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Capital IconMinnesota Legislature

SF 2934A

Conference Committee Report - 93rd Legislature (2023 - 2024) Posted on 05/18/2023 12:24pm

KEY: stricken = removed, old language.
underscored = added, new language.
Line numbers 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 1.23 1.24 1.25 1.26 1.27 1.28 1.29 1.30 1.31 1.32 1.33 1.34 1.35 1.36 1.37 1.38 1.39 1.40 1.41 1.42 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9
2.10 2.11
2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 2.22 2.23 2.24 2.25 2.26 2.27 2.28 2.29 2.30 2.31 2.32 2.33 2.34 3.1 3.2 3.3 3.4 3.5
3.6 3.7 3.8 3.9 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 3.20 3.21 3.22 3.23 3.24 3.25 3.26 3.27 3.28 3.29 3.30 3.31 3.32 3.33 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16 4.17 4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 4.33 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 5.34 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17
6.18
6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17
7.18
7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28 8.29 8.30 8.31 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 9.33 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10 11.11 11.12 11.13 11.14 11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26 11.27 11.28 11.29 11.30 11.31 11.32
11.33
12.1 12.2 12.3 12.4 12.5 12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16 12.17 12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 12.30 12.31 12.32 12.33 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 13.30 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11 14.12 14.13 14.14 14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9
15.10 15.11 15.12
15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17 16.18 16.19 16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16 17.17 17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31
17.32
18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15
18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25
18.26 18.27 18.28 18.29 18.30 18.31 19.1 19.2
19.3 19.4 19.5 19.6 19.7 19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24 20.25 20.26 20.27 20.28 20.29 20.30 20.31 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17
22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18
23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 24.31 24.32 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15
25.16 25.17 25.18
25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13
26.14 26.15 26.16
26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 27.1
27.2 27.3 27.4
27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21 27.22 27.23 27.24 27.25 27.26 27.27 27.28 27.29 27.30 27.31 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24
28.25 28.26 28.27
28.28 28.29 28.30 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24 29.25 29.26 29.27 29.28 29.29 29.30 29.31 30.1 30.2 30.3
30.4 30.5 30.6
30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14 30.15 30.16 30.17 30.18 30.19 30.20 30.21
30.22 30.23 30.24 30.25 30.26 30.27 30.28 30.29 30.30 31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14 31.15 31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29 31.30 31.31 31.32 32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23
32.24 32.25 32.26 32.27 32.28 32.29 32.30 32.31 32.32 32.33 33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 33.31 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 35.1 35.2 35.3 35.4 35.5
35.6 35.7 35.8
35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19 35.20 35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 37.1 37.2 37.3 37.4 37.5 37.6
37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17
37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17
38.18 38.19 38.20 38.21 38.22 38.23 38.24 38.25 38.26 38.27 38.28 38.29 38.30 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15
39.16 39.17 39.18
39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21
40.22 40.23 40.24 40.25 40.26
40.27 40.28 40.29 40.30 40.31 41.1 41.2
41.3 41.4 41.5
41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 42.1 42.2 42.3 42.4 42.5 42.6 42.7
42.8 42.9 42.10 42.11
42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24
43.25 43.26 43.27
43.28 43.29 43.30 43.31 43.32 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11
44.12 44.13 44.14
44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 45.1 45.2 45.3 45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13 46.14 46.15 46.16 46.17 46.18 46.19 46.20 46.21
46.22 46.23 46.24 46.25 46.26
46.27 46.28 46.29 46.30 46.31 46.32 46.33 47.1 47.2 47.3 47.4 47.5 47.6 47.7
47.8 47.9 47.10 47.11 47.12
47.13 47.14 47.15 47.16 47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24
47.25 47.26 47.27
47.28 47.29 47.30 47.31 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 49.1 49.2 49.3 49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15
49.16 49.17 49.18
49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9 50.10 50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 51.1 51.2 51.3 51.4 51.5 51.6
51.7 51.8 51.9
51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 52.1 52.2 52.3 52.4 52.5 52.6 52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14 52.15 52.16 52.17 52.18 52.19 52.20 52.21 52.22
52.23 52.24 52.25
52.26 52.27 52.28 52.29 52.30 52.31 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12
54.13 54.14 54.15
54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 56.1 56.2
56.3 56.4 56.5
56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23
57.24 57.25 57.26
57.27 57.28 57.29 57.30 57.31 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27
59.28 59.29 59.30
60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24 60.25 60.26 60.27 60.28 60.29 60.30 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21
61.22 61.23 61.24
61.25 61.26 61.27 61.28 61.29 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15 62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 63.1 63.2
63.3 63.4 63.5
63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17 63.18 63.19 63.20 63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 64.1 64.2 64.3 64.4 64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19 64.20 64.21 64.22 64.23 64.24 64.25
64.26 64.27 64.28 64.29
64.30 64.31 64.32 64.33 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11 65.12 65.13 65.14 65.15
65.16
65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11
66.12
66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 67.1 67.2 67.3 67.4 67.5 67.6
67.7 67.8 67.9
67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 69.1 69.2 69.3 69.4 69.5
69.6 69.7 69.8 69.9
69.10 69.11 69.12 69.13 69.14 69.15 69.16
69.17 69.18 69.19
69.20 69.21 69.22 69.23 69.24 69.25 69.26
69.27 69.28 69.29
70.1 70.2 70.3 70.4 70.5 70.6 70.7
70.8 70.9 70.10
70.11 70.12 70.13 70.14 70.15 70.16
70.17 70.18 70.19
70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 70.31 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23
71.24 71.25 71.26
