SF 2934

1st Unofficial Engrossment - 93rd Legislature (2023 - 2024) Posted on 04/21/2023 12:44pm

A bill for an act
relating to state government; modifying provisions governing disability services,
aging services, behavioral health, opioid overdose prevention and opiate epidemic
response, the opioid prescribing improvement program, the Department of Direct
Care and Treatment, human services licensing, and self-directed worker contract
ratification; requiring reports; appropriating money; amending Minnesota Statutes
2022, sections 4.046, subdivisions 6, 7; 15.01; 15.06, subdivision 1; 16A.151,
subdivision 2; 43A.08, subdivision 1a; 151.065, subdivision 7; 177.24, by adding
a subdivision; 179A.54, by adding a subdivision; 241.021, subdivision 1; 241.31,
subdivision 5; 241.415; 245.91, subdivision 4; 245A.03, subdivision 7; 245A.04,
subdivision 7; 245A.07, by adding subdivisions; 245A.10, subdivisions 3, 6, by
adding a subdivision; 245A.11, subdivisions 7, 7a; 245A.13, subdivisions 1, 2, 3,
6, 7, 9; 245D.03, subdivision 1; 245G.01, by adding subdivisions; 245G.02,
subdivision 2; 245G.05, subdivision 1, by adding a subdivision; 245G.06,
subdivisions 1, 3, 4, by adding subdivisions; 245G.08, subdivision 3; 245G.09,
subdivision 3; 245G.22, subdivision 15; 245I.10, subdivision 6; 252.44; 253B.10,
subdivision 1; 254B.01, by adding subdivisions; 254B.04, by adding a subdivision;
254B.05, subdivision 5; 256.042, subdivisions 2, 4; 256.043, subdivisions 3, 3a;
256.482, by adding a subdivision; 256.975, subdivision 6; 256.9754; 256B.056,
subdivision 3; 256B.057, subdivision 9; 256B.0638, subdivisions 1, 2, 4, 5, by
adding a subdivision; 256B.0659, subdivisions 1, 12, 19, 24, by adding a
subdivision; 256B.0759, subdivision 2; 256B.0911, subdivision 13; 256B.0917,
subdivision 1b; 256B.092, subdivision 1a; 256B.0949, subdivision 15; 256B.49,
subdivision 13; 256B.4905, subdivision 4a; 256B.4914, subdivisions 3, 5, 5a, 5b,
6, 10a, 14, by adding subdivisions; 256B.5012, by adding a subdivision; 256B.851,
subdivisions 3, 5, 6; 256D.425, subdivision 1; 256M.42; 256R.17, subdivision 2;
256R.25; 256R.47; 256S.211; 256S.214; 256S.215, subdivision 15; 268.19,
subdivision 1; Laws 2019, chapter 63, article 3, section 1, as amended; Laws 2021,
chapter 30, article 12, section 5, as amended; Laws 2021, First Special Session
chapter 7, article 16, section 28, as amended; article 17, sections 8; 16; proposing
coding for new law in Minnesota Statutes, chapters 121A; 245D; 252; 254B; 256;
256B; 256I; proposing coding for new law as Minnesota Statutes, chapter 246C;
repealing Minnesota Statutes 2022, sections 245G.06, subdivision 2; 246.18,
subdivisions 2, 2a; 256B.0759, subdivision 6; 256B.0917, subdivisions 1a, 6, 7a,
13; 256B.4914, subdivision 6b; 256S.2101, subdivisions 1, 2.

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

ARTICLE 1

DISABILITY SERVICES

Section 1.

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

new text begin Subd. 6. new text end

new text begin Special certificate prohibition. new text end

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

Sec. 2.

Minnesota Statutes 2022, section 179A.54, is amended by adding a subdivision to
read:

new text begin Subd. 11. new text end

new text begin Home Care Orientation Trust. new text end

new text begin (a) The state and an exclusive representative
certified pursuant to this section may establish a joint labor and management trust, referred
to as the Home Care Orientation Trust, for the exclusive purpose of rendering voluntary
orientation training to individual providers of direct support services who are represented
by the exclusive representative.
new text end

new text begin (b) Financial contributions made by the state to the Home Care Orientation Trust shall
be made pursuant to a collective bargaining agreement negotiated under this section. All
such financial contributions made by the state shall be held in trust for the purpose of paying
from principle, from interest, or from both, the costs associated with developing, delivering,
and promoting voluntary orientation training for individual providers of direct support
services working under a collective bargaining agreement and providing services through
a covered program under section 256B.0711. The Home Care Orientation Trust shall be
administered, managed, and otherwise controlled jointly by a board of trustees composed
of an equal number of trustees appointed by the state and trustees appointed by the exclusive
representative under this section. The trust shall not be an agent of either the state or the
exclusive representative.
new text end

new text begin (c) Trust administrative, management, legal, and financial services may be provided by
the board of trustees by a third-party administrator, financial management institution, or
other appropriate entity, as designated by the board of trustees from time to time, and those
services shall be paid from the money held in trust and created by the state's financial
contributions to the Home Care Orientation Trust.
new text end

new text begin (d) The state is authorized to purchase liability insurance for members of the board of
trustees appointed by the state.
new text end

new text begin (e) Financial contributions to, and participation in, the administration and management
of the Home Care Orientation Trust shall not be considered an unfair labor practice under
section 179A.13, or a violation of Minnesota law.
new text end

Sec. 3.

Minnesota Statutes 2022, section 245A.03, subdivision 7, is amended to read:

Subd. 7.

Licensing moratorium.

(a) The commissioner shall not issue an initial license
for child foster care licensed under Minnesota Rules, parts 2960.3000 to 2960.3340, or adult
foster care licensed under Minnesota Rules, parts 9555.5105 to 9555.6265, under this chapter
for a physical location that will not be the primary residence of the license holder for the
entire period of licensure. If a family child foster care home or family adult foster care home
license is issued during this moratorium, and the license holder changes the license holder's
primary residence away from the physical location of the foster care license, the
commissioner shall revoke the license according to section 245A.07. The commissioner
shall not issue an initial license for a community residential setting licensed under chapter
245D. When approving an exception under this paragraph, the commissioner shall consider
the resource need determination process in paragraph (h), the availability of foster care
licensed beds in the geographic area in which the licensee seeks to operate, the results of a
person's choices during their annual assessment and service plan review, and the
recommendation of the local county board. The determination by the commissioner is final
and not subject to appeal. Exceptions to the moratorium include:

(1) foster care settings where at least 80 percent of the residents are 55 years of age or
older;

(2) foster care licenses replacing foster care licenses in existence on May 15, 2009, or
community residential setting licenses replacing adult foster care licenses in existence on
December 31, 2013, and determined to be needed by the commissioner under paragraph
(b);

(3) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for the closure of a nursing facility, ICF/DD,
or regional treatment center; restructuring of state-operated services that limits the capacity
of state-operated facilities; or allowing movement to the community for people who no
longer require the level of care provided in state-operated facilities as provided under section
256B.092, subdivision 13, or 256B.49, subdivision 24;

(4) new foster care licenses or community residential setting licenses determined to be
needed by the commissioner under paragraph (b) for persons requiring hospital-level care;
or

(5) new foster care licenses or community residential setting licenses for people receiving
customized living or 24-hour customized living services under the brain injury or community
access for disability inclusion waiver plans under section 256B.49 new text begin or elderly waiver plan
under chapter 256S new text end and residing in the customized living setting deleted text begin before July 1, 2022, deleted text end for
which a license is required. A customized living service provider subject to this exception
may rebut the presumption that a license is required by seeking a reconsideration of the
commissioner's determination. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14. The exception is available
until deleted text begin June 30 deleted text end new text begin December 31 new text end , 2023. This exception is available when:

(i) the person's customized living services are provided in a customized living service
setting serving four or fewer people deleted text begin under the brain injury or community access for disability
inclusion waiver plans under section 256B.49 deleted text end in a single-family home operational on or
before June 30, 2021. Operational is defined in section 256B.49, subdivision 28;

(ii) the person's case manager provided the person with information about the choice of
service, service provider, and location of service, including in the person's home, to help
the person make an informed choice; and

(iii) the person's services provided in the licensed foster care or community residential
setting are less than or equal to the cost of the person's services delivered in the customized
living setting as determined by the lead agency.

(b) The commissioner shall determine the need for newly licensed foster care homes or
community residential settings as defined under this subdivision. As part of the determination,
the commissioner shall consider the availability of foster care capacity in the area in which
the licensee seeks to operate, and the recommendation of the local county board. The
determination by the commissioner must be final. A determination of need is not required
for a change in ownership at the same address.

(c) When an adult resident served by the program moves out of a foster home that is not
the primary residence of the license holder according to section 256B.49, subdivision 15,
paragraph (f), or the adult community residential setting, the county shall immediately
inform the Department of Human Services Licensing Division. The department may decrease
the statewide licensed capacity for adult foster care settings.

(d) Residential settings that would otherwise be subject to the decreased license capacity
established in paragraph (c) shall be exempt if the license holder's beds are occupied by
residents whose primary diagnosis is mental illness and the license holder is certified under
the requirements in subdivision 6a or section 245D.33.

(e) A resource need determination process, managed at the state level, using the available
data required by section 144A.351, and other data and information shall be used to determine
where the reduced capacity determined under section 256B.493 will be implemented. The
commissioner shall consult with the stakeholders described in section 144A.351, and employ
a variety of methods to improve the state's capacity to meet the informed decisions of those
people who want to move out of corporate foster care or community residential settings,
long-term service needs within budgetary limits, including seeking proposals from service
providers or lead agencies to change service type, capacity, or location to improve services,
increase the independence of residents, and better meet needs identified by the long-term
services and supports reports and statewide data and information.

(f) At the time of application and reapplication for licensure, the applicant and the license
holder that are subject to the moratorium or an exclusion established in paragraph (a) are
required to inform the commissioner whether the physical location where the foster care
will be provided is or will be the primary residence of the license holder for the entire period
of licensure. If the primary residence of the applicant or license holder changes, the applicant
or license holder must notify the commissioner immediately. The commissioner shall print
on the foster care license certificate whether or not the physical location is the primary
residence of the license holder.

(g) License holders of foster care homes identified under paragraph (f) that are not the
primary residence of the license holder and that also provide services in the foster care home
that are covered by a federally approved home and community-based services waiver, as
authorized under chapter 256S or section 256B.092 or 256B.49, must inform the human
services licensing division that the license holder provides or intends to provide these
waiver-funded services.

(h) The commissioner may adjust capacity to address needs identified in section
144A.351. Under this authority, the commissioner may approve new licensed settings or
delicense existing settings. Delicensing of settings will be accomplished through a process
identified in section 256B.493.

(i) The commissioner must notify a license holder when its corporate foster care or
community residential setting licensed beds are reduced under this section. The notice of
reduction of licensed beds must be in writing and delivered to the license holder by certified
mail or personal service. The notice must state why the licensed beds are reduced and must
inform the license holder of its right to request reconsideration by the commissioner. The
license holder's request for reconsideration must be in writing. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 20 calendar days
after the license holder's receipt of the notice of reduction of licensed beds. If a request for
reconsideration is made by personal service, it must be received by the commissioner within
20 calendar days after the license holder's receipt of the notice of reduction of licensed beds.

(j) The commissioner shall not issue an initial license for children's residential treatment
services licensed under Minnesota Rules, parts 2960.0580 to 2960.0700, under this chapter
for a program that Centers for Medicare and Medicaid Services would consider an institution
for mental diseases. Facilities that serve only private pay clients are exempt from the
moratorium described in this paragraph. The commissioner has the authority to manage
existing statewide capacity for children's residential treatment services subject to the
moratorium under this paragraph and may issue an initial license for such facilities if the
initial license would not increase the statewide capacity for children's residential treatment
services subject to the moratorium under this paragraph.

new text begin EFFECTIVE DATE. new text end

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

Sec. 4.

Minnesota Statutes 2022, section 245A.10, subdivision 3, is amended to read:

Subd. 3.

Application fee for initial license or certification.

(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.
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.

Sec. 5.

Minnesota Statutes 2022, section 245A.11, subdivision 7, is amended to read:

Subd. 7.

Adult foster care; variance for alternate overnight supervision.

(a) The
commissioner may grant a variance under section 245A.04, subdivision 9, to rule parts
requiring a caregiver to be present in an adult foster care home during normal sleeping hours
to allow for alternative methods of overnight supervision. The commissioner may grant the
variance if the local county licensing agency recommends the variance and the county
recommendation includes documentation verifying that:

(1) the county has approved the license holder's plan for alternative methods of providing
overnight supervision and determined the plan protects the residents' health, safety, and
rights;

(2) the license holder has obtained written and signed informed consent from each
resident or each resident's legal representative documenting the resident's or legal
representative's agreement with the alternative method of overnight supervision; and

(3) the alternative method of providing overnight supervision, which may include the
use of technology, is specified for each resident in the resident's: (i) individualized plan of
care; (ii) individual service plan under section 256B.092, subdivision 1b, if required; or (iii)
individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart
19, if required.

(b) To be eligible for a variance under paragraph (a), the adult foster care license holder
must not have had a conditional license issued under section 245A.06, or any other licensing
sanction issued under section 245A.07 during the prior 24 months based on failure to provide
adequate supervision, health care services, or resident safety in the adult foster care home.

(c) A license holder requesting a variance under this subdivision to utilize technology
as a component of a plan for alternative overnight supervision may request the commissioner's
review in the absence of a county recommendation. Upon receipt of such a request from a
license holder, the commissioner shall review the variance request with the county.

