04
and must hold a current credential from the Minnesota Certification Board.
new text end

Minnesota Statutes 2022, section 256B.0759, subdivision 2, is amended to read:

(a) deleted text begin Outpatientdeleted text end new text begin Programs licensed by the Department
of Human Services as nonresidentialnew text end substance use disorder treatment deleted text begin providers may elect
to participate in the demonstration project and meet the requirements of subdivision 3. To
participate, a provider must notify the commissioner of the provider's intent to participate
in a format required by the commissioner and enroll as a demonstration project providerdeleted text end new text begin
programs that receive payment under this chapter must enroll as demonstration project
providers and meet the requirements of subdivision 3 by January 1, 2025. Programs that do
not meet the requirements of this paragraph are ineligible for payment for services provided
under section 256B.0625new text end .

(b) Programs licensed by the Department of Human Services as residential treatment
programs according to section 245G.21 that receive payment under this chapter must enroll
as demonstration project providers and meet the requirements of subdivision 3 by January
1, 2024. Programs that do not meet the requirements of this paragraph are ineligible for
payment for services provided under section 256B.0625.

(c) Programs licensed by the Department of Human Services as withdrawal management
programs according to chapter 245F that receive payment under this chapter must enroll as
demonstration project providers and meet the requirements of subdivision 3 by January 1,
2024. Programs that do not meet the requirements of this paragraph are ineligible for payment
for services provided under section 256B.0625.

(d) Out-of-state residential substance use disorder treatment programs that receive
payment under this chapter must enroll as demonstration project providers and meet the
requirements of subdivision 3 by January 1, 2024. Programs that do not meet the requirements
of this paragraph are ineligible for payment for services provided under section 256B.0625.

(e) Tribally licensed programs may elect to participate in the demonstration project and
meet the requirements of subdivision 3. The Department of Human Services must consult
with Tribal nations to discuss participation in the substance use disorder demonstration
project.

(f) The commissioner shall allow providers enrolled in the demonstration project before
July 1, 2021, to receive applicable rate enhancements authorized under subdivision 4 for
all services provided on or after the date of enrollment, except that the commissioner shall
allow a provider to receive applicable rate enhancements authorized under subdivision 4
for services provided on or after July 22, 2020, to fee-for-service enrollees, and on or after
January 1, 2021, to managed care enrollees, if the provider meets all of the following
requirements:

(1) the provider attests that during the time period for which the provider is seeking the
rate enhancement, the provider took meaningful steps in their plan approved by the
commissioner to meet the demonstration project requirements in subdivision 3; and

(2) the provider submits attestation and evidence, including all information requested
by the commissioner, of meeting the requirements of subdivision 3 to the commissioner in
a format required by the commissioner.

(g) The commissioner may recoup any rate enhancements paid under paragraph (f) to a
provider that does not meet the requirements of subdivision 3 by July 1, 2021.

new text begin The commissioner of human services must increase the reimbursement rate for adult
day treatment by 50 percent over the reimbursement rate in effect as of June 30, 2023.
new text end

new text begin The commissioner must update the behavioral health fund room and board rate schedule
to include services provided under Minnesota Statutes, section 245.4882, for individuals
who do not have a placement under Minnesota Statutes, chapter 260C or 260D. The
commissioner must establish room and board rates commensurate with current room and
board rates for adolescent programs licensed under Minnesota Statutes, section 245G.18.
new text end

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

new text begin The commissioner must revise the payment methodology for substance use services
with medications for opioid use disorder under Minnesota Statutes, section 254B.05,
subdivision 5, paragraph (b), clause (6). Payment must occur only if the provider renders
the service or services billed on that date of service or, in the case of drugs and drug-related
services, within a week as defined by the commissioner. The revised payment methodology
must include a weekly bundled rate that includes the costs of drugs, drug administration
and observation, drug packaging and preparation, and nursing time. The bundled weekly
rate must be based on the Medicare rate. The commissioner must seek all necessary waivers,
state plan amendments, and federal authorities required to implement the revised payment
methodology.
new text end

new text begin The commissioner, in consultation with stakeholders, must evaluate the feasibility,
potential design, and federal authorities needed to cover traditional healing behavioral health
services in correctional facilities and contingency management under the medical assistance
program.
new text end

new text begin The revisor of statutes shall renumber Minnesota Statutes, section 245G.01, subdivision
20b, as Minnesota Statutes, section 245G.01, subdivision 20d, and make any necessary
cross-references.
new text end

new text begin Minnesota Statutes 2022, sections 245G.06, subdivision 2; and 245G.11, subdivision 8, new text end new text begin
are repealed.
new text end