71.27 71.28 71.29 71.30 71.31 71.32 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9 72.10 72.11 72.12 72.13 72.14
72.15 72.16 72.17
72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 73.1 73.2 73.3
73.4 73.5 73.6
73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18
74.19 74.20 74.21 74.22 74.23 74.24
74.25 74.26 74.27 74.28 74.29 74.30 74.31 74.32 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21
75.22 75.23 75.24
75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 76.1 76.2 76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10
76.11
76.12 76.13 76.14 76.15 76.16 76.17
76.18 76.19 76.20
76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30 76.31 76.32 77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 77.31 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24
78.25 78.26 78.27 78.28 78.29 78.30 78.31 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19 79.20 79.21 79.22
79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 80.33 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22 81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16
82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 82.31 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14 83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29
83.30 83.31 83.32 83.33 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10
84.11
84.12 84.13 84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26
84.27 84.28 84.29 84.30
85.1 85.2 85.3 85.4
85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14
85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22 85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 86.1 86.2 86.3 86.4 86.5
86.6 86.7 86.8 86.9 86.10 86.11 86.12
86.13 86.14 86.15
86.16 86.17 86.18 86.19 86.20
86.21 86.22 86.23
86.24 86.25 86.26 86.27 86.28 86.29 86.30 86.31
87.1 87.2 87.3 87.4
87.5 87.6 87.7
87.8 87.9 87.10 87.11 87.12
87.13 87.14 87.15
87.16 87.17 87.18 87.19 87.20 87.21
87.22 87.23 87.24
87.25 87.26 87.27 87.28 87.29 87.30 87.31 88.1 88.2
88.3 88.4 88.5 88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21
88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 88.30 88.31 88.32 88.33 89.1 89.2 89.3 89.4
89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29
90.1 90.2 90.3 90.4 90.5 90.6 90.7 90.8 90.9
90.10 90.11 90.12
90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20
90.21 90.22 90.23 90.24 90.25 90.26 90.27
90.28 90.29 90.30 90.31 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10 91.11
91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9 92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9 93.10 93.11 93.12 93.13 93.14 93.15 93.16 93.17 93.18 93.19 93.20 93.21 93.22
93.23 93.24 93.25 93.26 93.27 93.28 93.29 93.30 93.31 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12
94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24
94.25
94.26 94.27 94.28
94.29 94.30 94.31 94.32
95.1 95.2
95.3 95.4 95.5 95.6 95.7 95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13 96.14
96.15 96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 96.31 96.32 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 98.34 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29 100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12
101.13 101.14 101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29
102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 103.32 103.33 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16
104.17 104.18 104.19
104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10 105.11 105.12 105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21
105.22 105.23 105.24
105.25 105.26 105.27 105.28 105.29 105.30 105.31 106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14
106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 106.33 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23 107.24 107.25 107.26 107.27 107.28 107.29 107.30 107.31 107.32 108.1 108.2 108.3
108.4
108.5 108.6 108.7 108.8 108.9 108.10
108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29 108.30 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15 109.16 109.17 109.18 109.19 109.20 109.21
109.22 109.23 109.24
109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 110.1 110.2 110.3 110.4 110.5 110.6 110.7 110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29 110.30 110.31 110.32 110.33 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8
111.9 111.10 111.11
111.12 111.13 111.14 111.15 111.16 111.17 111.18
111.19 111.20 111.21
111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 111.32 112.1 112.2 112.3 112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29 112.30 112.31 112.32 112.33 113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18 113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26
113.27
113.28 113.29 113.30 113.31 114.1 114.2
114.3 114.4 114.5
114.6 114.7 114.8 114.9 114.10 114.11
114.12 114.13 114.14
114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30
115.1 115.2 115.3
115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24
116.25 116.26 116.27
117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31 117.32 118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15
118.16 118.17 118.18 118.19
118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 118.32 118.33 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23 119.24 119.25 119.26 119.27 119.28 119.29 119.30 119.31 119.32 119.33 119.34 120.1 120.2 120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 120.31 120.32 120.33 120.34 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14
121.15 121.16 121.17
121.18 121.19 121.20 121.21 121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 121.32 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27 122.28 122.29 122.30 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13
123.14 123.15 123.16
123.17 123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 124.1 124.2
124.3 124.4 124.5
124.6 124.7 124.8 124.9 124.10 124.11 124.12
124.13 124.14 124.15
124.16 124.17 124.18 124.19 124.20 124.21 124.22
124.23 124.24 124.25
124.26 124.27 124.28 125.1 125.2 125.3 125.4
125.5 125.6 125.7
125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15
125.16 125.17 125.18
125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26
125.27 125.28 125.29
126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9
126.10 126.11 126.12
126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20
126.21 126.22 126.23
126.24 126.25 126.26 126.27 126.28 126.29 127.1 127.2 127.3
127.4 127.5 127.6
127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16
127.17 127.18 127.19
127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29
128.1 128.2 128.3
128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12
128.13 128.14 128.15
128.16 128.17 128.18 128.19 128.20 128.21
128.22 128.23 128.24
128.25 128.26 128.27 128.28 128.29 128.30 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9
129.10 129.11 129.12
129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25
129.26 129.27 129.28
130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9