(d) deleted text begin A variance granted by the commissioner according to this subdivision before January
1, 2014, to a license holder for an adult foster care home must transfer with the license when
the license converts to a community residential setting license under chapter 245D. The
terms and conditions of the variance remain in effect as approved at the time the variance
was granted deleted text end new text begin The variance requirements under this subdivision for alternative overnight
supervision do not apply to community residential settings licensed under chapter 245D new text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2022, section 245A.11, subdivision 7a, is amended to read:

Subd. 7a.

Alternate overnight supervision technology; adult foster care deleted text begin and
community residential setting deleted text end licenses.

(a) The commissioner may grant an applicant or
license holder an adult foster care deleted text begin or community residential setting deleted text end license for a residence
that does not have a caregiver in the residence during normal sleeping hours as required
under Minnesota Rules, part 9555.5105, subpart 37, item B, or section 245D.02, subdivision
33b, but uses monitoring technology to alert the license holder when an incident occurs that
may jeopardize the health, safety, or rights of a foster care recipient. The applicant or license
holder must comply with all other requirements under Minnesota Rules, parts 9555.5105
to 9555.6265, or applicable requirements under chapter 245D, and the requirements under
this subdivision. The license printed by the commissioner must state in bold and large font:

(1) that the facility is under electronic monitoring; and

(2) the telephone number of the county's common entry point for making reports of
suspected maltreatment of vulnerable adults under section 626.557, subdivision 9.

(b) Applications for a license under this section must be submitted directly to the
Department of Human Services licensing division. The licensing division must immediately
notify the county licensing agency. The licensing division must collaborate with the county
licensing agency in the review of the application and the licensing of the program.

(c) Before a license is issued by the commissioner, and for the duration of the license,
the applicant or license holder must establish, maintain, and document the implementation
of written policies and procedures addressing the requirements in paragraphs (d) through
(f).

(d) The applicant or license holder must have policies and procedures that:

(1) establish characteristics of target populations that will be admitted into the home,
and characteristics of populations that will not be accepted into the home;

(2) explain the discharge process when a resident served by the program requires
overnight supervision or other services that cannot be provided by the license holder due
to the limited hours that the license holder is on site;

(3) describe the types of events to which the program will respond with a physical
presence when those events occur in the home during time when staff are not on site, and
how the license holder's response plan meets the requirements in paragraph (e), clause (1)
or (2);

(4) establish a process for documenting a review of the implementation and effectiveness
of the response protocol for the response required under paragraph (e), clause (1) or (2).
The documentation must include:

(i) a description of the triggering incident;

(ii) the date and time of the triggering incident;

(iii) the time of the response or responses under paragraph (e), clause (1) or (2);

(iv) whether the response met the resident's needs;

(v) whether the existing policies and response protocols were followed; and

(vi) whether the existing policies and protocols are adequate or need modification.

When no physical presence response is completed for a three-month period, the license
holder's written policies and procedures must require a physical presence response drill to
be conducted for which the effectiveness of the response protocol under paragraph (e),
clause (1) or (2), will be reviewed and documented as required under this clause; and

(5) establish that emergency and nonemergency phone numbers are posted in a prominent
location in a common area of the home where they can be easily observed by a person
responding to an incident who is not otherwise affiliated with the home.

(e) The license holder must document and include in the license application which
response alternative under clause (1) or (2) is in place for responding to situations that
present a serious risk to the health, safety, or rights of residents served by the program:

(1) response alternative (1) requires only the technology to provide an electronic
notification or alert to the license holder that an event is underway that requires a response.
Under this alternative, no more than ten minutes will pass before the license holder will be
physically present on site to respond to the situation; or

(2) response alternative (2) requires the electronic notification and alert system under
alternative (1), but more than ten minutes may pass before the license holder is present on
site to respond to the situation. Under alternative (2), all of the following conditions are
met:

(i) the license holder has a written description of the interactive technological applications
that will assist the license holder in communicating with and assessing the needs related to
the care, health, and safety of the foster care recipients. This interactive technology must
permit the license holder to remotely assess the well being of the resident served by the
program without requiring the initiation of the foster care recipient. Requiring the foster
care recipient to initiate a telephone call does not meet this requirement;

(ii) the license holder documents how the remote license holder is qualified and capable
of meeting the needs of the foster care recipients and assessing foster care recipients' needs
under item (i) during the absence of the license holder on site;

(iii) the license holder maintains written procedures to dispatch emergency response
personnel to the site in the event of an identified emergency; and

(iv) each resident's individualized plan of care, support plan under sections 256B.0913,
subdivision 8; 256B.092, subdivision 1b; 256B.49, subdivision 15; and 256S.10, if required,
or individual resident placement agreement under Minnesota Rules, part 9555.5105, subpart
19, if required, identifies the maximum response time, which may be greater than ten minutes,
for the license holder to be on site for that resident.

(f) Each resident's placement agreement, individual service agreement, and plan must
clearly state that the adult foster care deleted text begin or community residential setting deleted text end license category is
a program without the presence of a caregiver in the residence during normal sleeping hours;
the protocols in place for responding to situations that present a serious risk to the health,
safety, or rights of residents served by the program under paragraph (e), clause (1) or (2);
and a signed informed consent from each resident served by the program or the person's
legal representative documenting the person's or legal representative's agreement with
placement in the program. If electronic monitoring technology is used in the home, the
informed consent form must also explain the following:

(1) how any electronic monitoring is incorporated into the alternative supervision system;

(2) the backup system for any electronic monitoring in times of electrical outages or
other equipment malfunctions;

(3) how the caregivers or direct support staff are trained on the use of the technology;

(4) the event types and license holder response times established under paragraph (e);

(5) how the license holder protects each resident's privacy related to electronic monitoring
and related to any electronically recorded data generated by the monitoring system. A
resident served by the program may not be removed from a program under this subdivision
for failure to consent to electronic monitoring. The consent form must explain where and
how the electronically recorded data is stored, with whom it will be shared, and how long
it is retained; and

(6) the risks and benefits of the alternative overnight supervision system.

The written explanations under clauses (1) to (6) may be accomplished through
cross-references to other policies and procedures as long as they are explained to the person
giving consent, and the person giving consent is offered a copy.

(g) Nothing in this section requires the applicant or license holder to develop or maintain
separate or duplicative policies, procedures, documentation, consent forms, or individual
plans that may be required for other licensing standards, if the requirements of this section
are incorporated into those documents.

(h) The commissioner may grant variances to the requirements of this section according
to section 245A.04, subdivision 9.

(i) For the purposes of paragraphs (d) through (h), "license holder" has the meaning
under section 245A.02, subdivision 9, and additionally includes all staff, volunteers, and
contractors affiliated with the license holder.

(j) For the purposes of paragraph (e), the terms "assess" and "assessing" mean to remotely
determine what action the license holder needs to take to protect the well-being of the foster
care recipient.

(k) The commissioner shall evaluate license applications using the requirements in
paragraphs (d) to (f). The commissioner shall provide detailed application forms, including
a checklist of criteria needed for approval.

(l) To be eligible for a license under paragraph (a), the adult foster care deleted text begin or community
residential setting deleted text end license holder must not have had a conditional license issued under section
245A.06 or any licensing sanction under section 245A.07 during the prior 24 months based
on failure to provide adequate supervision, health care services, or resident safety in the
adult foster care home deleted text begin or community residential setting deleted text end .

(m) The commissioner shall review an application for an alternative overnight supervision
license within 60 days of receipt of the application. When the commissioner receives an
application that is incomplete because the applicant failed to submit required documents or
that is substantially deficient because the documents submitted do not meet licensing
requirements, the commissioner shall provide the applicant written notice that the application
is incomplete or substantially deficient. In the written notice to the applicant, the
commissioner shall identify documents that are missing or deficient and give the applicant
45 days to resubmit a second application that is substantially complete. An applicant's failure
to submit a substantially complete application after receiving notice from the commissioner
is a basis for license denial under section 245A.05. The commissioner shall complete
subsequent review within 30 days.

(n) Once the application is considered complete under paragraph (m), the commissioner
will approve or deny an application for an alternative overnight supervision license within
60 days.

(o) For the purposes of this subdivision, "supervision" means:

(1) oversight by a caregiver or direct support staff as specified in the individual resident's
place agreement or support plan and awareness of the resident's needs and activities; and

(2) the presence of a caregiver or direct support staff in a residence during normal sleeping
hours, unless a determination has been made and documented in the individual's support
plan that the individual does not require the presence of a caregiver or direct support staff
during normal sleeping hours.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

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

Subdivision 1.

Applicability.

(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 EFFECTIVE DATE. new text end

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

Sec. 8.

new text begin [245D.261] COMMUNITY RESIDENTIAL SETTINGS; REMOTE
OVERNIGHT SUPERVISION.
new text end

new text begin Subdivision 1. new text end

new text begin Definitions. new text end

new text begin (a) For purposes of this section, the following terms have
the meanings given them, unless otherwise specified.
new text end

new text begin (b) "Resident" means an adult residing in a community residential setting.
new text end

new text begin (c) "Technology" means:
new text end

new text begin (1) enabling technology, which is a device capable of live, two-way communication or
engagement between a resident and direct support staff at a remote location; or
new text end

new text begin (2) monitoring technology, which is the use of equipment to oversee, monitor, and
supervise an individual who receives medical assistance waiver or alternative care services
under section 256B.0913, 256B.092, or 256B.49 or chapter 256S.
new text end

new text begin Subd. 2. new text end

new text begin Documentation of permissible remote overnight supervision. new text end

new text begin A license
holder providing remote overnight supervision in a community residential setting in lieu of
on-site direct support staff must comply with the requirements of this chapter, including
the requirement under section 245D.02, subdivision 33b, paragraph (a), clause (3), that the
absence of direct support staff from the community residential setting while services are
being delivered must be documented in the resident's support plan or support plan addendum.
new text end

new text begin Subd. 3. new text end

new text begin Provider requirements for remote overnight supervision; commissioner
notification. new text end

new text begin (a) A license holder providing remote overnight supervision in a community
residential setting must:
new text end

new text begin (1) use technology;
new text end

new text begin (2) notify the commissioner of the community residential setting's intent to use technology
in lieu of on-site staff. The notification must:
new text end

new text begin (i) indicate a start date for the use of technology; and
new text end

new text begin (ii) attest that all requirements under this section are met and policies required under
subdivision 4 are available upon request;
new text end

new text begin (3) clearly state in each person's support plan addendum that the community residential
setting is a program without the in-person presence of overnight direct support;
new text end

new text begin (4) include with each person's support plan addendum the license holder's protocols for
responding to situations that present a serious risk to the health, safety, or rights of residents
served by the program; and
new text end

new text begin (5) include in each person's support plan addendum the person's maximum permissible
response time as determined by the person's support team.
new text end

new text begin (b) Upon being notified via technology that an incident has occurred that may jeopardize
the health, safety, or rights of a resident, the license holder must conduct an evaluation of
the need for the physical presence of a staff member. If a physical presence is needed, a
staff person, volunteer, or contractor must be on site to respond to the situation within the
resident's maximum permissible response time.
new text end

new text begin (c) A license holder must notify the commissioner if remote overnight supervision
technology will no longer be used by the license holder.
new text end

new text begin (d) When no physical presence response is completed for a three-month period, the
license holder must conduct a physical presence response drill. The effectiveness of the
response protocol must be reviewed and documented.
new text end

new text begin (e) Upon receipt of notification of use of remote overnight supervision or discontinuation
of use of remote overnight supervision by a license holder, the commissioner shall notify
the county licensing agency and update the license.
new text end

new text begin Subd. 4. new text end

new text begin Required policies and procedures for remote overnight supervision. new text end

new text begin (a) A
license holder providing remote overnight supervision must have policies and procedures
that:
new text end

new text begin (1) protect the residents' health, safety, and rights;
new text end

new text begin (2) explain the discharge process if a person served by the program requires in-person
supervision or other services that cannot be provided by the license holder due to the limited
hours that direct support staff are on site;
new text end

new text begin (3) explain the backup system for technology in times of electrical outages or other
equipment malfunctions;
new text end

new text begin (4) explain how the license holder trains the direct support staff on the use of the
technology; and
new text end

new text begin (5) establish a plan for dispatching emergency response personnel to the site in the event
of an identified emergency.
new text end

new text begin (b) Nothing in this section requires the license holder to develop or maintain separate
or duplicative policies, procedures, documentation, consent forms, or individual plans that
may be required for other licensing standards if the requirements of this section are
incorporated into those documents.
new text end

new text begin Subd. 5. new text end

new text begin Consent to use of monitoring technology. new text end

new text begin If a license holder uses monitoring
technology in a community residential setting, the license holder must obtain a signed
informed consent form from each resident served by the program or the resident's legal
representative documenting the resident's or legal representative's agreement to use of the
specific monitoring technology used in the setting. The informed consent form documenting
this agreement must also explain:
new text end

new text begin (1) how the license holder uses monitoring technology to provide remote supervision;
new text end

new text begin (2) the risks and benefits of using monitoring technology;
new text end

new text begin (3) how the license holder protects each resident's privacy while monitoring technology
is being used in the setting; and
new text end

new text begin (4) how the license holder protects each resident's privacy when the monitoring
technology system electronically records personally identifying data.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

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

252.44 LEAD AGENCY BOARD RESPONSIBILITIES.

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 services deleted 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

Sec. 10.

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

Sec. 11.

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

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

Sec. 12.