Minnesota Statutes 2022, section 15.01, is amended to read:

The following agencies are designated as the departments of the state government: the
Department of Administrationdeleted text begin ;deleted text end new text begin ,new text end the Department of Agriculturedeleted text begin ;deleted text end new text begin ,new text end the Department of
Commercedeleted text begin ;deleted text end new text begin ,new text end the Department of Correctionsdeleted text begin ;deleted text end new text begin , the Department of Direct Care and Treatment,new text end
the Department of Educationdeleted text begin ;deleted text end new text begin ,new text end the Department of Employment and Economic Developmentdeleted text begin ;deleted text end new text begin ,new text end
the Department of Healthdeleted text begin ;deleted text end new text begin ,new text end the Department of Human Rightsdeleted text begin ;deleted text end new text begin , the Department of Human
Services,new text end the Department of Information Technology Servicesdeleted text begin ;deleted text end new text begin ,new text end the Department of Iron
Range Resources and Rehabilitationdeleted text begin ;deleted text end new text begin ,new text end the Department of Labor and Industrydeleted text begin ;deleted text end new text begin ,new text end the Department
of Management and Budgetdeleted text begin ;deleted text end new text begin ,new text end the Department of Military Affairsdeleted text begin ;deleted text end new text begin ,new text end the Department of Natural
Resourcesdeleted text begin ;deleted text end new text begin ,new text end the Department of Public Safetydeleted text begin ; the Department of Human Services;deleted text end new text begin ,new text end the
Department of Revenuedeleted text begin ;deleted text end new text begin ,new text end the Department of Transportationdeleted text begin ;deleted text end new text begin ,new text end the Department of Veterans
Affairsdeleted text begin ;deleted text end new text begin ,new text end and their successor departments.

new text begin This section is effective January 1, 2025.
new text end

Minnesota Statutes 2022, section 15.06, subdivision 1, is amended to read:

This section applies to the following departments or
agencies: the Departments of Administration, Agriculture, Commerce, Corrections, new text begin Direct
Care and Treatment, new text end Education, Employment and Economic Development, Health, Human
Rights, new text begin Human Services, new text end Labor and Industry, Management and Budget, Natural Resources,
Public Safety, deleted text begin Human Services,deleted text end Revenue, Transportation, and Veterans Affairs; the Housing
Finance and Pollution Control Agencies; the Office of Commissioner of Iron Range
Resources and Rehabilitation; the Department of Information Technology Services; the
Bureau of Mediation Services; and their successor departments and agencies. The heads of
the foregoing departments or agencies are "commissioners."

new text begin This section is effective January 1, 2025.
new text end

Minnesota Statutes 2022, section 43A.08, subdivision 1a, is amended to read:

Appointing authorities for the following
agencies may designate additional unclassified positions according to this subdivision: the
Departments of Administrationdeleted text begin ;deleted text end new text begin ,new text end Agriculturedeleted text begin ;deleted text end new text begin ,new text end Commercedeleted text begin ;deleted text end new text begin ,new text end Correctionsdeleted text begin ;deleted text end new text begin , Direct Care and
Treatment,new text end Educationdeleted text begin ;deleted text end new text begin ,new text end Employment and Economic Developmentdeleted text begin ;deleted text end new text begin ,new text end Explore Minnesota
Tourismdeleted text begin ;deleted text end new text begin ,new text end Management and Budgetdeleted text begin ;deleted text end new text begin ,new text end Healthdeleted text begin ;deleted text end new text begin ,new text end Human Rightsdeleted text begin ;deleted text end new text begin , Human Services,new text end Labor and
Industrydeleted text begin ;deleted text end new text begin ,new text end Natural Resourcesdeleted text begin ;deleted text end new text begin ,new text end Public Safetydeleted text begin ;deleted text end new text begin ,new text end deleted text begin Human Services;deleted text end Revenuedeleted text begin ;deleted text end new text begin ,new text end Transportationdeleted text begin ;deleted text end new text begin ,new text end
and Veterans Affairs; the Housing Finance and Pollution Control Agencies; the State Lottery;
the State Board of Investment; the Office of Administrative Hearings; the Department of
Information Technology Services; the Offices of the Attorney General, Secretary of State,
and State Auditor; the Minnesota State Colleges and Universities; the Minnesota Office of
Higher Education; the Perpich Center for Arts Education; and the Minnesota Zoological
Board.