130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10
131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31
132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9
132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18
132.19 132.20 132.21 132.22 132.23 132.24
132.25 132.26 132.27
132.28 132.29 132.30 132.31 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17 133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25
133.26 133.27 133.28 133.29
134.1 134.2 134.3 134.4 134.5
134.6 134.7 134.8
134.9 134.10
134.11 134.12 134.13 134.14 134.15 134.16 134.17 134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 135.32 135.33 135.34 136.1 136.2 136.3 136.4 136.5 136.6 136.7 136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11
137.12 137.13 137.14 137.15 137.16 137.17 137.18
137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28 137.29 137.30 137.31 137.32 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 138.32 138.33 139.1 139.2 139.3 139.4
139.5
139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 140.32 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20
141.21 141.22 141.23 141.24
141.25 141.26 141.27 141.28 141.29 141.30 141.31 141.32 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9 143.10 143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 143.32 143.33 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20 144.21 144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17 145.18 145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 145.29 145.30 145.31 145.32 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14
146.15 146.16 146.17
146.18 146.19 146.20 146.21 146.22 146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 146.32 146.33 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11 147.12 147.13 147.14 147.15 147.16 147.17 147.18
147.19 147.20 147.21
147.22 147.23 147.24 147.25 147.26 147.27 147.28 147.29 147.30 147.31 147.32 147.33 148.1 148.2 148.3 148.4 148.5 148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19 148.20 148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32 149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12
149.13 149.14 149.15 149.16 149.17 149.18 149.19 149.20 149.21 149.22 149.23 149.24 149.25 149.26 149.27 149.28 149.29 149.30 149.31 150.1 150.2
150.3
150.4 150.5 150.6 150.7 150.8 150.9 150.10
150.11
150.12 150.13 150.14 150.15 150.16 150.17 150.18 150.19 150.20 150.21 150.22 150.23 150.24 150.25 150.26 150.27 150.28 150.29 150.30
150.31
151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25
151.26 151.27 151.28 151.29 151.30 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15 152.16 152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24
152.25
152.26 152.27 152.28 152.29 152.30 152.31 152.32 153.1 153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13 153.14 153.15 153.16 153.17 153.18 153.19
153.20 153.21 153.22 153.23 153.24 153.25 153.26 153.27 153.28 153.29 153.30 153.31 153.32 153.33 153.34 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24 154.25 154.26 154.27 154.28 154.29 154.30 154.31 154.32 154.33 154.34 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21 155.22 155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 155.33 155.34 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30
157.1 157.2
157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16
157.17 157.18 157.19 157.20 157.21 157.22
157.23 157.24 157.25 157.26 157.27 157.28 157.29 157.30 157.31
158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13
158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32
159.1 159.2 159.3 159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13
159.14
159.15 159.16 159.17 159.18 159.19 159.20 159.21 159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 160.1 160.2 160.3 160.4 160.5 160.6 160.7 160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27
160.28
160.29 160.30 160.31 160.32 160.33 161.1 161.2 161.3 161.4 161.5 161.6 161.7
161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15 161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 161.31 161.32 162.1 162.2
162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13 162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13 163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 164.32 165.1 165.2 165.3 165.4 165.5
165.6 165.7 165.8
165.9 165.10 165.11 165.12 165.13 165.14 165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29
165.30 165.31 165.32
166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16
166.17
166.18 166.19 166.20 166.21 166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15
167.16 167.17 167.18 167.19 167.20 167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26 168.27 168.28 168.29 168.30 169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8
169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25
169.26 169.27 169.28 169.29 169.30 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8
171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17
171.18 171.19 171.20 171.21 171.22 171.23 171.24 171.25 171.26
171.27 171.28 171.29 171.30 171.31 171.32 172.1 172.2 172.3
172.4
172.5 172.6 172.7 172.8 172.9 172.10
172.11 172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20 172.21
172.22
172.23 172.24 172.25 172.26 172.27 172.28 172.29 173.1 173.2 173.3 173.4 173.5 173.6 173.7
173.8 173.9 173.10 173.11 173.12 173.13
173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23
173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 173.32 174.1 174.2 174.3 174.4
174.5 174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13
174.14 174.15 174.16 174.17
174.18 174.19 174.20 174.21
174.22 174.23
174.24 174.25
174.26 174.27 174.28 174.29 175.1 175.2 175.3 175.4 175.5 175.6 175.7
175.8
175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17 175.18 175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 176.1 176.2 176.3 176.4 176.5 176.6 176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16 176.17 176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 177.1 177.2 177.3 177.4 177.5 177.6 177.7 177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32 177.33 177.34 178.1 178.2 178.3 178.4 178.5 178.6 178.7
178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17
178.18 178.19 178.20 178.21 178.22 178.23 178.24 178.25 178.26
178.27 178.28 178.29 178.30 178.31 179.1 179.2
179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21
179.22 179.23 179.24 179.25 179.26 179.27 179.28 179.29 179.30 179.31
180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15 180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 181.32 181.33 181.34 182.1 182.2 182.3 182.4
182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 182.32 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 183.30 183.31 183.32 184.1 184.2 184.3
184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 185.31 185.32 185.33
185.34
186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 186.32 186.33
187.1
187.2 187.3 187.4 187.5 187.6 187.7