Minnesota Statutes 2022, section 256.482, is amended by adding a subdivision
to read:

new text begin Subd. 9. new text end

new text begin Report to legislature. new text end

new text begin On or before January 15, 2025, and annually on January
15 thereafter, the Minnesota Council on Disability shall submit a report to the chair and
ranking minority members of the legislative committees with jurisdiction over state
government finance Next and local government specifying the number of cities and counties that
received training or technical assistance on website accessibility, the outcomes of website
accessibility training and outreach, the costs incurred by cities and counties to make website
accessibility improvements, and any other information that the council deems relevant.
new text end

Sec. 13.

Minnesota Statutes 2022, section 256B.056, subdivision 3, is amended to read:

Subd. 3.

Asset limitations for certain individuals.

(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 spouse deleted 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 EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2022, section 256B.057, subdivision 9, is amended to read:

Subd. 9.

Employed persons with disabilities.

(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.

(c) After the month of enrollment, a person enrolled in medical assistance under this
subdivision who:

(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 EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2022, section 256B.0659, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in
paragraphs (b) to (r) have the meanings given unless otherwise provided in text.

(b) "Activities of daily living" means grooming, dressing, bathing, transferring, mobility,
positioning, eating, and toileting.

(c) "Behavior," effective January 1, 2010, means a category to determine the home care
rating and is based on the criteria found in this section. "Level I behavior" means physical
aggression deleted text begin towards deleted text end new text begin toward new text end self, others, or destruction of property that requires the immediate
response of another person.

(d) "Complex health-related needs," effective January 1, 2010, means a category to
determine the home care rating and is based on the criteria found in this section.

(e) "Critical activities of daily living," effective January 1, 2010, means transferring,
mobility, eating, and toileting.

(f) "Dependency in activities of daily living" means a person requires assistance to begin
and complete one or more of the activities of daily living.

(g) "Extended personal care assistance service" means personal care assistance services
included in a service plan under one of the home and community-based services waivers
authorized under chapter 256S and sections 256B.092, subdivision 5, and 256B.49, which
exceed the amount, duration, and frequency of the state plan personal care assistance services
for participants who:

(1) need assistance provided periodically during a week, but less than daily will not be
able to remain in their homes without the assistance, and other replacement services are
more expensive or are not available when personal care assistance services are to be reduced;
or

(2) need additional personal care assistance services beyond the amount authorized by
the state plan personal care assistance assessment in order to ensure that their safety, health,
and welfare are provided for in their homes.

(h) "Health-related procedures and tasks" means procedures and tasks that can be
delegated or assigned by a licensed health care professional under state law to be performed
by a personal care assistant.

(i) "Instrumental activities of daily living" means activities to include meal planning and
preparation; basic assistance with paying bills; shopping for food, clothing, and other
essential items; performing household tasks integral to the personal care assistance services;
communication by telephone and other media; and traveling, including to medical
appointments and to participate in the community. new text begin For purposes of this paragraph, traveling
includes driving and accompanying the recipient in the recipient's chosen mode of
transportation and according to the recipient's personal care assistance care plan.
new text end

(j) "Managing employee" has the same definition as Code of Federal Regulations, title
42, section 455.

(k) "Qualified professional" means a professional providing supervision of personal care
assistance services and staff as defined in section 256B.0625, subdivision 19c.

(l) "Personal care assistance provider agency" means a medical assistance enrolled
provider that provides or assists with providing personal care assistance services and includes
a personal care assistance provider organization, personal care assistance choice agency,
class A licensed nursing agency, and Medicare-certified home health agency.

(m) "Personal care assistant" or "PCA" means an individual employed by a personal
care assistance agency who provides personal care assistance services.

(n) "Personal care assistance care plan" means a written description of personal care
assistance services developed by the personal care assistance provider according to the
service plan.

(o) "Responsible party" means an individual who is capable of providing the support
necessary to assist the recipient to live in the community.

(p) "Self-administered medication" means medication taken orally, by injection, nebulizer,
or insertion, or applied topically without the need for assistance.

(q) "Service plan" means a written summary of the assessment and description of the
services needed by the recipient.

(r) "Wages and benefits" means wages and salaries, the employer's share of FICA taxes,
Medicare taxes, state and federal unemployment taxes, workers' compensation, mileage
reimbursement, health and dental insurance, life insurance, disability insurance, long-term
care insurance, uniform allowance, and contributions to employee retirement accounts.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 16.

Minnesota Statutes 2022, section 256B.0659, subdivision 12, is amended to read:

Subd. 12.

Documentation of personal care assistance services provided.

(a) Personal
care assistance services for a recipient must be documented daily by each personal care
assistant, on a time sheet form approved by the commissioner. All documentation may be
web-based, electronic, or paper documentation. The completed form must be submitted on
a monthly basis to the provider and kept in the recipient's health record.

(b) The activity documentation must correspond to the personal care assistance care plan
and be reviewed by the qualified professional.

(c) The personal care assistant time sheet must be on a form approved by the
commissioner documenting time the personal care assistant provides services in the home.
The following criteria must be included in the time sheet:

(1) full name of personal care assistant and individual provider number;

(2) provider name and telephone numbers;

(3) full name of recipient and either the recipient's medical assistance identification
number or date of birth;

(4) consecutive dates, including month, day, and year, and arrival and departure times
with a.m. or p.m. notations;

(5) signatures of recipient or the responsible party;

(6) personal signature of the personal care assistant;

(7) any shared care provided, if applicable;

(8) a statement that it is a federal crime to provide false information on personal care
service billings for medical assistance payments; deleted text begin and
deleted text end

(9) dates and location of recipient stays in a hospital, care facility, or incarceration deleted text begin . deleted text end new text begin ; and
new text end

new text begin (10) any time spent traveling, as described in subdivision 1, paragraph (i), including
start and stop times with a.m. and p.m. designations, the origination site, and the destination
site.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 17.

Minnesota Statutes 2022, section 256B.0659, is amended by adding a subdivision
to read:

new text begin Subd. 14a. new text end

new text begin Qualified professional; remote supervision. new text end

new text begin (a) For recipients with chronic
health conditions or severely compromised immune systems, a qualified professional may
conduct the supervision required under subdivision 14 via two-way interactive audio and
visual telecommunication if, at the recipient's request, the recipient's primary health care
provider:
new text end

new text begin (1) determines that remote supervision is appropriate; and
new text end

new text begin (2) documents the determination under clause (1) in a statement of need or other document
that is subsequently included in the recipient's personal care assistance care plan.
new text end

new text begin (b) Notwithstanding any other provision of law, a care plan developed or amended via
remote supervision may be executed by electronic signature.
new text end

new text begin (c) A personal care assistance provider agency must not conduct its first supervisory
visit for a recipient and complete its initial personal care assistance care plan via a remote
visit.
new text end

new text begin (d) A recipient may request to return to in-person supervisory visits at any time.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end

Sec. 18.

Minnesota Statutes 2022, section 256B.0659, subdivision 19, is amended to read:

Subd. 19.

Personal care assistance choice option; qualifications; duties.

(a) Under
personal care assistance choice, the recipient or responsible party shall:

(1) recruit, hire, schedule, and terminate personal care assistants according to the terms
of the written agreement required under subdivision 20, paragraph (a);

(2) develop a personal care assistance care plan based on the assessed needs and
addressing the health and safety of the recipient with the assistance of a qualified professional
as needed;

(3) orient and train the personal care assistant with assistance as needed from the qualified
professional;

(4) supervise and evaluate the personal care assistant with the qualified professional,
who is required to visit the recipient at least every 180 days;

(5) monitor and verify in writing and report to the personal care assistance choice agency
the number of hours worked by the personal care assistant and the qualified professional;

(6) engage in an annual reassessment as required in subdivision 3a to determine
continuing eligibility and service authorization; deleted text begin and
deleted text end

(7) use the same personal care assistance choice provider agency if shared personal
assistance care is being used deleted text begin . deleted text end new text begin ; and
new text end

new text begin (8) ensure that a personal care assistant driving the recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota law.
new text end

(b) The personal care assistance choice provider agency shall:

(1) meet all personal care assistance provider agency standards;

(2) enter into a written agreement with the recipient, responsible party, and personal
care assistants;

(3) not be related as a parent, child, sibling, or spouse to the recipient or the personal
care assistant; and

(4) ensure arm's-length transactions without undue influence or coercion with the recipient
and personal care assistant.

(c) The duties of the personal care assistance choice provider agency are to:

(1) be the employer of the personal care assistant and the qualified professional for
employment law and related regulations including but not limited to purchasing and
maintaining workers' compensation, unemployment insurance, surety and fidelity bonds,
and liability insurance, and submit any or all necessary documentation including but not
limited to workers' compensation, unemployment insurance, and labor market data required
under section 256B.4912, subdivision 1a;

(2) bill the medical assistance program for personal care assistance services and qualified
professional services;

(3) request and complete background studies that comply with the requirements for
personal care assistants and qualified professionals;

(4) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(5) withhold and pay all applicable federal and state taxes;

(6) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(7) make the arrangements and pay taxes and other benefits, if any, and comply with
any legal requirements for a Minnesota employer;

(8) enroll in the medical assistance program as a personal care assistance choice agency;
and

(9) enter into a written agreement as specified in subdivision 20 before services are
provided.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 19.

Minnesota Statutes 2022, section 256B.0659, subdivision 24, is amended to read:

Subd. 24.

Personal care assistance provider agency; general duties.

A personal care
assistance provider agency shall:

(1) enroll as a Medicaid provider meeting all provider standards, including completion
of the required provider training;

(2) comply with general medical assistance coverage requirements;

(3) demonstrate compliance with law and policies of the personal care assistance program
to be determined by the commissioner;

(4) comply with background study requirements;

(5) verify and keep records of hours worked by the personal care assistant and qualified
professional;

(6) not engage in any agency-initiated direct contact or marketing in person, by phone,
or other electronic means to potential recipients, guardians, or family members;

(7) pay the personal care assistant and qualified professional based on actual hours of
services provided;

(8) withhold and pay all applicable federal and state taxes;

(9) document that the agency uses a minimum of 72.5 percent of the revenue generated
by the medical assistance rate for personal care assistance services for employee personal
care assistant wages and benefits. The revenue generated by the qualified professional and
the reasonable costs associated with the qualified professional shall not be used in making
this calculation;

(10) make the arrangements and pay unemployment insurance, taxes, workers'
compensation, liability insurance, and other benefits, if any;

(11) enter into a written agreement under subdivision 20 before services are provided;

(12) report suspected neglect and abuse to the common entry point according to section
256B.0651;

(13) provide the recipient with a copy of the home care bill of rights at start of service;

(14) request reassessments at least 60 days prior to the end of the current authorization
for personal care assistance services, on forms provided by the commissioner;

(15) comply with the labor market reporting requirements described in section 256B.4912,
subdivision 1a; deleted text begin and
deleted text end

(16) document that the agency uses the additional revenue due to the enhanced rate under
subdivision 17a for the wages and benefits of the PCAs whose services meet the requirements
under subdivision 11, paragraph (d) deleted text begin . deleted text end new text begin ; and
new text end

new text begin (17) ensure that a personal care assistant driving a recipient under subdivision 1,
paragraph (i), has a valid driver's license and the vehicle used is registered and insured
according to Minnesota law.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective 90 days following federal approval. The
commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 20.

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

Subd. 13.

MnCHOICES assessor qualifications, training, and certification.

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

(b) MnCHOICES certified assessors 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
experience deleted 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.

Sec. 21.

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

Subd. 1a.

Case management services.

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

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

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

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

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

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

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

(ii) employment service providers;

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

(iv) providers of financial management services;

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

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

(7) evaluation and monitoring of the services identified in the support plan, which must
incorporate at least one annual face-to-face visit by the case manager with each person; 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 ten deleted text end new text begin 20 new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planning new text begin , informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supports new text end . new text begin By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services. new 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.
new text end

Sec. 22.

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

Subd. 15.

EIDBI provider qualifications.

(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.

(c) A level II treatment provider must be employed by an agency and must be:

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

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

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

(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 language new text begin or is an individual certified by a Tribal nation new 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 language new text begin or Tribal nation certification new 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 EFFECTIVE DATE. new text end

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

Sec. 23.

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

Subd. 13.

Case management.

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

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

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

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

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

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

(iii) employment service providers;

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

(v) providers of financial management services;

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

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

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

(1) finalizing the person-centered support plan;

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

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

(c) Case management services must be provided by a public or private agency that is
enrolled as a medical assistance provider determined by the commissioner to meet all of
the requirements in the approved federal waiver plans. 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.

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

(e) The Department of Human Services shall offer ongoing education in case management
to case managers. Case managers shall receive no less than deleted text begin ten deleted text end new text begin 20 new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planning new text begin , informed choice, cultural competency, employment planning,
community living planning, self-direction options, and use of technology supports new text end . new text begin By
August 1, 2024, all case managers must complete an employment support training course
identified by the commissioner of human services. For case managers hired after August
1, 2024, this training must be completed within the first six months of providing case
management services. new 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.
new text end

Sec. 24.

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

Subd. 4a.

Informed choice in employment policy.

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 wage deleted 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

Sec. 25.

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

new text begin Subdivision 1. new text end

new text begin Subminimum wage outcome reporting. 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 to the
commissioner of human services 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:
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 report required under paragraph (a) must include the following data about each
individual being paid subminimum wages:
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.
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 Subd. 2. new text end

new text begin Prohibition of subminimum wages. 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

Sec. 26.

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

Subd. 3.

Applicable services.

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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

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

Subd. 5.

Base wage index; establishment and updates.

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

(b) The commissioner shall update the base wage index in subdivision 5a, publish these
updated values, and load them into the rate management system 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 November deleted text end new text begin January new text end 1, 2024, based on wage data by SOC from the Bureau of Labor
Statistics deleted text begin available as of December 31, 2021 deleted text end new text begin published in March 2022 new text end ; and

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 28.