A position designated by an appointing authority according to this subdivision must
meet the following standards and criteria:

(1) the designation of the position would not be contrary to other law relating specifically
to that agency;

(2) the person occupying the position would report directly to the agency head or deputy
agency head and would be designated as part of the agency head's management team;

(3) the duties of the position would involve significant discretion and substantial
involvement in the development, interpretation, and implementation of agency policy;

(4) the duties of the position would not require primarily personnel, accounting, or other
technical expertise where continuity in the position would be important;

(5) there would be a need for the person occupying the position to be accountable to,
loyal to, and compatible with, the governor and the agency head, the employing statutory
board or commission, or the employing constitutional officer;

(6) the position would be at the level of division or bureau director or assistant to the
agency head; and

(7) the commissioner has approved the designation as being consistent with the standards
and criteria in this subdivision.

new text begin This section is effective January 1, 2025.
new text end

new text begin This chapter may be cited as the "Department of Direct Care & Treatment Act."
new text end

new text begin (a) The Department of Direct Care and Treatment is created. An executive board shall
head the Department of Direct Care and Treatment. The executive board shall develop and
maintain direct care and treatment in a manner consistent with applicable law, including
chapters 13, 245, 246, 246B, 252, 253, 253B, 253C, 253D, 254A, 254B, and 256. The
Department of Direct Care and Treatment shall provide direct care and treatment services
in coordination with counties and other vendors. Direct care and treatment services shall
include specialized inpatient programs at secure treatment facilities as defined in sections
253B.02, subdivision 18a, and 253D.02, subdivision 13; community preparation services;
regional treatment centers; enterprise services; consultative services; aftercare services;
community-based services and programs; transition services; nursing home services; and
other services consistent with the mission of the Department of Direct Care and Treatment.
new text end

new text begin (b) "Community preparation services" means specialized inpatient or outpatient services
or programs operated outside of a secure environment but administered by a secure treatment
facility.
new text end

new text begin This section is effective January 1, 2025.
new text end

new text begin Upon the
effective date of this act, the commissioner of human services shall continue to exercise all
authorities and responsibilities under chapters 13, 245, 246, 246B, 252, 253, 253B, 253C,
253D, 254A, 254B, and 256, until legislation is effective that develops the Department of
Direct Care and Treatment executive board and defines the responsibilities and powers of
the Department of Direct Care and Treatment and its executive board.
new text end

new text begin (a) The
commissioner of human services shall prepare legislation for introduction during the 2024
legislative session, with input from stakeholders the commissioner deems necessary,
proposing legislation for the creation and implementation of the Direct Care and Treatment
executive board and defining the responsibilities, powers, and function of the Department
of Direct Care and Treatment executive board.
new text end

new text begin (b) The Department of Direct Care and Treatment executive board shall consist of no
more than five members, all appointed by the governor.
new text end

new text begin (c) An executive board member's qualifications must be appropriate for overseeing a
complex behavioral health system, such as experience serving on a hospital or non-profit
board or working as a licensed health care provider, in an allied health profession, or in
health care administration.
new text end

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

new text begin (a) Section 15.039 applies to the transfer of duties required by this chapter.
new text end

new text begin (b) The commissioner of administration, with the governor's approval, shall issue
reorganization orders under section 16B.37 as necessary to carry out the transfer of duties
required by section 246C.01. The provision of section 16B.37, subdivision 1, stating that
transfers under section 16B.37 may only be to an agency that has existed for at least one
year does not apply to transfers to an agency created by this chapter.
new text end

new text begin (c) The initial salary for the health systems chief executive officer of the Department of
Direct Care and Treatment is the same as the salary for the health systems chief executive
officer of direct care and treatment at the Department of Human Services immediately before
July 1, 2024.
new text end

new text begin (a) Personnel who perform the functions assigned to the commissioner of direct care
and treatment in chapters 13, 43A, 245, 246, 246B, 252, 253, 253B, 253D, and 256 and any
other applicable chapters or sections of law are transferred to the Department of Direct Care
and Treatment effective 30 days after approval of the transfer by the commissioner of direct
care and treatment.
new text end