187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27 187.28 187.29 187.30 187.31 188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 188.30 188.31 188.32 188.33 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 190.1 190.2 190.3
190.4
190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18
190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 190.32 191.1 191.2 191.3 191.4 191.5 191.6 191.7 191.8 191.9 191.10
191.11 191.12
191.13 191.14 191.15 191.16 191.17 191.18 191.19
191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16
192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28 192.29 192.30 192.31 193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12
193.13 193.14 193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30 193.31 193.32 194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22 194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 194.32
195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9 195.10 195.11
195.12 195.13 195.14 195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24
195.25 195.26
195.27 195.28 195.29 195.30 195.31 195.32 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8 197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 197.32 197.33 197.34 198.1 198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18
198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28
198.29 198.30 198.31 198.32 198.33 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8
199.9 199.10 199.11 199.12 199.13 199.14 199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22
199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 199.32 199.33
200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 200.33 201.1 201.2 201.3 201.4 201.5 201.6
201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23
201.24 201.25 201.26 201.27 201.28 201.29 201.30 201.31 201.32 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 202.33 202.34 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11
203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19 203.20 203.21 203.22 203.23
203.24 203.25 203.26 203.27 203.28 203.29 203.30 203.31 203.32 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8
204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20
204.21 204.22 204.23 204.24 204.25
204.26 204.27
204.28 204.29 204.30 204.31 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9
205.10
205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20
205.21
205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19
206.20
206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 207.1 207.2 207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13
207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31
208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14
208.15 208.16
208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 208.31 208.32
209.1
209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9 209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21
209.22
209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 210.1 210.2
210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29 210.30 210.31 210.32 211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17
211.18
211.19 211.20 211.21 211.22 211.23 211.24 211.25 211.26 211.27 211.28 211.29 211.30 211.31
212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10 212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27 213.28 213.29 213.30 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30 214.31 214.32 214.33 215.1
215.2
215.3 215.4 215.5 215.6 215.7 215.8
215.9
215.10 215.11
215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23
215.24 215.25 215.26 215.27 215.28 215.29 215.30 215.31 216.1 216.2 216.3 216.4 216.5 216.6 216.7 216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 216.31 216.32 216.33 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14 217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 217.33 217.34 217.35 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10 218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33 218.34 219.1 219.2 219.3 219.4 219.5 219.6 219.7 219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21 219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 219.32 220.1 220.2 220.3 220.4 220.5 220.6 220.7 220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23 220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 220.32 220.33 220.34 220.35 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9 221.10 221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22 221.23 221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 221.32 221.33 221.34 221.35 222.1 222.2 222.3 222.4 222.5 222.6 222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20 222.21 222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 222.32 222.33 222.34 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8 223.9 223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21 223.22 223.23 223.24 223.25 223.26 223.27 223.28 223.29 223.30 223.31 223.32 223.33 224.1 224.2 224.3 224.4 224.5 224.6 224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18 224.19 224.20 224.21 224.22 224.23 224.24 224.25 224.26 224.27 224.28 224.29 224.30 224.31 224.32 224.33 224.34 224.35 225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19 225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 225.33 225.34 225.35 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8 226.9 226.10 226.11 226.12 226.13 226.14 226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 226.31 226.32 226.33 226.34 226.35 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23 227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 227.32 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25 228.26 228.27 228.28 228.29 228.30 228.31 228.32 228.33 228.34 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27 229.28 229.29 229.30 229.31 229.32 229.33 229.34 229.35 230.1 230.2 230.3 230.4 230.5 230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 230.31 230.32 230.33 230.34 230.35 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14 231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17 232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 232.31 232.32 232.33 232.34 232.35 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22 233.23 233.24 233.25 233.26 233.27 233.28 233.29 233.30 233.31 233.32 233.33 233.34 234.1 234.2 234.3 234.4 234.5 234.6 234.7 234.8 234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 234.31 234.32 234.33 234.34 234.35 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20
235.21 235.22 235.23 235.24
235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32
235.33 235.34 236.1 236.2 236.3 236.4
236.5 236.6 236.7 236.8 236.9 236.10 236.11 236.12 236.13
236.14 236.15 236.16 236.17 236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25
236.26
236.27 236.28 236.29 236.30
237.1
237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17 237.18
237.19 237.20 237.21
237.22 237.23 237.24
237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 238.33 238.34 238.35 238.36 238.37 238.38 239.1 239.2 239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11