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

Subd. 5a.

Base wage index; calculations.

The base wage index must be calculated as
follows:

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

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

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

(4) for residential asleep-overnight staff, the minimum wage in Minnesota for large
employers deleted 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 employers deleted 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 substance
abuse, behavioral disorder, and mental health counselor (SOC code 21-1018);

(9) for positive supports professional staff, 100 percent of the median wage for clinical
counseling and school psychologist (SOC code 19-3031);

(10) for positive supports specialist staff, 100 percent of the median wage for psychiatric
technicians (SOC code 29-2053);

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

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

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

(14) for employment exploration services staff, 50 percent of the median wage for
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 EFFECTIVE DATE. new text end

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

Sec. 29.

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

Subd. 5b.

Standard component value adjustments.

The commissioner shall update
the client and programming support, transportation, and program facility cost component
values as required in subdivisions 6 to 9a new text begin and the rates identified in subdivision 19 new 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 November deleted text end new text begin January new 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, deleted text begin 2021 deleted text end new text begin 2022 new text end ; and

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

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2026, or upon federal approval,
whichever is later, 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

Sec. 30.

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

Subd. 6.

Residential support services; generally.

(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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 31.

Minnesota Statutes 2022, section 256B.4914, subdivision 10a, is amended to
read:

Subd. 10a.

Reporting and analysis of cost data.

(a) The commissioner must ensure
that wage values and component values in subdivisions 5 to 9a reflect the cost to provide
the service. As determined by the commissioner, in consultation with stakeholders identified
in subdivision 17, a provider enrolled to provide services with rates determined under this
section must submit requested cost data to the commissioner to support research on the cost
of providing services that have rates determined by the disability waiver rates system.
Requested cost data may include, but is not limited to:

(1) worker wage costs;

(2) benefits paid;

(3) supervisor wage costs;

(4) executive wage costs;

(5) vacation, sick, and training time paid;

(6) taxes, workers' compensation, and unemployment insurance costs paid;

(7) administrative costs paid;

(8) program costs paid;

(9) transportation costs paid;

(10) vacancy rates; and

(11) other data relating to costs required to provide services requested by the
commissioner.

(b) At least once in any five-year period, a provider must submit cost data for a fiscal
year that ended not more than 18 months prior to the submission date. The commissioner
shall provide each provider a 90-day notice prior to its submission due date. If a provider
fails to submit required reporting data, the commissioner shall provide notice to providers
that have not provided required data 30 days after the required submission date, and a second
notice for providers who have not provided required data 60 days after the required
submission date. The commissioner shall temporarily suspend payments to the provider if
cost data is not received 90 days after the required submission date. Withheld payments
shall be made once data is received by the commissioner.

(c) The commissioner shall conduct a random validation of data submitted under
paragraph (a) to ensure data accuracy. new text begin The commissioner shall analyze cost documentation
in paragraph (a) and provide recommendations for adjustments to cost components.
new text end

(d) The commissioner shall analyze cost data submitted under paragraph (a) and, in
consultation with stakeholders identified in subdivision 17, may submit recommendations
on component values and inflationary factor adjustments to the chairs and ranking minority
members of the legislative committees with jurisdiction over human services once every
four years beginning January 1, 2021. The commissioner shall make recommendations in
conjunction with reports submitted to the legislature according to subdivision 10, paragraph
(c). new text begin The commissioner shall release cost data in an aggregate form. Cost data from individual
providers must not be released except as provided for in current law.
new text end

(e) deleted text begin The commissioner shall release cost data in an aggregate form, and cost data from
individual providers shall not be released except as provided for in current law. deleted text end new text begin The
commissioner shall use data collected in paragraph (a) to determine the compliance with
requirements identified under subdivision 10d. The commissioner shall identify providers
who have not met the thresholds identified under subdivision 10d on the Department of
Human Services website for the year for which the providers reported their costs.
new text end

deleted text begin (f) The commissioner, in consultation with stakeholders identified in subdivision 17,
shall develop and implement a process for providing training and technical assistance
necessary to support provider submission of cost documentation required under paragraph
(a).
deleted text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025.
new text end

Sec. 32.

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

new text begin Subd. 10d. new text end

new text begin Direct care staff; compensation. new text end

new text begin (a) A provider paid with rates determined
under subdivision 6 must use a minimum of 66 percent of the revenue generated by rates
determined under that subdivision for direct care staff compensation.
new text end

new text begin (b) A provider paid with rates determined under subdivision 7 must use a minimum of
45 percent of the revenue generated by rates determined under that subdivision for direct
care compensation.
new text end

new text begin (c) A provider paid with rates determined under subdivision 8 or 9 must use a minimum
of 60 percent of the revenue generated by rates determined under those subdivisions for
direct care compensation.
new text end

new text begin (d) Compensation under this subdivision includes:
new text end

new text begin (1) wages;
new text end

new text begin (2) taxes and workers' compensation;
new text end

new text begin (3) health insurance;
new text end

new text begin (4) dental insurance;
new text end

new text begin (5) vision insurance;
new text end

new text begin (6) life insurance;
new text end

new text begin (7) short-term disability insurance;
new text end

new text begin (8) long-term disability insurance;
new text end

new text begin (9) retirement spending;
new text end

new text begin (10) tuition reimbursement;
new text end

new text begin (11) wellness programs;
new text end

new text begin (12) paid vacation time;
new text end

new text begin (13) paid sick time; or
new text end

new text begin (14) other items of monetary value provided to direct care staff.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025.
new text end

Sec. 33.

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

Subd. 14.

Exceptions.

(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.

(c) An application for a rate exception may be submitted for the following criteria:

(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

new text begin EFFECTIVE DATE. new text end

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

Sec. 34.

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

new text begin Subd. 19. new text end

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 35.

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

new text begin Subd. 19. new text end

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 36.

Minnesota Statutes 2022, section 256B.851, subdivision 3, is amended to read:

Subd. 3.

Payment rates; base wage index.

When initially establishing the base wage
component values, the commissioner must use the Minnesota-specific median wage for the
standard occupational classification (SOC) codes published by the Bureau of Labor Statistics
in the edition of the Occupational Handbook deleted text begin available January 1, deleted text end new text begin published in March new text end 2021.
The commissioner must calculate the base wage component values as follows for:

(1) personal care assistance services, CFSS, extended personal care assistance services,
and extended CFSS. The base wage component value equals the median wage for personal
care aide (SOC code 31-1120);

(2) enhanced rate personal care assistance services and enhanced rate CFSS. The base
wage component value equals the product of median wage for personal care aide (SOC
code 31-1120) and the value of the enhanced rate under section 256B.0659, subdivision
17a; and

(3) qualified professional services and CFSS worker training and development. The base
wage component value equals the sum of 70 percent of the median wage for registered nurse
(SOC code 29-1141), 15 percent of the median wage for health care social worker (SOC
code 21-1099), and 15 percent of the median wage for social and human service assistant
(SOC code 21-1093).

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2024, or within 90 days of
federal approval, whichever is later. The commissioner of human services shall notify the
revisor of statutes when federal approval is obtained.
new text end

Sec. 37.

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

Subd. 5.

Payment rates; component values.

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

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

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

(3) employee benefits factor, 12.04 percent;

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

(5) program plan support factor, 7.00 percent;

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

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

(8) absence and utilization factor, 3.90 percent.

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

(1) personal care assistance services and CFSS: deleted text begin 75.45 deleted text end new text begin 88.66 new text end percent;

(2) enhanced rate personal care assistance services and enhanced rate CFSS: deleted text begin 75.45 deleted text end new text begin 88.66 new text end
percent; and

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

new text begin (c) Effective January 1, 2025, for purposes of implementation, the commissioner shall
use the following implementation components:
new text end

new text begin (1) personal care assistance services and CFSS: 92.08 percent;
new text end

new text begin (2) enhanced rate personal care assistance services and enhanced rate CFSS: 92.08
percent; and
new text end

new text begin (3) qualified professional services and CFSS worker training and development: 92.08
percent.
new text end

new text begin (d) The commissioner shall use the following worker retention components:
new text end

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

new text begin (2) for workers who have provided between 1,001 and 2,000 cumulative hours in personal
care assistance services or CFSS, the worker retention component is 2.17 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 4.36 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 7.35 percent;
and
new text end

new text begin (5) for workers who have provided more than 10,000 cumulative hours in personal care
assistance services or CFSS, the worker retention component is 10.81 percent.
new text end

new text begin (e) 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 EFFECTIVE DATE. new text end

new text begin The amendments to paragraph (b) are effective January 1, 2024,
or within 90 days of federal approval, whichever is later. Paragraph (b) expires January 1,
2025, or within 90 days of federal approval of paragraph (c), whichever is later. Paragraphs
(c) to (e) are effective January 1, 2025, or within 90 days of federal approval, whichever is
later. The commissioner of human services shall notify the revisor of statutes when federal
approval is obtained.
new text end

Sec. 38.

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

Subd. 6.

Payment rates; rate determination.

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

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

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

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

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

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

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

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

(8) divide the adjusted hourly rate by four. The quotient is the total adjusted payment
rate.

new text begin (b) In processing claims, the commissioner shall incorporate the worker retention
component specified in subdivision 5, by multiplying one plus the total adjusted payment
rate by the appropriate worker retention component under subdivision 5, paragraph (d).
new text end

deleted text begin (b) deleted text end new text begin (c) new text end The commissioner must publish the total deleted text begin adjusted deleted text end new text begin final new text end payment rates.

new text begin EFFECTIVE DATE. new text end

new text begin This section is effective January 1, 2025, or 90 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

Sec. 39.

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

Subdivision 1.

Persons entitled to receive aid.

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 EFFECTIVE DATE. new text end

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

Sec. 40.

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

Subdivision 1.

Use of data.

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

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

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

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

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

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

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

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

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

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

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.

Sec. 41.

Laws 2021, First Special Session chapter 7, article 17, section 16, is amended to
read:

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

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

Sec. 42. new text begin HOME AND COMMUNITY-BASED WORKFORCE INCENTIVE FUND
GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall
establish grants for disability and home and community-based providers to assist with
recruiting and retaining direct support and frontline workers.
new text end

new text begin Subd. 2. new text end

new text begin Definitions. new text end

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

new text begin (b) "Commissioner" means the commissioner of human services.
new text end

new text begin (c) "Eligible employer" means an organization enrolled in a Minnesota health care
program or providing housing services and is:
new text end

new text begin (1) a provider of home and community-based services under Minnesota Statutes, chapter
245D; or
new text end

new text begin (2) a facility certified as an intermediate care facility for persons with developmental
disabilities.
new text end

new text begin (d) "Eligible worker" means a worker who earns $30 per hour or less and is currently
employed or recruited to be employed by an eligible employer.
new text end

new text begin Subd. 3. new text end

new text begin Allowable uses of grant money. new text end

new text begin (a) Grantees must use grant money to provide
payments to eligible workers for the following purposes:
new text end

new text begin (1) retention, recruitment, and incentive payments;
new text end

new text begin (2) postsecondary loan and tuition payments;
new text end

new text begin (3) child care costs;
new text end

new text begin (4) transportation-related costs; and
new text end

new text begin (5) other costs associated with retaining and recruiting workers, as approved by the
commissioner.
new text end

new text begin (b) Eligible workers may receive payments up to $1,000 per year from the home and
community-based workforce incentive fund.
new text end

new text begin (c) The commissioner must develop a grant cycle distribution plan that allows for
equitable distribution of money among eligible employers. The commissioner's determination
of the grant awards and amounts is final and is not subject to appeal.
new text end

new text begin Subd. 4. new text end

new text begin Attestation. new text end

new text begin As a condition of obtaining grant payments under this section, an
eligible employer must attest and agree to the following:
new text end

new text begin (1) the employer is an eligible employer;
new text end

new text begin (2) the total number of eligible employees;
new text end

new text begin (3) the employer will distribute the entire value of the grant to eligible workers allowed
under this section;
new text end

new text begin (4) the employer will create and maintain records under subdivision 6;
new text end

new text begin (5) the employer will not use the money appropriated under this section for any purpose
other than the purposes permitted under this section; and
new text end

new text begin (6) the entire value of any grant amounts will be distributed to eligible workers identified
by the employer.
new text end

new text begin Subd. 5. new text end

new text begin Distribution plan; report. new text end

new text begin (a) A provider agency or individual provider that
receives a grant under subdivision 4 shall prepare, and upon request submit to the
commissioner, a distribution plan that specifies the amount of money the provider expects
to receive and how that money will be distributed for recruitment and retention purposes
for eligible employees. Within 60 days of receiving the grant, 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.
new text end

new text begin (b) Within 12 months of receiving a grant under this section, each provider agency or
individual provider that receives a grant under subdivision 4 shall submit a report to the
commissioner that includes the following information:
new text end

new text begin (1) a description of how grant money was distributed to eligible employees; and
new text end

new text begin (2) the total dollar amount distributed.
new text end

new text begin (c) Failure to submit the report under paragraph (b) may result in recoupment of grant
money.
new text end

new text begin Subd. 6. new text end

new text begin Audits and recoupment. new text end

new text begin (a) The commissioner may perform an audit under
this section up to six years after a grant is awarded to ensure:
new text end

new text begin (1) the grantee used the money solely for allowable purposes under subdivision 3;
new text end

new text begin (2) the grantee was truthful when making attestations under subdivision 4; and
new text end

new text begin (3) the grantee complied with the conditions of receiving a grant under this section.
new text end

new text begin (b) If the commissioner determines that a grantee used grant money for purposes not
authorized under this section, the commissioner must treat any amount used for a purpose
not authorized under this section as an overpayment. The commissioner must recover any
overpayment.
new text end

new text begin Subd. 7. new text end

new text begin Grants not to be considered income. new text end

new text begin (a) Notwithstanding any law to the
contrary, grant awards under this section must not be considered income, assets, or personal
property for purposes of determining eligibility or recertifying eligibility for:
new text end