new text begin (b) All employees of the Department of Human Services transferred to the Department
of Direct Care and Treatment will become employees of the Department of Direct Care and
Treatment and will cease to be employees of the Department of Human Services, effective
30 days after approval of the transfer by the commissioner of direct care and treatment.
Transferred employees must be assigned the same employment status, bargaining unit, and
job classification as they had at the time of the transfer. Nothing in this provision prohibits
the Department of Direct Care and Treatment from taking any action subsequent to the
transfer that is allowed under chapter 43A, a collective bargaining agreement, or
compensation plan, or is otherwise permitted by law.
new text end

new text begin (c) All collective bargaining agreements and compensation plans that cover any employee
of the Department of Human Services who is transferred to the Department of Direct Care
and Treatment continue in full force and effect with the Department of Direct Care and
Treatment.
new text end

new text begin The revisor of statutes, in consultation with staff from the House Research Department;
House Fiscal Analysis; the Office of Senate Counsel, Research and Fiscal Analysis; and
the respective departments shall prepare legislation for introduction in the 2024 legislative
session proposing the statutory changes necessary to implement the transfers of duties that
this article requires.
new text end

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

new text begin The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2021, First Special
Session chapter 7, article 15, and Laws 2021, First Special Session chapter 7, article 16,
from the general fund, or any other fund named, to the commissioner of human services for
the purposes specified in this article, to be available for the fiscal year indicated for each
purpose. The figure "2023" used in this article means that the appropriations listed are
available for the fiscal year ending June 30, 2023.
new text end

new text begin $
new text end

(944,000)

new text begin Appropriations by Fund new text end
	new text begin 2023 new text end
new text begin General new text end	new text begin (944,000) new text end

new text begin Behavioral Health Fund
new text end

(944,000)

new text begin Sections 1 and 2 are effective the day following final enactment.
new text end

new text begin The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2024" and "2025" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2024, or June 30, 2025, respectively.
"The first year" is fiscal year 2024. "The second year" is fiscal year 2025. "The biennium"
is fiscal years 2024 and 2025.
new text end

new text begin $
new text end

new text begin 4,429,166,000
new text end

new text begin $
new text end

new text begin 4,750,908,000
new text end

new text begin Appropriations by Fund new text end
	new text begin 2024 new text end	new text begin 2025 new text end
new text begin General new text end	new text begin 4,423,839,000 new text end	new text begin 4,475,981,000 new text end
new text begin State Government Special Revenue new text end	new text begin 865,000 new text end	new text begin 865,000 new text end
new text begin Lottery Prize new text end	new text begin 1,896,000 new text end	new text begin 1,896,000 new text end
new text begin Opiate Epidemic Response new text end	new text begin 2,566,000 new text end	new text begin 2,166,000 new text end

new text begin The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 14,805,000 new text end	new text begin 10,574,000 new text end
new text begin State Government Special Revenue new text end	new text begin 740,000 new text end	new text begin 740,000 new text end

new text begin Base level adjustment. The general fund base
is $9,031,000 in fiscal year 2026 and
$9,214,000 in fiscal year 2027.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 2,505,000 new text end	new text begin 3,032,000 new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 46,646,000 new text end	new text begin 46,816,000 new text end
new text begin State Government Special Revenue new text end	new text begin 125,000 new text end	new text begin 125,000 new text end

new text begin (a) Research on access to long-term care
services. $700,000 in fiscal year 2024 is from
the general fund to support an actuarial
research study of public and private financing
options for long-term services and supports
reform to increase access across the state. This
is a onetime appropriation.
new text end

new text begin (b) Base level adjustment. The general fund
base is $45,376,000 in fiscal year 2026 and
$45,232,000 in fiscal year 2027.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 1,867,000 new text end	new text begin 1,994,000 new text end
new text begin Lottery Prize new text end	new text begin 163,000 new text end	new text begin 163,000 new text end
new text begin Opioid Epidemic Response new text end	new text begin 66,000 new text end	new text begin 66,000 new text end

new text begin (a) $143,000 in fiscal year 2024 and $100,000
in fiscal year 2025 are from the general fund
to provide funding for the Minnesota
Certification Board to standardize
requirements, integrate training, and require
the board to certify peer specialists using an
integrated mental health and substance use
disorder curriculum.
new text end

new text begin (b) Base level adjustment. The general fund
base is $1,745,000 in fiscal year 2026 and
$1,645,000 in fiscal year 2027.
new text end