CONFERENCE COMMITTEE REPORT ON S. F. No. 2934

A bill for an act
relating to human services; establishing an office of addiction and recovery;
establishing the Minnesota board of recovery services; establishing title protection
for sober homes; modifying provisions governing disability services, aging services,
and behavioral health; modifying medical assistance eligibility requirements for
certain populations; making technical and conforming changes; establishing certain
grants; requiring reports; appropriating money; amending Minnesota Statutes 2022,
sections 4.046, subdivisions 6, 7, by adding a subdivision; 179A.54, by adding a
subdivision; 241.021, subdivision 1; 241.31, subdivision 5; 241.415; 245A.03,
subdivision 7; 245A.11, subdivisions 7, 7a; 245D.04, subdivision 3; 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; 246.54, subdivisions 1a, 1b; 252.27, subdivision 2a; 254B.01,
subdivision 8, by adding subdivisions; 254B.04, by adding a subdivision; 254B.05,
subdivisions 1, 5; 256.043, subdivisions 3, 3a; 256.9754; 256B.04, by adding a
subdivision; 256B.056, subdivision 3; 256B.057, subdivision 9; 256B.0625,
subdivisions 17, 17a, 18h, 22, by adding a subdivision; 256B.0638, subdivisions
2, 4, 5; 256B.0659, subdivisions 1, 12, 19, 24; 256B.073, subdivision 3, by adding
a subdivision; 256B.0759, subdivision 2; 256B.0911, subdivision 13; 256B.0913,
subdivisions 4, 5; 256B.0917, subdivision 1b; 256B.0922, subdivision 1;
256B.0949, subdivision 15; 256B.14, subdivision 2; 256B.434, by adding a
subdivision; 256B.49, subdivisions 11, 28; 256B.4905, subdivision 5a; 256B.4911,
by adding a subdivision; 256B.4912, by adding subdivisions; 256B.4914,
subdivisions 3, as amended, 4, 5, 5a, 5b, 5c, 5d, 5e, 8, 9, 10, 10a, 10c, 12, 14, by
adding a subdivision; 256B.492; 256B.5012, by adding subdivisions; 256B.766;
256B.85, subdivision 7, by adding a subdivision; 256B.851, subdivisions 5, 6;
256I.05, by adding subdivisions; 256M.42; 256R.02, subdivision 19; 256R.17,
subdivision 2; 256R.25; 256R.47; 256R.481; 256R.53, by adding subdivisions;
256S.15, subdivision 2; 256S.18, by adding a subdivision; 256S.19, subdivision
3; 256S.203, subdivisions 1, 2; 256S.205, subdivisions 3, 5; 256S.21; 256S.2101,
subdivisions 1, 2, by adding subdivisions; 256S.211, by adding subdivisions;
256S.212; 256S.213; 256S.214; 256S.215, subdivisions 2, 3, 4, 7, 8, 9, 10, 11, 12,
13, 14, 15, 16, 17; Laws 2019, chapter 63, article 3, section 1, as amended; Laws
2021, First Special Session chapter 7, article 16, section 28, as amended; article
17, sections 16; 20; proposing coding for new law in Minnesota Statutes, chapters
121A; 144A; 245; 245D; 254B; 256; 256I; 256S; 325F; repealing Minnesota
Statutes 2022, sections 245G.05, subdivision 2; 246.18, subdivisions 2, 2a;
256B.0638, subdivisions 1, 2, 3, 4, 5, 6; 256B.0759, subdivision 6; 256B.0917,
subdivisions 1a, 6, 7a, 13; 256B.4914, subdivision 9a; 256S.19, subdivision 4.

May 18, 2023
The Honorable Bobby Joe Champion
President of the Senate

The Honorable Melissa Hortman
Speaker of the House of Representatives

We, the undersigned conferees for S. F. No. 2934 report that we have agreed upon the
items in dispute and recommend as follows:

That the House recede from its amendments and that S. F. No. 2934 be further amended
as follows:

Delete everything after the enacting clause and insert:

"ARTICLE 1

DISABILITY SERVICES

Section 1.

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 by the state to the Home Care Orientation Trust must be
made by the state pursuant to a collective bargaining agreement negotiated under this section.
All such financial contributions by the state must be held in trust for the purpose of paying,
from principal, from income, 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 must 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 of the
exclusive representative.
new text end

new text begin (c) Trust administrative, management, legal, and financial services may be provided to
the board of trustees by a third-party administrator, financial management institution, other
appropriate entity, or any combination thereof, as designated by the board of trustees from
time to time, and those services must 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 or participation in the management or administration of
the Home Care Orientation Trust must not be considered an unfair labor practice under
section 179A.13, or a violation of Minnesota law.
new text end

Sec. 2.

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.49new 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 30deleted text end new text begin December 31new 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. 3.

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. 4.

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 settingdeleted 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 settingdeleted 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 settingdeleted 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. 5.

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. 6.

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, 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 document 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) 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, including information explaining that if a resident
provides informed consent to the use of monitoring technology but later revokes their
consent, the resident may be subject to a service termination in accordance with section
245D.10, subdivision 3a;
new text end

new text begin (3) ensure that services may not be terminated for any person or resident currently served
by the program and receiving in-person services solely because the person declines to
provide informed consent to the initial change to the use of monitoring technology as required
under subdivision 5;
new text end

new text begin (4) explain the backup system for technology in times of electrical outages or other
equipment malfunctions;
new text end

new text begin (5) explain how the license holder trains the direct support staff on the use of the
technology; and
new text end

new text begin (6) 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 (c) 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 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. 7.

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. 8.

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

Sec. 9.

Minnesota Statutes 2022, section 256.01, subdivision 19, is amended to read:


Subd. 19.

Grants for deleted text begin case managementdeleted text end new text begin supportivenew text end services to persons with HIV or
AIDS.

The commissioner may award grants to eligible vendors for the development,
implementation, and evaluation of deleted text begin case managementdeleted text end new text begin supportivenew text end services for individuals
infected with the human immunodeficiency virus. HIV/AIDS deleted text begin case managementdeleted text end new text begin supportivenew text end
services will be provided to increase access to cost effective health care services, to reduce
the risk of HIV transmission, to ensure that basic client needs are met, and to increase client
access to needed community supports or services.