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

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

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

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

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

new text begin (b) The commissioner must not consider grant awards under this section as income or
assets under Minnesota Statutes, section 256B.056, subdivision 1a, paragraph (a), 3, or 3c,
or for persons with eligibility determined under Minnesota Statutes, section 256B.057,
subdivision 3, 3a, 3b, 4, or 9.
new text end

Sec. 43.

new text begin NEW AMERICAN LEGAL AND SOCIAL SERVICES WORKFORCE
GRANT PROGRAM.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. new text end

new text begin "Eligible workers" means persons who require legal services
to seek or maintain status and secure or maintain legal authorization for employment.
new text end

new text begin Subd. 2. new text end

new text begin Grant program established. new text end

new text begin The commissioner of human services shall
establish a new American legal and social services workforce grant program for organizations
that assist eligible workers:
new text end

new text begin (1) in seeking or maintaining legal or citizenship status to become or remain legally
authorized for employment in any field or industry, including but not limited to the long-term
care workforce; or
new text end

new text begin (2) to provide supports during the legal process or while seeking qualified legal assistance.
new text end

new text begin Subd. 3. new text end

new text begin Distribution of grants. new text end

new text begin The commissioner shall ensure that grant money is
awarded to organizations and entities that demonstrate that they have the qualifications,
experience, expertise, cultural competency, and geographic reach to offer legal or social
services under this section to eligible workers. In distributing grant awards, the commissioner
shall prioritize organizations or entities serving populations for whom existing legal services
and social services for the purposes listed in subdivision 2 are unavailable or insufficient.
new text end

new text begin Subd. 4. new text end

new text begin Eligible grantees. new text end

new text begin Organizations or entities eligible to receive grant money
under this section include local governmental units, federally recognized Tribal Nations,
and nonprofit organizations as defined under section 501(c)(3) of the Internal Revenue Code
that provide legal or social services to eligible populations. Priority should be given to
organizations and entities that serve populations in areas of the state where worker shortages
are most acute.
new text end

new text begin Subd. 5. new text end

new text begin Grantee duties. new text end

new text begin Organizations or entities receiving grant money under this
section must provide services that include the following activities:
new text end

new text begin (1) intake, assessment, referral, orientation, legal advice, or representation to eligible
workers to seek or maintain legal or citizenship status and secure or maintain legal
authorization for employment in the United States; or
new text end

new text begin (2) social services designed to help eligible populations meet their immediate basic needs
during the process of seeking or maintaining legal status and legal authorization for
employment, including but not limited to accessing housing, food, employment or
employment training, education, course fees, community orientation, transportation, child
care, and medical care. Social services may also include navigation services to address
ongoing needs once immediate basic needs have been met and repaying student loan debt
directly incurred as a result of pursuing a qualifying course of study or training.
new text end

new text begin Subd. 6. new text end

new text begin Reporting. new text end

new text begin (a) Grant recipients under this section must collect and report to
the commissioner information on program participation and program outcomes. The
commissioner shall determine the form and timing of reports.
new text end

new text begin (b) Grant recipients providing immigration legal services under this section must collect
and report to the commissioner data that are consistent with the requirements established
for the advisory committee established by the supreme court under Minnesota Statutes,
section 480.242, subdivision 1.
new text end

Sec. 44. new text begin SUPPORTING NEW AMERICANS IN THE LONG-TERM CARE
WORKFORCE GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Definition. 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 Subd. 2. new text end

new text begin Grant program established. 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 Subd. 3. new text end

new text begin Eligibility. 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 Subd. 4. new text end

new text begin Allowable grant activities. new text end

new text begin 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

Sec. 45.

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

new text begin Subdivision 1. new text end

new text begin Establishment and authority. 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 commissioners of management and budget and 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 Subd. 2. new text end

new text begin Eligibility. 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 Subd. 3. new text end

new text begin Allowable grant activities. 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

Sec. 46. new text begin APPROVAL OF CORPORATE FOSTER CARE MORATORIUM
EXCEPTIONS.
new text end

new text begin (a) The commissioner of human services may approve or deny corporate foster care
moratorium exceptions requested under Minnesota Statutes, section 245A.03, subdivision
7, paragraph (a), clause (5), prior to approval of a service provider's home and
community-based services license under Minnesota Statutes, chapter 245D. Approval of
the moratorium exception must not be construed as final approval of a service provider's
home and community-based services or community residential setting license.
new text end

new text begin (b) Approval under paragraph (a) must be available only for service providers that have
requested a home and community-based services license under Minnesota Statutes, chapter
245D.
new text end

new text begin (c) Approval under paragraph (a) must be rescinded if the service provider's application
for a home and community-based services or community residential setting license is denied.
new text end

new text begin (d) This section expires December 31, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 47. new text begin BUDGET INCREASE FOR CONSUMER-DIRECTED COMMUNITY
SUPPORTS.
new text end

new text begin (a) Effective January 1, 2024, or upon federal approval, whichever is later,
consumer-directed community support budgets identified in the waiver plans under Minnesota
Statutes, sections 256B.092 and 256B.49, and chapter 256S, and the alternative care program
under Minnesota Statutes, section 256B.0913, must be increased by 8.49 percent.
new text end

new text begin (b) Effective January 1, 2025, or upon federal approval, whichever is later,
consumer-directed community support budgets identified in the waiver plans under Minnesota
Statutes, sections 256B.092 and 256B.49, and chapter 256S, and the alternative care program
under Minnesota Statutes, section 256B.0913, must be increased by 4.53 percent.
new text end

Sec. 48. new text begin EARLY INTENSIVE DEVELOPMENTAL AND BEHAVIORAL
INTERVENTION LICENSURE STUDY.
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) consideration of 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

Sec. 49. new text begin STUDY TO EXPAND ACCESS TO SERVICES FOR PEOPLE WITH
CO-OCCURRING BEHAVIORAL HEALTH CONDITIONS AND DISABILITIES.
new text end

new text begin The commissioner of human services, 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

Sec. 50. new text begin SELF-DIRECTED WORKER CONTRACT RATIFICATION.
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 Commission on February 27, 2023, is ratified.
new text end

Sec. 51. new text begin MEMORANDUMS OF UNDERSTANDING.
new text end

new text begin The memorandums of understanding with the Service Employees International Union
Healthcare Minnesota and Iowa, submitted by the commissioner of management and budget
on February 27, 2023, are ratified.
new text end

Sec. 52. new text begin SPECIALIZED EQUIPMENT AND SUPPLIES LIMIT INCREASE.
new text end

new text begin Upon federal approval, the commissioner of human services 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 EFFECTIVE DATE. new text end

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

Sec. 53. new text begin INTERAGENCY EMPLOYMENT SUPPORTS ALIGNMENT STUDY.
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

Sec. 54. new text begin MONITORING EMPLOYMENT OUTCOMES.
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

Sec. 55. new text begin PHASE-OUT OF THE USE OF SUBMINIMUM WAGE FOR MEDICAL
ASSISTANCE DISABILITY SERVICES.
new text end

new text begin The commissioner of human services 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

Sec. 56. new text begin RATE INCREASE FOR CERTAIN DISABILITY WAIVER SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for chore services,
homemaker services, and home-delivered meals provided under Minnesota Statutes, sections
256B.092 and 256B.49, by 15.8 percent from the rates in effect on December 31, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 57. new text begin RATE INCREASE FOR EARLY INTENSIVE DEVELOPMENTAL AND
BEHAVIORAL INTERVENTION BENEFIT SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for early intensive
developmental and behavioral intervention services under Minnesota Statutes, section
256B.0949, by 15.8 percent from the rates in effect on December 31, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 58. new text begin RATE INCREASE FOR HOME CARE SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for home health
services and home care nursing services under Minnesota Statutes, section 256B.0651,
subdivision 2, clauses (1) and (3); respiratory therapy under Minnesota Rules, part 9505.0295,
subpart 2, item E; and home health agency services under Minnesota Statutes, section
256B.0653, by 15.8 percent from the rates in effect on December 31, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 59. new text begin RATE INCREASE FOR INTERMEDIATE CARE FACILITIES FOR
PERSONS WITH DEVELOPMENTAL DISABILITIES DAY TRAINING AND
HABILITATION SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for day training and
habilitation services under Minnesota Statutes, section 252.46, by 15.8 percent from the
rates in effect on December 31, 2023.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 60. new text begin STUDY ON PRESUMPTIVE ELIGIBILITY FOR LONG-TERM SERVICES
AND SUPPORTS.
new text end

new text begin (a) The commissioner of human services 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.
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 Previous finance Next and policy.
new text end

Sec. 61. new text begin SYSTEMIC REVIEW OF ACUTE CARE HOSPITALIZATIONS STUDY.
new text end

new text begin (a) The commissioner of human services must conduct a systemic review of acute care
hospitalizations for older adults on medical assistance and people on medical assistance
with disabilities and behavioral health conditions. The review must include:
new text end

new text begin (1) an analysis of reimbursement rates to support people with complex support needs;
new text end

new text begin (2) a survey of other states' policies, models, and service options to reduce and respond
to acute care hospitalizations;
new text end

new text begin (3) systemic critical incident reviews of people who are hospitalized in acute care
hospitals for longer than 90 days in order to determine systemic, regulatory, staff training,
or other reoccurring barriers keeping individuals from returning to the community or lower
levels of care; and
new text end

new text begin (4) a comparison of different methods to increase and enhance statewide provider capacity
to support people with complex needs.
new text end

new text begin (b) The commissioner must submit a report to the chairs and ranking minority members
of the legislative committees and divisions with jurisdiction over health and human services
policy and Previous finance Next by January 15, 2025. The report must include proposed legislation
necessary to enact the report's recommendations.
new text end

Sec. 62. new text begin REPEALER.
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 EFFECTIVE DATE. new text end

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

ARTICLE 2

AGING SERVICES

Section 1.

Minnesota Statutes 2022, section 256.975, subdivision 6, is amended to read:

Subd. 6.

deleted text begin Indian deleted text end new text begin Native American new text end elders new text begin coordinator new text end position.

new text begin (a) new text end The Minnesota
Board on Aging shall create deleted text begin an Indian deleted text end new text begin a Native American new text end elders coordinator position deleted text begin , deleted text end and
shall hire staff as appropriations permit for the purposes of deleted text begin coordinating efforts with the
National Indian Council on Aging and developing deleted text end new text begin facilitating the coordination and
development of new text end a deleted text begin comprehensive deleted text end statewide new text begin Tribal-based new text end service system for deleted text begin Indian deleted text end new text begin Native
American new text end elders. deleted text begin An Indian elder is defined for purposes of this subdivision as an Indian
enrolled in a band or tribe who is 55 years or older.
deleted text end

new text begin (b) For purposes of this subdivision, the following terms have the meanings given:
new text end

new text begin (1) "Native American elder" means an individual enrolled in a federally recognized
Tribe and identified as an elder according to the requirements of the individual's home Tribe;
and
new text end

new text begin (2) "Tribal government" means representatives of each of the 11 federally recognized
Native American Tribes located wholly or partially within the boundaries of the state of
Minnesota.
new text end

new text begin (c) new text end The statewide new text begin Tribal-based new text end service system deleted text begin must deleted text end new text begin may new text end include the following
components:

deleted text begin (1) an assessment of the program eligibility, examining the need to change the age-based
eligibility criteria to need-based eligibility criteria;
deleted text end

deleted text begin (2) deleted text end new text begin (1) new text end a deleted text begin planning system that would deleted text end new text begin plan to new text end grant new text begin , new text end or make recommendations for granting new text begin , new text end
federal and state funding for new text begin statewide Tribal-based Native American programs and new text end services;

new text begin (2) a plan to develop business initiatives involving Tribal members that will qualify for
federal- and state-funded elder service contracts;
new text end

(3) a plan for new text begin statewide Tribal-based new text end service focal points deleted text begin , senior centers, or community
centers deleted text end for socialization and service accessibility for deleted text begin Indian deleted text end new text begin Native American new text end elders;

(4) a plan to develop and implement new text begin statewide new text end education and public awareness deleted text begin campaigns deleted text end new text begin
promotions, new text end including deleted text begin awareness programs, sensitivity deleted text end cultural new text begin sensitivity new text end training deleted text begin , deleted text end and
public education on deleted text begin Indian elder needs deleted text end new text begin Native American elders new text end ;

(5) a plan for new text begin statewide culturally appropriate new text end information and referral services new text begin for Native
American elders, new text end including new text begin legal advice and counsel and new text end trained advocates deleted text begin and an Indian
elder newsletter deleted text end ;

(6) a plan for a coordinated new text begin statewide Tribal-based new text end health care system including health
deleted text begin promotion/prevention deleted text end new text begin promotion and prevention new text end , in-home service, long-term care service,
and health care services;

(7) a plan for ongoing deleted text begin research involving Indian elders including needs assessment and
needs analysis; deleted text end new text begin collection of significant data on Native American elders, including population,
health, socialization, mortality, homelessness, and economic status; and
new text end

deleted text begin (8) information and referral services for legal advice or legal counsel; and
deleted text end

deleted text begin (9) deleted text end new text begin (8) new text end a plan to coordinate services with existing organizations new text begin , new text end including new text begin but not limited
to the state of Minnesota, new text end the deleted text begin Council of deleted text end new text begin Minnesota new text end Indian Affairs new text begin Council new text end , deleted text begin the Minnesota
Indian Council of Elders, deleted text end the Minnesota Board on Aging, new text begin Wisdom Steps, new text end and new text begin Minnesota new text end
Tribal governments.