3,664,000

7,565,000

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 3,511,719,000 new text end	new text begin 3,854,899,000 new text end

47,034,000

50,637,000

new text begin Any money allocated to the alternative care
program that is not spent for the purposes
indicated does not cancel but must be
transferred to the medical assistance account.
new text end

101,440,000

102,733,000

-0-

100,000

new text begin This appropriation is from the opiate epidemic
response fund.
new text end

24,013,000

24,925,000

new text begin (a) Continuing provider capacity grants.
$8,000,000 for fiscal year 2025 is from the
general fund for grants under Minnesota
Statutes, section 256.4761.
new text end

new text begin (b) Supporting New Americans grants.
$5,000,000 in fiscal year 2024 and
$15,000,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 256.7462.
new text end

43,605,000

44,465,000

new text begin (a) Age-friendly community grants. $0 in
fiscal year 2024, $1,000,000 in fiscal year
2025, $1,000,000 in fiscal year 2026, and
$1,000,000 in fiscal year 2027 are from the
general fund for the continuation of
age-friendly community grants originally
passed under Laws 2021, First Special Session
chapter 7, article 17, section 8, subdivision 1.
This is a onetime appropriation and is
available until June 30, 2027.
new text end

new text begin (b) Age-friendly technical assistance grants.
$0 in fiscal year 2024, $575,000 in fiscal year
2025, $575,000 in fiscal year 2026, and
$575,000 in fiscal year 2027 are from the
general fund for the continuation of
age-friendly technical assistance grants
originally passed under Laws 2021, First
Special Session chapter 7, article 17, section
8, subdivision 2. This is a onetime
appropriation and is available until June 30,
2027.
new text end

new text begin (c) Base level adjustment. The general fund
base is $45,201,000 in fiscal year 2026 and
$45,327,000 in fiscal year 2027.
new text end

95,824,000

32,460,000

new text begin (a) Direct support connect. $250,000 in fiscal
year 2026 is from the general fund to expand
direct support connect to diversify and
improve Disability Hub data outreach and
evaluation. This is a onetime base adjustment.
new text end

new text begin (b) Transition grants for small customized
living providers. $650,000 in fiscal year 2024
and $650,000 in fiscal year 2025 are from the
general fund for grants to assist transitions of
small customized living providers as defined
under Minnesota Statutes, section 245D.24.
This is a onetime appropriation available
through June 30, 2025.
new text end

new text begin (c) Lead agency capacity building grants.
$500,000 in fiscal year 2024 and $2,500,000
in fiscal year 2025 are from the general fund
for grants to assist organizations, counties, and
Tribes to build capacity for employment
opportunities for people with disabilities.
new text end

new text begin (d) Employment and technical assistance
center grants. $450,000 in fiscal year 2024
and $1,800,000 in fiscal year 2025 are from
the general fund for employment and technical
assistance grants to assist organizations and
employers in promoting a more inclusive
workplace for people with disabilities.
new text end

new text begin (e) Case management training grants.
$37,000 in fiscal year 2024, $123,000 in fiscal
year 2025, $45,000 in fiscal year 2026, and
$45,000 in fiscal year 2027 are from the
general fund for grants to provide case
management training to organizations and
employers to support the state's disability
employment supports system.
new text end

new text begin (f) Electronic visit verification stipends.
$6,440,000 in fiscal year 2024 is for onetime
stipends of $200 to bargaining members to
offset the potential costs related to people
using individual devices to access the
electronic visit verification system. $5,600,000
of the appropriation is for stipends and the
remaining 15 percent is for administration of
these stipends. This is a onetime appropriation.
new text end

new text begin (g) Self-directed collective bargaining
agreement; temporary rate increase
memorandum of understanding. $1,610,000
in fiscal year 2024 is for onetime stipends for
individual providers covered by the SEIU
collective bargaining agreement based on the
memorandum of understanding related to the
temporary rate increase in effect between
December 1, 2020, and February 7, 2021.
$1,400,000 of the appropriation is for stipends
and the remaining 15 percent is for
administration of the stipends. This is a
onetime appropriation.
new text end

new text begin (h) Self-directed collective bargaining
agreement; retention bonuses. $50,102,000
in fiscal year 2024 is for onetime retention
bonuses covered by the SEIU collective
bargaining agreement. $50,000,000 of the
appropriation is for retention bonuses and the
remaining 15 percent is for administration of
the bonuses. This is a onetime appropriation.
new text end