Sec. 10.

new text begin [256.4764] LONG-TERM SERVICES AND SUPPORTS WORKFORCE
INCENTIVE 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 long-term services and supports providers and facilities to assist with
recruiting and retaining direct support professionals.
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 that is:
new text end

new text begin (1) a provider of home and community-based services under Minnesota Statutes, chapter
245D;
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 (3) a nursing facility under section 256R.02, subdivision 33;
new text end

new text begin (4) a provider of personal care assistance services under section 256B.0659;
new text end

new text begin (5) a provider of community first services and supports under section 256B.85;
new text end

new text begin (6) a provider of early intensive developmental and behavioral intervention services
under section 256B.0949;
new text end

new text begin (7) a provider of home care services as defined under section 256B.0651, subdivision
1, paragraph (d);
new text end

new text begin (8) an eligible financial management services provider serving people through
consumer-directed community supports under chapter 256S and sections 256B.092 and
256B.49, or consumer support grants under section 256.476; or
new text end

new text begin (9) a provider of customized living services as defined in section 256S.02.
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;
new text end

new text begin (5) personal care assistant background study costs; and
new text end

new text begin (6) other costs associated with retaining and recruiting workers, as approved by the
commissioner.
new text end

new text begin (b) Eligible workers may receive cumulative payments up to $1,000 per year from the
workforce incentive grant account and all other state money intended for the same purpose.
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) Each grantee shall prepare, and upon request
submit to the commissioner, a distribution plan that specifies the amount of money the
grantee 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 grantee
must post the distribution plan and leave it posted for a period of at least six months in an
area of the grantee'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 grantee that receives
a grant 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 chapter 119B;
new text end

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

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

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

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

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

new text begin Subd. 8.new text end

new text begin Income tax subtractions.new text end

new text begin (a) For the purposes of this section, "subtraction"
has the meaning given in section 290.0132, subdivision 1, and the rules in that subdivision
apply for this section. The definitions in section 290.01 apply to this section.
new text end

new text begin (b) The amount of a payment received under this section is a subtraction.
new text end

new text begin (c) Payments under this section and Laws 2021, First Special Session chapter 7, article
17, section 20, as amended, are excluded from income as defined in sections 290.0674,
subdivision 2a, and 290A.03, subdivision 3.
new text end

new text begin Subd. 9.new text end

new text begin Account created.new text end

new text begin A workforce incentive grant account is created in the special
revenue fund. Appropriations made for grants and payments administered under this section
may be transferred to this account. Amounts in the account are appropriated to the
commissioner of human services. Appropriations transferred to this account cancel and are
returned to the fund of origin on the date the original appropriations would have lapsed.
new text end

new text begin Subd. 10.new text end

new text begin Nursing facilities; applicable credit.new text end

new text begin The commissioner must treat grant
payments awarded under this section as an applicable credit as defined under section 256R.10,
subdivision 6.
new text end

new text begin Subd. 11.new text end

new text begin Self-directed services workforce.new text end

new text begin Payments administered under this section,
including reimbursements for paid family medical leave premiums, do not constitute a
change in a term or condition for individual providers as defined in section 256B.0711 in
covered programs and are not subject to the state's obligation to meet and negotiate under
chapter 179A.
new text end

Sec. 11.

new text begin [256.4773] TECHNOLOGY FOR HOME GRANT.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner must establish a technology for home
grant program that provides assistive technology consultations and resources for people
with disabilities who want to stay in their own home, move to their own home, or remain
in a less restrictive residential setting. The grant program may be administered using a team
approach that allows multiple professionals to assess and meet a person's assistive technology
needs. The team may include but is not limited to occupational therapists, physical therapists,
speech therapists, nurses, and engineers.
new text end

new text begin Subd. 2.new text end

new text begin Eligible applicants.new text end

new text begin An eligible applicant is a person who uses or is eligible
for home care services under section 256B.0651, home and community-based services under
section 256B.092 or 256B.49, personal care assistance under section 256B.0659, or
community first services and supports under section 256B.85, and who meets one of the
following conditions:
new text end

new text begin (1) lives in the applicant's own home and may benefit from assistive technology for
safety, communication, community engagement, or independence;
new text end

new text begin (2) is currently seeking to live in the applicant's own home and needs assistive technology
to meet that goal; or
new text end

new text begin (3) resides in a residential setting under section 256B.4914, subdivision 3, and is seeking
to reduce reliance on paid staff to live more independently in the setting.
new text end

new text begin Subd. 3.new text end

new text begin Allowable grant activities.new text end

new text begin The technology for home grant program must
provide at-home, in-person assistive technology consultation and technical assistance to
help people with disabilities live more independently. Allowable activities include but are
not limited to:
new text end

new text begin (1) consultations in people's homes, workplaces, or community locations;
new text end

new text begin (2) connecting people to resources to help them live in their own homes, transition to
their own homes, or live more independently in residential settings;
new text end

new text begin (3) conducting training for and set up and installation of assistive technology; and
new text end

new text begin (4) participating on a person's care team to develop a plan to ensure assistive technology
goals are met.
new text end

new text begin Subd. 4.new text end

new text begin Data collection and outcomes.new text end

new text begin Grantees must provide data summaries to the
commissioner for the purpose of evaluating the effectiveness of the grant program. The
commissioner must identify outcome measures to evaluate program activities to assess
whether the grant programs help people transition to or remain in the least restrictive setting.
new text end

Sec. 12.

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 towardsdeleted text end new text begin towardnew 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. 13.

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 incarcerationnew 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. 14.

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 or 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. 15.

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 useddeleted 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. 16.

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)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. 17.

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. 18.

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 tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , 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. 19.

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 languagenew text begin or is an individual certified by a Tribal Nationnew text end ;

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

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

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

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

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

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

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

new text begin 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. 20.

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 tendeleted text end new text begin 20new text end hours of case management
education and disability-related training each year. The education and training must include
person-centered planningnew text begin , 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. 21.