Sec. 2.

Minnesota Statutes 2022, section 256.9754, is amended to read:

256.9754 deleted text begin COMMUNITY SERVICES DEVELOPMENT deleted text end new text begin LIVE WELL AT HOME new text end
GRANTS deleted text begin PROGRAM deleted text end .

Subdivision 1.

Definitions.

For purposes of this section, the following terms have the
meanings given.

(a) "Community" means a town, township, city, or targeted neighborhood within a city,
or a consortium of towns, townships, cities, or targeted neighborhoods within cities.

new text begin (b) "Core home and community-based services provider" means a Faith in Action, Living
at Home/Block Nurse, congregational nurse, or similar community-based program governed
by a board, the majority of whose members reside within the program's service area, that
organizes and uses volunteers and paid staff to deliver nonmedical services intended to
assist older adults to identify and manage risks and to maintain their community living and
integration in the community.
new text end

new text begin (c) "Long-term services and supports" means any service available under the elderly
waiver program or alternative care grant programs, nursing facility services, transportation
services, caregiver support and respite care services, and other home and community-based
services identified as necessary either to maintain lifestyle choices for older adults or to
support them to remain in their own home.
new text end

deleted text begin (b) deleted text end new text begin (d) new text end "Older adult services" means any services available under the elderly waiver
program or alternative care grant programs; nursing facility services; transportation services;
respite services; and other community-based services identified as necessary either to
maintain lifestyle choices for older Minnesotans, or to promote independence.

deleted text begin (c) deleted text end new text begin (e) new text end "Older adult" refers to individuals 65 years of age and older.

Subd. 2.

Creation new text begin ; purpose new text end .

new text begin (a) new text end The deleted text begin community services development deleted text end new text begin live well at home new text end
grants deleted text begin program is deleted text end new text begin are new text end created under the administration of the commissioner of human
services.

new text begin (b) The purpose of projects selected by the commissioner of human services under this
section is to make strategic changes in the long-term services and supports system for older
adults and people with dementia, including statewide capacity for local service development
and technical assistance, and statewide availability of home and community-based services
for older adult services, caregiver support and respite care services, and other supports in
Minnesota. These projects are intended to create incentives for new and expanded home
and community-based services in Minnesota in order to:
new text end

new text begin (1) reach older adults early in the progression of their need for long-term services and
supports, providing them with low-cost, high-impact services that will prevent or delay the
use of more costly services;
new text end

new text begin (2) support older adults to live in the most integrated, least restrictive community setting;
new text end

new text begin (3) support the informal caregivers of older adults;
new text end

new text begin (4) develop and implement strategies to integrate long-term services and supports with
health care services, in order to improve the quality of care and enhance the quality of life
of older adults and their informal caregivers;
new text end

new text begin (5) ensure cost-effective use of financial and human resources;
new text end

new text begin (6) build community-based approaches and community commitment to delivering
long-term services and supports for older adults in their own homes;
new text end

new text begin (7) achieve a broad awareness and use of lower-cost in-home services as an alternative
to nursing homes and other residential services;
new text end

new text begin (8) strengthen and develop additional home and community-based services and
alternatives to nursing homes and other residential services; and
new text end

new text begin (9) strengthen programs that use volunteers.
new text end

new text begin (c) The services provided by these projects are available to older adults who are eligible
for medical assistance and the elderly waiver under chapter 256S, the alternative care
program under section 256B.0913, or the essential community supports grant under section
256B.0922, and to persons who have their own money to pay for services.
new text end

Subd. 3.

deleted text begin Provision of deleted text end new text begin Community services development new text end grants.

The commissioner
shall make new text begin community services development new text end grants available to communities, providers of
older adult services deleted text begin identified in subdivision 1 deleted text end , or to a consortium of providers of older
adult services, to establish older adult services. Grants may be provided for capital and other
costs including, but not limited to, start-up and training costs, equipment, and supplies
related to older adult services or other residential or service alternatives to nursing facility
care. Grants may also be made to renovate current buildings, provide transportation services,
fund programs that would allow older adults or individuals with a disability to stay in their
own homes by sharing a home, fund programs that coordinate and manage formal and
informal services to older adults in their homes to enable them to live as independently as
possible in their own homes as an alternative to nursing home care, or expand state-funded
programs in the area.

Subd. 3a.

Priority for other grants.

The commissioner of health shall give priority to
a grantee selected under subdivision 3 when awarding technology-related grants, if the
grantee is using technology as part of the proposal unless that priority conflicts with existing
state or federal guidance related to grant awards by the Department of Health. The
commissioner of transportation shall give priority to a grantee under subdivision 3 when
distributing transportation-related funds to create transportation options for older adults
unless that preference conflicts with existing state or federal guidance related to grant awards
by the Department of Transportation.

Subd. 3b.

State waivers.

The commissioner of health may waive applicable state laws
and rules new text begin for grantees under subdivision 3 new text end on a time-limited basis if the commissioner of
health determines that a participating grantee requires a waiver in order to achieve
demonstration project goals.

new text begin Subd. 3c. new text end

new text begin Caregiver support and respite care projects. new text end

new text begin (a) The commissioner shall
establish projects to expand the availability of caregiver support and respite care services
for family and other caregivers. The commissioner shall use a request for proposals to select
nonprofit entities to administer the projects. Projects must:
new text end

new text begin (1) establish a local coordinated network of volunteer and paid respite workers;
new text end

new text begin (2) coordinate assignment of respite care services to caregivers of older adults;
new text end

new text begin (3) assure the health and safety of the older adults;
new text end

new text begin (4) identify at-risk caregivers;
new text end

new text begin (5) provide information, education, and training for caregivers in the designated
community; and
new text end

new text begin (6) demonstrate the need in the proposed service area, particularly where nursing facility
closures have occurred or are occurring or areas with service needs identified by section
144A.351. Preference must be given for projects that reach underserved populations.
new text end

new text begin (b) Projects must clearly describe:
new text end

new text begin (1) how they will achieve their purpose;
new text end

new text begin (2) the process for recruiting, training, and retraining volunteers; and
new text end

new text begin (3) a plan to promote the project in the designated community, including outreach to
persons needing the services.
new text end

new text begin (c) Money for all projects under this subdivision may be used to:
new text end

new text begin (1) hire a coordinator to develop a coordinated network of volunteer and paid respite
care services and assign workers to clients;
new text end

new text begin (2) recruit and train volunteer providers;
new text end

new text begin (3) provide information, training, and education to caregivers;
new text end

new text begin (4) advertise the availability of the caregiver support and respite care project; and
new text end

new text begin (5) purchase equipment to maintain a system of assigning workers to clients.
new text end

new text begin (d) Volunteer and caregiver training must include resources on how to support an
individual with dementia.
new text end

new text begin (e) Project money may not be used to supplant existing funding sources.
new text end

new text begin Subd. 3d. new text end

new text begin Core home and community-based services projects. new text end

new text begin The commissioner
shall select and contract with core home and community-based services providers for projects
to provide services and supports to older adults both with and without family and other
informal caregivers using a request for proposals process. Projects must:
new text end

new text begin (1) have a credible public or private nonprofit sponsor providing ongoing financial
support;
new text end

new text begin (2) have a specific, clearly defined geographic service area;
new text end

new text begin (3) use a practice framework designed to identify high-risk older adults and help them
take action to better manage their chronic conditions and maintain their community living;
new text end

new text begin (4) have a team approach to coordination and care, ensuring that the older adult
participants, their families, and the formal and informal providers are all part of planning
and providing services;
new text end

new text begin (5) provide information, support services, homemaking services, counseling, and training
for the older adults and family caregivers;
new text end

new text begin (6) encourage service area or neighborhood residents and local organizations to
collaborate in meeting the needs of older adults in their geographic service areas;
new text end

new text begin (7) recruit, train, and direct the use of volunteers to provide informal services and other
appropriate support to older adults and their caregivers; and
new text end

new text begin (8) provide coordination and management of formal and informal services to older adults
and their families using less expensive alternatives.
new text end

new text begin Subd. 3e. new text end

new text begin Community service grants. new text end

new text begin The commissioner shall award contracts for
grants to public and private nonprofit agencies to establish services that strengthen a
community's ability to provide a system of home and community-based services for elderly
persons. The commissioner shall use a request for proposals process.
new text end

Subd. 4.

Eligibility.

Grants may be awarded only to communities and providers or to a
consortium of providers that have a local match of 50 percent of the costs for the project in
the form of donations, local tax dollars, in-kind donations, fundraising, or other local matches.

Subd. 5.

Grant preference.

The commissioner of human services shall give preference
when awarding grants under this section to areas where nursing facility closures have
occurred or are occurring or areas with service needs identified by section 144A.351. The
commissioner may award grants to the extent grant funds are available and to the extent
applications are approved by the commissioner. Denial of approval of an application in one
year does not preclude submission of an application in a subsequent year. The maximum
grant amount is limited to $750,000.

Sec. 3.

new text begin [256.9756] CAREGIVER RESPITE SERVICES GRANTS.
new text end

new text begin Subdivision 1. new text end

new text begin Caregiver respite services grant program established. new text end

new text begin The
commissioner of human services must establish a caregiver respite services grant program
to increase the availability of respite services for family caregivers of people with dementia
and older adults and to provide information, education, and training to respite caregivers
and volunteers regarding caring for people with dementia. From the money made available
for this purpose, the commissioner must award grants on a competitive basis to respite
service providers, giving priority to areas of the state where there is a high need of respite
services.
new text end

new text begin Subd. 2. new text end

new text begin Eligible uses. new text end

new text begin Grant recipients awarded grant money under this section must
use a portion of the grant award as determined by the commissioner to provide free or
subsidized respite services for family caregivers of people with dementia and older adults.
new text end

new text begin Subd. 3. new text end

new text begin Report. new text end

new text begin By January 15, 2026, and every other January 15 thereafter, the
commissioner shall submit a progress report about the caregiver respite services grants in
this section to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services Previous finance Next and policy. The progress report must include
metrics of the use of the grant program money.
new text end

Sec. 4.

Minnesota Statutes 2022, section 256B.0917, subdivision 1b, is amended to read:

Subd. 1b.

Definitions.

(a) For purposes of this section, the following terms have the
meanings given.

deleted text begin (b) "Community" means a town; township; city; or targeted neighborhood within a city;
or a consortium of towns, townships, cities, or specific neighborhoods within a city.
deleted text end

deleted text begin (c) "Core home and community-based services provider" means a Faith in Action, Living
at Home Block Nurse, Congregational Nurse, or similar community-based program governed
by a board, the majority of whose members reside within the program's service area, that
organizes and uses volunteers and paid staff to deliver nonmedical services intended to
assist older adults to identify and manage risks and to maintain their community living and
integration in the community.
deleted text end

deleted text begin (d) deleted text end new text begin (b) new text end "Eldercare development partnership" means a team of representatives of county
social service and public health agencies, the area agency on aging, local nursing home
providers, local home care providers, and other appropriate home and community-based
providers in the area agency's planning and service area.

deleted text begin (e) deleted text end new text begin (c) new text end "Long-term services and supports" means any service available under the elderly
waiver program or alternative care grant programs, nursing facility services, transportation
services, caregiver support and respite care services, and other home and community-based
services identified as necessary either to maintain lifestyle choices for older adults or to
support them to remain in their own home.

deleted text begin (f) deleted text end new text begin (d) new text end "Older adult" refers to an individual who is 65 years of age or older.

Sec. 5.

Minnesota Statutes 2022, section 256M.42, is amended to read:

256M.42 ADULT PROTECTION GRANT ALLOCATIONS.

Subdivision 1.

Formula.

(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 duties deleted text end for adult deleted text begin protective services or as a
lead investigative agency deleted text end new text begin protection new text end under section 626.557 deleted text begin on an annual basis in an amount
determined deleted text end new text begin and to Tribal Nations that have voluntarily chosen by resolution of Tribal
government to participate in vulnerable adult protection programs new text end according to the following
formula new 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 responsible deleted 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 responsible deleted 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

Subd. 2.

Payment.

The commissioner shall make allocations for the state fiscal year
starting July 1, deleted text begin 2019 deleted text end new text begin 2023 new text end , and to each county board or Tribal government on or before
October 10, deleted text begin 2019 deleted text end new text begin 2023 new 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.

Subd. 3.

deleted text begin Prohibition on supplanting existing money deleted text end new text begin Purpose of expenditures new text end .

Money
received under this section must be used deleted text begin for staffing for protection of vulnerable adults or deleted text end new text begin
to meet the agency's duties under section 626.557 and new text end to expand adult protective services new text begin
to stop, prevent, and reduce risks of maltreatment for adults accepted for services under
section 626.557 or for multidisciplinary teams under section 626.5571 new 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 Subd. 4. new text end

new text begin Required expenditures. new text end

new text begin State money must be used to expand, not supplant,
county or Tribal expenditures for the fiscal year 2023 base for adult protection programs,
service interventions, or multidisciplinary teams. This prohibition on county or Tribal
expenditures supplanting state money ends July 1, 2027.
new text end

new text begin Subd. 5. new text end

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

new text begin The commissioner must
set vulnerable adult protection measures and standards for money received under this section.
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 development of
a performance improvement plan and additional remedies identified by the commissioner.
The commissioner may redirect up to 20 percent of an underperforming county's money
under this section toward the performance improvement plan.
new text end

new text begin Subd. 6. new text end

new text begin American Indian adult protection. 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 EFFECTIVE DATE. new text end

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

Sec. 6.