new text begin (i) Training stipends. $2,068,000 in fiscal
year 2024 and $68,000 in fiscal year 2025 are
for onetime stipends of $500 for collective
bargaining unit members who complete
designated, voluntary trainings made available
through or recommended by the State Provider
Cooperation Committee. $2,000,000 of the
appropriation is for stipends and the remaining
amount in both fiscal year 2024 and fiscal
2025 is for the administration of stipends. This
is a onetime appropriation.
new text end

new text begin (j) Orientation program and establishment
of Taft-Hartley trust fund. $3,193,000 in
fiscal year 2024 and $2,225,000 in fiscal year
2025 are for onetime $100 payments for
collective bargaining unit members who
complete orientation requirements. $1,500,000
in fiscal year 2024 and $1,500,000 in fiscal
year 2025 are for the onetime payments, while
$500,000 in fiscal year 2024 and $500,000 in
fiscal year 2025 are for orientation related
costs. $1,000,000 in fiscal year 2024
establishes the Taft-Hartley Trust Fund. The
remaining amount is for administration of the
orientation program and payments. This is a
onetime appropriation.
new text end

new text begin (k) Base level adjustment. The general fund
base is $29,605,000 in fiscal year 2026 and
$29,030,000 in fiscal year 2027.
new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 1,000,000 new text end	new text begin 1,000,000 new text end
new text begin Opiate Epidemic Response new text end	new text begin 2,000,000 new text end	new text begin -0- new text end

new text begin Appropriations by Fund new text end
new text begin General new text end	new text begin 5,747,000 new text end	new text begin 6,247,000 new text end
new text begin Lottery Prize new text end	new text begin 1,733,000 new text end	new text begin 1,733,000 new text end
new text begin Opiate Epidemic Response new text end	new text begin 500,000 new text end	new text begin 2,000,000 new text end

new text begin (a) $2,000,000 in fiscal year 2025 is from the
opioid epidemic response fund for traditional
healing grants.
new text end

new text begin (b) $1,000,000 in fiscal year 2024 and
$1,000,000 in fiscal year 2025 are from the
general fund for start-up grant funding for
culturally specific recovery community
organizations to build capacity and improve
access to substance use disorder treatment for
Black, Indigenous, and People of Color to
access culturally specific peer services.
new text end

new text begin (c) $1,000,000 in fiscal year 2024 and
$1,000,000 in fiscal year 2025 are from the
general fund for grants to expand the peer
workforce through training and development
of peers providing services to people impacted
by mental health and substance use disorders.
new text end

new text begin (a) Money appropriated for budget activities
under subdivisions 17 to 21 may be transferred
between budget activities and between years
of the biennium with the approval of the
commissioner of management and budget.
new text end

new text begin (b) Ending balances in obsolete accounts in
the special revenue fund and other dedicated
accounts within direct care and treatment may
be transferred to other dedicated and gift fund
accounts within direct care and treatment for
client use and other client activities, with
approval of the commissioner of management
and budget. These transactions shall be
completed by June 30, 2023.
new text end

175,350,000

183,215,000

new text begin (a) The commissioner responsible for
operations of direct care and treatment
services, with the approval of the
commissioner of management and budget,
may transfer any balance in the enterprise fund
established for the community addiction
recovery enterprise program to the general
fund appropriation within this subdivision.
Any balance remaining after June 30, 2025,
cancels to the general fund.
new text end

new text begin (b) During fiscal year 2024 and fiscal year
2025 balances in the chemical dependency
services fund may be transferred to the general
fund appropriation within this subdivision with
the approval of the commissioner of
management and budget. Balances remaining
in the Department of Human Services
chemical dependency services fund on July 1,
2026, shall cancel to the state's general fund.
new text end