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 wagedeleted text begin .deleted text end new text begin ; and
new text end

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

Sec. 22.

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

Sec. 23.

Minnesota Statutes 2022, section 256B.4911, is amended by adding a subdivision
to read:


new text begin Subd. 6.new text end

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

new text begin (a) This subdivision limits medical
assistance payments under the consumer-directed community supports option for personal
assistance services provided by a parent to the parent's minor child or by a participant's
spouse. This subdivision applies to the consumer-directed community supports option
available under all of the following:
new text end

new text begin (1) alternative care program;
new text end

new text begin (2) brain injury waiver;
new text end

new text begin (3) community alternative care waiver;
new text end

new text begin (4) community access for disability inclusion waiver;
new text end

new text begin (5) developmental disabilities waiver; and
new text end

new text begin (6) elderly waiver.
new text end

new text begin (b) For the purposes of this subdivision, "parent" means a parent, stepparent, or legal
guardian of a minor.
new text end

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

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

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

new text begin (f) This subdivision must not be construed to permit an increase in the total authorized
consumer-directed community supports budget for an individual.
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. 24.

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


new text begin Subd. 1b.new text end

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

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

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

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

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

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

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

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

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

Sec. 25.

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


new text begin Subd. 1c.new text end

new text begin Annual labor market report.new text end

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

Sec. 26.

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


new text begin Subd. 16.new text end

new text begin Rates established by the commissioner.new text end

new text begin For homemaker services eligible
for reimbursement under the developmental disabilities waiver, the brain injury waiver, the
community alternative care waiver, and the community access for disability inclusion waiver,
the commissioner must establish rates equal to the rates established under sections 256S.21
to 256S.215 for the corresponding homemaker services.
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. 27.

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


Subd. 3.

Applicable services.

new text begin (a) new text end 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 (b) Effective January 1, 2024, or upon federal approval, whichever is later, respite
services under paragraph (a), clause (20), are not an applicable service under this section.
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, except that paragraph (b) is effective the day following final enactment.
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end

Sec. 28.

Minnesota Statutes 2022, section 256B.4914, subdivision 4, is amended to read:


Subd. 4.

Data collection for rate determination.

(a) Rates for applicable home and
community-based waivered services, including customized rates under subdivision 12, are
set by the rates management system.

(b) Data and information in the rates management system must be used to calculate an
individual's rate.

(c) Service providers, with information from the support plan and oversight by lead
agencies, shall provide values and information needed to calculate an individual's rate in
the rates management system. The determination of service levels must be part of a discussion
with members of the support team as defined in section 245D.02, subdivision 34. This
discussion must occur prior to the final establishment of each individual's rate. The values
and information include:

(1) shared staffing hours;

(2) individual staffing hours;

(3) direct registered nurse hours;

(4) direct licensed practical nurse hours;

(5) staffing ratios;

(6) information to document variable levels of service qualification for variable levels
of reimbursement in each framework;

(7) shared or individualized arrangements for unit-based services, including the staffing
ratio;

(8) number of trips and miles for transportation services; and

(9) service hours provided through monitoring technology.

(d) Updates to individual data must include:

(1) data for each individual that is updated annually when renewing service plans; and

(2) requests by individuals or lead agencies to update a rate whenever there is a change
in an individual's service needs, with accompanying documentation.

(e) Lead agencies shall review and approve all services reflecting each individual's needs,
and the values to calculate the final payment rate for services with variables under
subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end for each individual. Lead agencies must notify the individual and the
service provider of the final agreed-upon values and rate, and provide information that is
identical to what was entered into the rates management system. If a value used was
mistakenly or erroneously entered and used to calculate a rate, a provider may petition lead
agencies to correct it. Lead agencies must respond to these requests. When responding to
the request, the lead agency must consider:

(1) meeting the health and welfare needs of the individual or individuals receiving
services by service site, identified in their support plan under section 245D.02, subdivision
4b
, and any addendum under section 245D.02, subdivision 4c;

(2) meeting the requirements for staffing under subdivision 2, paragraphs (h), (n), and
(o); and meeting or exceeding the licensing standards for staffing required under section
245D.09, subdivision 1; and

(3) meeting the staffing ratio requirements under subdivision 2, paragraph (o), and
meeting or exceeding the licensing standards for staffing required under section 245D.31.

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. 29.

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 Novemberdeleted text end new text begin Januarynew text end 1, 2024, based on wage data by SOC from the Bureau of Labor
Statistics deleted text begin available as of December 31, 2021deleted text end new text begin published in March 2022new text end ; and

(3) on deleted text begin Julydeleted text end new text begin Januarynew 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 daydeleted text end new text begin published in the spring
approximately 21 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. 30.

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
employersdeleted text begin , with the exception of asleep-overnight staff for family residential services, which
is 36 percent of the minimum wage in Minnesota for large 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 deleted text begin 31-1014deleted text end new text begin 31-1131new text end ); 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
deleted text begin rehabilitation counselor (SOC code 21-1015)deleted text end new text begin education, guidance, school, and vocational
counselor (SOC code 21-1012)
new text end ; 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);new text begin and
new text end

(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)deleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (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).
deleted text end

new text begin EFFECTIVE DATE.new text end

new text begin The amendment to clause (5), item (ii), the amendment to clause
(14), and the amendment striking clause (18) are effective January 1, 2024, or upon federal
approval, whichever is later. The amendment to clause (4) is effective January 1, 2026, or
upon federal approval, whichever is later. The commissioner of human services shall notify
the revisor of statutes when federal approval is obtained.
new text end

Sec. 31.