Minnesota Statutes 2022, section 256R.17, subdivision 2, is amended to read:

Subd. 2.

Case mix indices.

(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 study deleted text end new text begin as determined by the commissioner of health under section 144.0724 new 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).

Sec. 7.

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

256R.25 EXTERNAL FIXED COSTS PAYMENT RATE.

(a) The payment rate for external fixed costs is the sum of the amounts in paragraphs
(b) to deleted text begin (o) deleted text end new text begin (p) new text end .

(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

Sec. 8.

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

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

(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 facilities deleted 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 facility 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
costs 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 benefits deleted text end new text begin benefit new 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) 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

Sec. 9.

Minnesota Statutes 2022, section 256S.211, is amended to read:

256S.211 RATE SETTING; deleted text begin RATE ESTABLISHMENT deleted text end new text begin UPDATING RATES;
EVALUATION; COST REPORTING new text end .

Subdivision 1.

Establishing base wages.

When establishing the base wages according
to section 256S.212, the commissioner shall use standard occupational classification (SOC)
codes from the Bureau of Labor Statistics as defined in the edition of the Occupational
Handbook published immediately prior to January 1, 2019, using Minnesota-specific wages
taken from job descriptions.

Subd. 2.

deleted text begin Establishing deleted text end new text begin Updating new text end rates.

deleted text begin By January 1 of each year, deleted text end The commissioner
shall deleted text begin establish factors, deleted text end new text begin update new text end component rates deleted text begin , deleted text end and rates new text begin effective January 1, 2024, new text end according
to sections deleted text begin 256S.213 and deleted text end new text begin 256S.212 to new text end 256S.215, using new text begin the factor and new text end base wages deleted text begin established
according to section 256S.212 deleted text end new text begin values the commissioner used to establish rates effective
January 1, 2019 new text end .

new text begin Subd. 3. new text end

new text begin Spending requirements. 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 rate
adjustments under this section 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 any rate adjustments under
this section, 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 employees 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 Subd. 4. new text end

new text begin Evaluation of rate setting. new text end

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 Previous finance Next and policy with a full report on
the information and data gathered under paragraph (a).
new text end

new text begin Subd. 5. new text end

new text begin Cost reporting. new text end

new text begin (a) As determined by the commissioner, in consultation with
stakeholders, a provider enrolled to provide services with rates determined under this chapter
must submit requested cost data to the commissioner to support evaluation of the rate
methodologies in this chapter. Requested cost data may include but is not limited to:
new text end

new text begin (1) worker wage costs;
new text end

new text begin (2) benefits paid;
new text end

new text begin (3) supervisor wage costs;
new text end

new text begin (4) executive wage costs;
new text end

new text begin (5) vacation, sick, and training time paid;
new text end

new text begin (6) taxes, workers' compensation, and unemployment insurance costs paid;
new text end

new text begin (7) administrative costs paid;
new text end

new text begin (8) program costs paid;
new text end

new text begin (9) transportation costs paid;
new text end

new text begin (10) vacancy rates; and
new text end

new text begin (11) other data relating to costs required to provide services requested by the
commissioner.
new text end

new text begin (b) At least once in any five-year period, a provider must submit cost data for a fiscal
year that ended not more than 18 months prior to the submission date. The commissioner
shall provide each provider a 90-day notice prior to the provider's submission due date. If
by 30 days after the required submission date a provider fails to submit required reporting
data, the commissioner shall provide notice to the provider, and if by 60 days after the
required submission date a provider has not provided the required data the commissioner
shall provide a second notice. The commissioner shall temporarily suspend payments to the
provider if cost data are not received 90 days after the required submission date. Withheld
payments must be made once data is received by the commissioner.
new text end

new text begin (c) The commissioner shall coordinate the cost reporting activities required under this
section with the cost reporting activities directed under section 256B.4914, subdivision 10a.
new text end

new text begin (d) The commissioner shall analyze cost documentation in paragraph (a) and, in
consultation with stakeholders, may submit recommendations on rate methodologies in this
chapter, including ways to monitor and enforce the spending requirements directed in
subdivision 3, through the reports directed by subdivision 4.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Subdivisions 2 to 4 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. Subdivision 5 is effective January 1, 2025.
new text end

Sec. 10.

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

256S.214 RATE SETTING; ADJUSTED BASE WAGE.

new text begin (a) new text end 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;

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

(3) the position's base wage multiplied by the program plan support factor under section
256S.213, subdivision 3.

new text begin (b) If the base wage described in paragraph (a) is below $16.96, the base wage shall
equal $16.96.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

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

Subd. 15.

Home-delivered meals rate.

The home-delivered meals rate deleted text begin equals $9.30 deleted text end new text begin is
the rate in effect on July 1, 2023, adjusted by 15.8 percent new text end . 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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

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:

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

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

Sec. 13.

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

Sec. 8. AGE-FRIENDLY MINNESOTA.

Subdivision 1.

Age-friendly community grants.

(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 and deleted text begin $0 deleted text end new text begin
$3,000,000 new text end in fiscal year 2025.

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

(c) This subdivision expires June 30, deleted text begin 2024 deleted text end new text begin 2027 new text end .

Subd. 2.

Technical assistance grants.

(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 and deleted text begin $0 deleted text end new text begin $1,725,000 new text end in fiscal year 2025.

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

(c) This subdivision expires June 30, deleted text begin 2024 deleted text end new text begin 2027 new text end .

Sec. 14. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; CAREGIVER
RESPITE SERVICES GRANTS.
new text end

new text begin Beginning in fiscal year 2025, the commissioner of human services must continue the
respite services for older adults grant program established under Laws 2021, First Special
Session chapter 7, article 17, section 17, subdivision 3, under the authority granted under
Minnesota Statutes, section 256.9756. The commissioner may begin the grant application
process for awarding grants under Minnesota Statutes, section 256.9756, during fiscal year
2024 in order to facilitate the continuity of the grant program during the transition from a
temporary program to a permanent one.
new text end

Sec. 15. new text begin DIRECTION TO COMMISSIONER; FUTURE PACE IMPLEMENTATION
FUNDING.
new text end

new text begin (a) The commissioner of human services shall work collaboratively with stakeholders
to undertake an actuarial analysis of Medicaid costs for nursing home eligible beneficiaries
for the purposes of establishing a monthly Medicaid capitation rate for the program of
all-inclusive care for the elderly (PACE). The analysis must include all sources of state
Medicaid expenditures for nursing home eligible beneficiaries, including but not limited to
capitation payments to plans and additional state expenditures to skilled nursing facilities
consistent with Code of Federal Regulations, chapter 42, part 447, and long-term care costs.
new text end

new text begin (b) The commissioner shall also estimate the administrative costs associated with
implementing and monitoring PACE.
new text end

new text begin (c) The commissioner shall provide a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over health care Previous finance Next on the actuarial
analysis, proposed capitation rate, and estimated administrative costs by December 15,
2023. The commissioner shall recommend a financing mechanism and administrative
framework by July 1, 2024.
new text end

new text begin (d) By September 1, 2024, the commissioner shall inform the chairs and ranking minority
members of the legislative committees with jurisdiction over health care Previous finance Next on the
commissioner's progress toward developing a recommended financing mechanism. For
purposes of this section, the commissioner may issue or extend a request for proposal to an
outside vendor.
new text end

Sec. 16. new text begin RATE INCREASE FOR CERTAIN HOME AND COMMUNITY-BASED
SERVICES.
new text end

new text begin The commissioner of human services shall increase payment rates for community living
assistance and family caregiver services under Minnesota Statutes, sections 256B.0913 and
256B.0922, and chapter 256S by 15.8 percent from the rates in effect on December 31,
2023.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 17. new text begin TEMPORARY GRANT FOR SMALL CUSTOMIZED LIVING
PROVIDERS.
new text end

new text begin The commissioner of human services 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 community residential setting licensure or integrated community supports
licensure. Allowable uses of grant money include physical plant updates required for
community residential setting 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 determined by the commissioner. Grant money
approved by the commissioner is a onetime 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

Sec. 18. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall change the headnote in Minnesota Statutes, section
256B.0917, from "HOME AND COMMUNITY-BASED SERVICES FOR OLDER
ADULTS" to "ELDERCARE DEVELOPMENT PARTNERSHIPS."
new text end

Sec. 19. new text begin REPEALER.
new text end

new text begin (a) Minnesota Statutes 2022, section 256S.2101, subdivisions 1 and 2, new text end new text begin are repealed.
new text end

new text begin (b) Minnesota Statutes 2022, section 256B.0917, subdivisions 1a, 6, 7a, and 13, new text end new text begin are
repealed.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (a) is effective January 1, 2024.
new text end

ARTICLE 3

BEHAVIORAL HEALTH

Section 1.

Minnesota Statutes 2022, section 4.046, subdivision 6, is amended to read:

Subd. 6.

new text begin Office of new text end Addiction and deleted text begin recovery deleted text end new text begin Recovery new text end new text begin ; new text end director.

new text begin The Office of Addiction
and Recovery is created in the Department of Management and Budget. new text end The governor must
appoint an addiction and recovery director, who shall serve as chair of the subcabinet new text begin and
administer the Office of Addiction and Recovery new text end . The director shall serve in the unclassified
service and shall report to the governor. The director must:

(1) make efforts to break down silos and work across agencies to better target the state's
role in addressing addiction, treatment, and recovery new text begin for youth and adults new text end ;

(2) assist in leading the subcabinet and the advisory council toward progress on
measurable goals that track the state's efforts in combatting addiction new text begin for youth and adults,
and preventing substance use and addiction among the state's youth population new text end ; and

(3) establish and manage external partnerships and build relationships with communities,
community leaders, and those who have direct experience with addiction to ensure that all
voices of recovery are represented in the work of the subcabinet and advisory council.

Sec. 2.

Minnesota Statutes 2022, section 4.046, subdivision 7, is amended to read:

Subd. 7.

Staff and administrative support.

The commissioner of deleted text begin human services deleted text end new text begin
management and budget new text end , in coordination with other state agencies and boards as applicable,
must provide staffing and administrative support to the new text begin Office of Addiction and Recovery,
the new text end addiction and recovery director, the subcabinet, and the advisory council established in
this section.

Sec. 3.

Minnesota Statutes 2022, section 245.91, subdivision 4, is amended to read:

Subd. 4.

Facility or program.

"Facility" or "program" means a nonresidential or
residential program as defined in section 245A.02, subdivisions 10 and 14, and any agency,
facility, or program that provides services or treatment for mental illness, developmental
disability, substance use disorder, or emotional disturbance that is required to be licensed,
certified, or registered by the commissioner of human services, health, or education; new text begin a sober
home under section 254B.18; new text end and an acute care inpatient facility that provides services or
treatment for mental illness, developmental disability, substance use disorder, or emotional
disturbance.

Sec. 4.

Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
read:

new text begin Subd. 4a. new text end

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

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

Sec. 5.

Minnesota Statutes 2022, section 245G.01, is amended by adding a subdivision to
read:

new text begin Subd. 20c. new text end

new text begin Protective factors. new text end

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 nutritious diet, exercise, attending counseling or 12-step
groups, and taking appropriate medications.
new text end

Sec. 6.

Minnesota Statutes 2022, section 245G.02, subdivision 2, is amended to read:

Subd. 2.

Exemption from license requirement.

This chapter does not apply to a county
or recovery community organization that is providing a service for which the county or
recovery community organization is an eligible vendor under section 254B.05. This chapter
does not apply to an organization whose primary functions are information, referral,
diagnosis, case management, and assessment for the purposes of client placement, education,
support group services, or self-help programs. This chapter does not apply to the activities
of a licensed professional in private practice. A license holder providing the initial set of
substance use disorder services allowable under section 254A.03, subdivision 3, paragraph
(c), to an individual referred to a licensed nonresidential substance use disorder treatment
program after a positive screen for alcohol or substance misuse is exempt from sections
245G.05; 245G.06, subdivisions 1, new text begin 1a, new text end 2, and 4; 245G.07, subdivisions 1, paragraph (a),
clauses (2) to (4), and 2, clauses (1) to (7); and 245G.17.

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2022, section 245G.05, subdivision 1, is amended to read:

Subdivision 1.

Comprehensive assessment.

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 three deleted text end new text begin five new 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 client deleted text end new text begin by the end of the fifth day on which a treatment
service is provided new 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

new text begin EFFECTIVE DATE. new text end

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

Sec. 8.

Minnesota Statutes 2022, section 245G.05, is amended by adding a subdivision to
read:

new text begin Subd. 3. new text end

new text begin Comprehensive assessment requirements. new text end

new text begin (a) A comprehensive assessment
must meet the requirements under section 245I.10, subdivision 6, paragraphs (b) and (c).
It must also 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;
new text end

new text begin (3) a risk rating and summary to support the risk ratings within each of the dimensions
listed in section 254B.04, subdivision 4; and
new text end

new text begin (4) a recommendation for the ASAM level of care 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 and recognition of opioid overdose; and
new text end

new text begin (4) the use, availability, and administration of an opiate antagonist 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 required educational
material 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

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2022, section 245G.06, subdivision 1, is amended to read:

Subdivision 1.

General.

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 deleted text begin and within five calendar days deleted text end new text begin , new text end 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 program new text begin , not to exceed 30 days new text end . Opioid treatment programs must
complete the individual treatment plan within 21 days from the day of service initiation. new text begin
The number of days to complete the individual treatment plan excludes the day of service
initiation. 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.