15,462,000

15,776,000

141,020,000

148,513,000

115,920,000

121,726,000

74,218,000

89,404,000

new text begin The general fund base is $82,056,000 in fiscal
year 2026 and $82,976,000 in fiscal year 2027.
new text end

new text begin The commissioner of human services, with the approval of the
commissioner of management and budget, may transfer unencumbered appropriation balances
for the biennium ending June 30, 2025, within fiscal years among the MFIP; general
assistance; medical assistance; MinnesotaCare; MFIP child care assistance under Minnesota
Statutes, section 119B.05; Minnesota supplemental aid program; group residential housing
program; the entitlement portion of Northstar Care for Children under Minnesota Statutes,
chapter 256N; and the entitlement portion of the behavioral health fund between fiscal years
of the biennium. The commissioner shall inform the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services quarterly
about transfers made under this subdivision.
new text end

new text begin Positions, salary money, and nonsalary administrative money
may be transferred within the Department of Human Services as the commissioner considers
necessary, with the advance approval of the commissioner of management and budget. The
commissioners shall inform the chairs and ranking minority members of the legislative
committees with jurisdiction over health and human services finance quarterly about transfers
made under this section.
new text end

Repealed Minnesota Statutes: 23-03356

An individual treatment plan must be recorded in the six dimensions listed in section 245G.05, subdivision 2, paragraph (c), must address each issue identified in the assessment summary, prioritized according to the client's needs and focus, and must include:

(1) specific goals and methods to address each identified need in the comprehensive assessment summary, including amount, frequency, and anticipated duration of treatment service. The methods must be appropriate to the client's language, reading skills, cultural background, and strengths;

(2) resources to refer the client to when the client's needs are to be addressed concurrently by another provider; and

(3) goals the client must reach to complete treatment and terminate services.

A recovery peer must:

(1) have a high school diploma or its equivalent;

(2) have a minimum of one year in recovery from substance use disorder;

(3) hold a current credential from the Minnesota Certification Board, the Upper Midwest Indian Council on Addictive Disorders, or the National Association for Alcoholism and Drug Abuse Counselors. An individual may also receive a credential from a tribal nation when providing peer recovery support services in a tribally licensed program. The credential must demonstrate skills and training in the domains of ethics and boundaries, advocacy, mentoring and education, and recovery and wellness support; and

(4) receive ongoing supervision in areas specific to the domains of the recovery peer's role by an alcohol and drug counselor.

(a) Component values for family residential services are:

(1) competitive workforce factor: 4.7 percent;

(2) supervisory span of control ratio: 11 percent;

(3) employee vacation, sick, and training allowance ratio: 8.71 percent;

(4) employee-related cost ratio: 23.6 percent;

(5) general administrative support ratio: 3.3 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence factor: 1.7 percent.

(b) Payments for family residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours to meet a recipient's needs provided on site or through monitoring technology;

(2) determine the appropriate hourly staff wage rates derived by the commissioner as provided in subdivisions 5 and 5a;

(3) except for subdivision 5a, clauses (1) to (4), multiply the result of clause (2) by the product of one plus the competitive workforce factor;

(4) for a recipient requiring customization for deaf and hard-of-hearing language accessibility under subdivision 12, add the customization rate provided in subdivision 12 to the result of clause (3);

(5) multiply the number of shared direct staffing and individual direct staffing hours provided on site or through monitoring technology and nursing hours by the appropriate staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours provided on site or through monitoring technology and nursing hours by the product of the supervisory span of control ratio and the appropriate supervisory staff wage in subdivision 5a, clause (1);

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and individual direct staffing hours provided through monitoring technology, and multiply the result by one plus the employee vacation, sick, and training allowance ratio. This is defined as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared and individual direct staffing hours provided through monitoring technology, by one plus the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided by 365 if customized for adapted transport, based on the resident with the highest assessed need. The commissioner shall update the amounts in this clause as specified in subdivision 5b;

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing and individual direct staffing hours provided through monitoring technology that was excluded in clause (8);

(12) sum the standard general administrative support ratio, the program-related expense ratio, and the absence and utilization factor ratio;

(13) divide the result of clause (11) by one minus the result of clause (12). This is the total payment rate; and

(14) adjust the result of clause (13) by a factor to be determined by the commissioner to adjust for regional differences in the cost of providing services.

For the elderly waiver monthly conversion budget cap for the cost of elderly waiver services with consumer-directed community supports, the nursing facility case mix adjusted total payment rate used under subdivision 3 to calculate the monthly conversion budget cap for elderly waiver services without consumer-directed community supports must be reduced by a percentage equal to the percentage difference between the consumer-directed community supports budget limit that would be assigned according to the elderly waiver plan and the corresponding monthly case mix budget cap under this chapter, but not to exceed 50 percent.

new text begin APPROPRIATIONS
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new text begin Available for the Year
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new text begin Ending June 30
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new text begin 2023
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