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision
to read:

new text begin Subd. 1a. new text end

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

new text begin (a) After completing a
client'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 in relation to any or all of the applicable ASAM
six dimensions identified in section 254B.04, subdivision 4, to ensure measurable treatment
objectives, a treatment strategy, and a schedule for accomplishing the client's treatment
goals and objectives;
new text end

new text begin (4) document in the treatment plan the ASAM level of care identified in section 254B.19,
subdivision 1, under which the client is receiving services;
new text end

new text begin (5) identify the participants involved in the client's treatment planning. The client must
participate 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 will 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

new text begin EFFECTIVE DATE. new text end

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

Sec. 11.

Minnesota Statutes 2022, section 245G.06, subdivision 3, is amended to read:

Subd. 3.

Treatment plan review.

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 completed new 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). The review deleted text end new text begin and new text end must:

(1) deleted text begin address each goal in the deleted text end new text begin document client goals addressed since the last new 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 are deleted text end new text begin continue to be
new text end effective;

(2) deleted text begin include deleted text end new text begin document new text end monitoring of any physical and mental health problems new text begin and include
toxicology results for alcohol and substance use, when available new text end ;

(3) document the participation of others new text begin involved in the individual's treatment planning,
including when services are offered to the client's family or significant others new 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.65 deleted 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

new text begin EFFECTIVE DATE. new text end

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

Sec. 12.

Minnesota Statutes 2022, section 245G.06, is amended by adding a subdivision
to read:

new text begin Subd. 3a. new text end

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

new text begin (a) A license holder must ensure that
the alcohol and drug counselor responsible for a client's treatment plan completes and
documents a treatment plan review that meets the requirements of subdivision 3 in each
client's file, according to the frequencies required in this subdivision. All ASAM levels
referred to in this chapter are those described in section 254B.19, subdivision 1.
new text end

new text begin (b) For a client receiving residential ASAM level 3.3 or 3.5 high-intensity services or
residential hospital-based services, a treatment plan review must be completed once every
14 days.
new text end

new text begin (c) For a client receiving residential ASAM level 3.1 low-intensity services or any other
residential level not listed in paragraph (b), a treatment plan review must be completed once
every 30 days.
new text end

new text begin (d) For a client receiving nonresidential ASAM level 2.5 partial hospitalization services,
a treatment plan review must be completed once every 14 days.
new text end

new text begin (e) For a client receiving nonresidential ASAM level 1.0 outpatient or 2.1 intensive
outpatient services or any other nonresidential level not included in paragraph (d), a treatment
plan review must be completed once every 30 days.
new text end

new text begin (f) For a client receiving nonresidential opioid treatment program services according to
section 245G.22, a treatment plan review must be completed weekly for the ten weeks
following completion of the treatment plan and monthly thereafter. Treatment plan reviews
must be completed more frequently when clinical needs warrant.
new text end

new text begin (g) Notwithstanding paragraphs (e) and (f), for a client in a nonresidential program with
a treatment plan that clearly indicates less than five hours of skilled treatment services will
be provided to the client each month, a treatment plan review must be completed once every
90 days.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 13.

Minnesota Statutes 2022, section 245G.06, subdivision 4, is amended to read:

Subd. 4.

Service discharge summary.

(a) An alcohol and drug counselor must write a
service discharge summary for each client. The service discharge summary must be
completed within five days of the client's service termination. A copy of the client's service
discharge summary must be provided to the client upon the client's request.

(b) The service discharge summary must be recorded in the six dimensions listed in
section deleted text begin 245G.05, subdivision 2, paragraph (c) deleted text end new text begin 254B.04, subdivision 4 new text end , and include the
following information:

(1) the client's issues, strengths, and needs while participating in treatment, including
services provided;

(2) the client's progress toward achieving each goal identified in the individual treatment
plan;

(3) a risk description according to section deleted text begin 245G.05 deleted text end new text begin 254B.04, subdivision 4 new text end ;

(4) the reasons for and circumstances of service termination. If a program discharges a
client at staff request, the reason for discharge and the procedure followed for the decision
to discharge must be documented and comply with the requirements in section 245G.14,
subdivision 3, clause (3);

(5) the client's living arrangements at service termination;

(6) continuing care recommendations, including transitions between more or less intense
services, or more frequent to less frequent services, and referrals made with specific attention
to continuity of care for mental health, as needed; and

(7) service termination diagnosis.

new text begin EFFECTIVE DATE. new text end

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

Sec. 14.

Minnesota Statutes 2022, section 245G.09, subdivision 3, is amended to read:

Subd. 3.

Contents.

Client records must contain the following:

(1) documentation that the client was given information on client rights and
responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
an orientation to the program abuse prevention plan required under section 245A.65,
subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record
must contain documentation that the client was provided educational information according
to section 245G.05, subdivision deleted text begin 1 deleted text end new text begin 3 new text end , paragraph (b);

(2) an initial services plan completed according to section 245G.04;

(3) a comprehensive assessment completed according to section 245G.05;

deleted text begin (4) an assessment summary completed according to section 245G.05, subdivision 2;
deleted text end

deleted text begin (5) deleted text end new text begin (4) new text end an individual abuse prevention plan according to sections 245A.65, subdivision
2, and 626.557, subdivision 14, when applicable;

deleted text begin (6) deleted text end new text begin (5) new text end an individual treatment plan according to section 245G.06, subdivisions 1 and
2;

deleted text begin (7) deleted text end new text begin (6) new text end documentation of treatment services, significant events, appointments, concerns,
and treatment plan reviews according to section 245G.06, subdivisions 2a, 2b, deleted text begin and deleted text end 3 new text begin , and
3a new text end ; and

deleted text begin (8) deleted text end new text begin (7) new text end a summary at the time of service termination according to section 245G.06,
subdivision 4.

new text begin EFFECTIVE DATE. new text end

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

Sec. 15.

Minnesota Statutes 2022, section 245G.22, subdivision 15, is amended to read:

Subd. 15.

Nonmedication treatment services; documentation.

(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 necessary deleted 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 service is documented according to the requirements in section 245G.06,
subdivision 2a new 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.

deleted text begin (c) Notwithstanding the requirements of individual treatment plans set forth in section
deleted text end deleted text begin :
deleted text end

deleted text begin (1) treatment plan contents for a maintenance client are not required to include goals
deleted text end deleted text begin the client must reach to complete treatment and have services terminated;
deleted text end

deleted text begin (2) treatment plans for a client in a taper or detox status must include goals the client
deleted text end deleted text begin must reach to complete treatment and have services terminated; and
deleted text end

deleted text begin (3) deleted text end deleted text begin for deleted text end deleted text begin the ten weeks following the day of service initiation for all new admissions,
readmissions, deleted text end deleted text begin and transfers, a weekly treatment plan review must be documented once the
treatment plan deleted text end deleted text begin is completed. Subsequently, the counselor must document treatment plan
reviews in the six deleted text end deleted text begin dimensions at least once monthly or, when clinical need warrants, more
frequently.
deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 16.

Minnesota Statutes 2022, section 245I.10, subdivision 6, is amended to read:

Subd. 6.

Standard diagnostic assessment; required elements.

(a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context. 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 safety new text begin , including withdrawal symptoms,
medical conditions, and behavioral and emotional symptoms new 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 health new text begin and substance use disorder new text end treatment; deleted text begin and
deleted text end

(10) cultural influences on the client deleted 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.

Sec. 17.

Minnesota Statutes 2022, section 253B.10, subdivision 1, is amended to read:

Subdivision 1.

Administrative requirements.

(a) When a person is committed, the
court shall issue a warrant or an order committing the patient to the custody of the head of
the treatment facility, state-operated treatment program, or community-based treatment
program. The warrant or order shall state that the patient meets the statutory criteria for
civil commitment.

(b) The commissioner shall prioritize new text begin civilly committed new text end patients new text begin who are determined by
the Office of Medical Director or a designee to require emergency admission to a
state-operated treatment program, as well as patients new text end being admitted from jail or a correctional
institution who are:

(1) ordered confined in a state-operated treatment program for an examination under
Minnesota Rules of Criminal Procedure, rules 20.01, subdivision 4, paragraph (a), and
20.02, subdivision 2;

(2) under civil commitment for competency treatment and continuing supervision under
Minnesota Rules of Criminal Procedure, rule 20.01, subdivision 7;

(3) found not guilty by reason of mental illness under Minnesota Rules of Criminal
Procedure, rule 20.02, subdivision 8, and under civil commitment or are ordered to be
detained in a state-operated treatment program pending completion of the civil commitment
proceedings; or

(4) committed under this chapter to the commissioner after dismissal of the patient's
criminal charges.

Patients described in this paragraph must be admitted to a state-operated treatment program
within 48 hours new text begin of the Office of Medical Director or a designee determining that a medically
appropriate bed is available new text end . The commitment must be ordered by the court as provided in
section 253B.09, subdivision 1, paragraph (d).

(c) Upon the arrival of a patient at the designated treatment facility, state-operated
treatment program, or community-based treatment program, the head of the facility or
program shall retain the duplicate of the warrant and endorse receipt upon the original
warrant or acknowledge receipt of the order. The endorsed receipt or acknowledgment must
be filed in the court of commitment. After arrival, the patient shall be under the control and
custody of the head of the facility or program.

(d) Copies of the petition for commitment, the court's findings of fact and conclusions
of law, the court order committing the patient, the report of the court examiners, and the
prepetition report, and any medical and behavioral information available shall be provided
at the time of admission of a patient to the designated treatment facility or program to which
the patient is committed. Upon a patient's referral to the commissioner of human services
for admission pursuant to subdivision 1, paragraph (b), any inpatient hospital, treatment
facility, jail, or correctional facility that has provided care or supervision to the patient in
the previous two years shall, when requested by the treatment facility or commissioner,
provide copies of the patient's medical and behavioral records to the Department of Human
Services for purposes of preadmission planning. This information shall be provided by the
head of the treatment facility to treatment facility staff in a consistent and timely manner
and pursuant to all applicable laws.

Sec. 18.

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

new text begin Subd. 2a. new text end

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

new text begin "American Society of Addiction Medicine criteria" or "ASAM" means the clinical
guidelines for purposes of 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

Sec. 19.

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

new text begin Subd. 9. new text end

new text begin Skilled treatment services. new text end

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

Sec. 20.

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

new text begin Subd. 10. new text end

new text begin Sober home. new text end

new text begin A 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 substance use disorders;
new text end

new text begin (2) stipulates that residents must abstain from using alcohol or other illicit drugs or
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

Sec. 21.

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

new text begin Subd. 11. new text end

new text begin Comprehensive assessment. new text end

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

Sec. 22.

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

new text begin Subd. 4. new text end

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sec. 23.

Minnesota Statutes 2022, section 254B.05, subdivision 5, is amended to read:

Subd. 5.

Rate requirements.

(a) The commissioner shall establish rates for substance
use disorder services and service enhancements funded under this chapter.

(b) Eligible substance use disorder treatment services include:

(1) 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 according to 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 care deleted text end new text begin treatment new 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 are deleted text end new text begin provided in an opioid treatment program new 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 treatment deleted text end new text begin (9) ASAM 3.5 clinically managed high-intensity
residential new 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 week deleted text end new text begin ASAM
level of care 3.5 according to section 254B.19, subdivision 1, clause (7), and is new 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 (i) Payment for substance use disorder services under this section must start from the
day of service initiation, when the comprehensive assessment is completed within the
required timelines.
new text end

new text begin EFFECTIVE DATE. new text end

new text begin Paragraph (b), clause (1), items (i) to (iv), are effective January
1, 2025, or upon federal approval, whichever is later. Paragraph (b), clause (1), items (v)
to (vii), are effective January 1, 2024, or upon federal approval, whichever is later. Paragraph
(b), clauses (2) to (10), are effective January 1, 2024.
new text end

Sec. 24.

new text begin [254B.17] WITHDRAWAL MANAGEMENT START-UP AND
CAPACITY-BUILDING GRANTS.
new text end

new text begin The commissioner must establish start-up and capacity-building grants for prospective
or new withdrawal management programs licensed under chapter 245F 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 EFFECTIVE DATE. new text end

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

Sec. 25.

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

new text begin Subdivision 1. new text end

new text begin Requirements. 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 an opiate antagonist in the home;
new text end

new text begin (2) have trained staff that can administer an opiate antagonist;
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 and 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 for the
discharged person so that the items are returned.
new text end

new text begin Subd. 2. new text end

new text begin Certification. new text end

new text begin (a) The commissioner shall establish a certification program for
sober homes. 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 documentation of names and contact
information for persons to contact 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 an opiate antagonist on site and in a conspicuous location;
new text end

new text begin (11) prohibiting charging exorbitant fees 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 the reasons
for the involuntary discharge 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) a policy on referrals to substance use disorder treatment services, mental health
services, peer support services, and support groups;
new text end

new text begin (14) training for staff on opiate antagonists, 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) a 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 Subd. 3. new text end

new text begin Registry. 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 Subd. 4. new text end

new text begin Bill of rights. 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 drugs or
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, sections 626.557 to 626.5572;
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 sober home'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 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 Subd. 5. new text end

new text begin Private right of action. 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 Subd. 6. new text end

new text begin Complaints; ombudsman for mental health and developmental
disabilities. new text end

new text begin Any complaints about a sober home may be made to and reviewed or
investigated by the ombudsman for mental health and developmental disabilities, pursuant
to sections 245.91 and 245.94.
new text end

Sec. 26.

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

new text begin Subdivision 1. new text end

new text begin Level of care requirements. 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 services 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 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 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 Subd. 2. new text end

new text begin Patient referral arrangement agreement. new text end

new text begin The license holder must maintain
documentation of a formal patient referral arrangement agreement for each of the following
ASAM 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