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 deleted text begin 9adeleted text end new text begin 9 and the rates identified in subdivision 19new text end for
changes in the Consumer Price Index. The commissioner shall adjust these values higher
or lower, publish these updated values, and load them into the rate management system as
follows:

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

(2) on deleted text begin Novemberdeleted text end new text begin Januarynew text end 1, 2024, by the percentage change in the CPI-U from the date
of the previous update to the data available as of December 31, deleted text begin 2021deleted text end new text begin 2022new text end ; and

(3) on deleted text begin Julydeleted text end new text begin Januarynew 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 deleted text begin 30deleted text end new text begin 24new text end 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 amendment striking the cross-reference to subdivision
9a and 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. 32.

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. 33.

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


Subd. 6a.

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

(a) Component values for community residential services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 1.3 percent; and

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

(b) Payments for community residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;

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

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

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

(5) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervision span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
individual direct staffing hours provided through monitoring technology, and multiply the
result by one plus the employee vacation, sick, and training allowance ratio. This is defined
as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
direct staffing and individual hours provided through monitoring technology, by one plus
the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
by 365 if customized for adapted transport, based on the resident with the highest assessed
need. The commissioner shall update the amounts in this clause as specified in subdivision
5b;

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
and individual direct staffing hours provided through monitoring technology that was
excluded in clause (8);

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

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

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

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. 34.

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


Subd. 6b.

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

(a) Component values for family residential services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) general administrative support ratio: 3.3 percent;

(6) program-related expense ratio: 1.3 percent; and

(7) absence factor: 1.7 percent.

(b) Payments for family residential services must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs provided on site or through monitoring technology;

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

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

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

(5) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the appropriate
staff wages;

(6) multiply the number of shared direct staffing and individual direct staffing hours
provided on site or through monitoring technology and nursing hours by the product of the
supervisory span of control ratio and the appropriate supervisory staff wage in subdivision
5a, clause (1);

(7) combine the results of clauses (5) and (6), excluding any shared direct staffing and
individual direct staffing hours provided through monitoring technology, and multiply the
result by one plus the employee vacation, sick, and training allowance ratio. This is defined
as the direct staffing cost;

(8) for employee-related expenses, multiply the direct staffing cost, excluding any shared
and individual direct staffing hours provided through monitoring technology, by one plus
the employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) for transportation, if provided, add $1,742.62 divided by 365, or $3,111.81 divided
by 365 if customized for adapted transport, based on the resident with the highest assessed
need. The commissioner shall update the amounts in this clause as specified in subdivision
5b;

(11) subtotal clauses (8) to (10) and the direct staffing cost of any shared direct staffing
and individual direct staffing hours provided through monitoring technology that was
excluded in clause (8);

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

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

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

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. 35.

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


Subd. 6c.

Integrated community supports; component values and calculation of
payment rates.

(a) Component values for integrated community supports are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) general administrative support ratio: 13.25 percent;

(6) program-related expense ratio: 1.3 percent; and

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

(b) Payments for integrated community supports must be calculated as follows:

(1) determine the number of shared direct staffing and individual direct staffing hours
to meet a recipient's needs. The base shared direct staffing hours must be eight hours divided
by the number of people receiving support in the integrated community support setting, and
the individual direct staffing hours must be the average number of direct support hours
provided directly to the service recipient;

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

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

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

(5) multiply the number of shared direct staffing and individual direct staffing hours in
clause (1) by the appropriate staff wages;

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

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

(8) for employee-related expenses, multiply the direct staffing cost by one plus the
employee-related cost ratio;

(9) for client programming and supports, add $2,260.21 divided by 365. The
commissioner shall update the amount in this clause as specified in subdivision 5b;

(10) add the results of clauses (8) and (9);

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

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

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

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.4914, subdivision 7a, is amended to read:


Subd. 7a.

Adult day services; component values and calculation of payment rates.

(a)
Component values for adult day services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) program plan support ratio: 5.6 percent;

(6) client programming and support ratio: 7.4 percent, updated as specified in subdivision
5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(b) A unit of service for adult day services is either a day or 15 minutes. A day unit of
service is six or more hours of time spent providing direct service.

(c) Payments for adult day services must be calculated as follows:

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

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

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

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

(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;

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

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

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

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

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

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;

(12) for adult day bath services, add $7.01 per 15 minute unit;

(13) this is the subtotal rate;

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

(15) divide the result of clause (13) by one minus the result of clause (14). This is the
total payment amount; and

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

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. 37.

Minnesota Statutes 2022, section 256B.4914, subdivision 7b, is amended to read:


Subd. 7b.

Day support services; component values and calculation of payment
rates.

(a) Component values for day support services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) program plan support ratio: 5.6 percent;

(6) client programming and support ratio: 10.37 percent, updated as specified in
subdivision 5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(b) A unit of service for day support services is 15 minutes.

(c) Payments for day support services must be calculated as follows:

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

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

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

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

(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;

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

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

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

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

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

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;

(12) this is the subtotal rate;

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

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

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

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. 38.

Minnesota Statutes 2022, section 256B.4914, subdivision 7c, is amended to read:


Subd. 7c.

Prevocational services; component values and calculation of payment
rates.

(a) Component values for prevocational services are:

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) program plan support ratio: 5.6 percent;

(6) client programming and support ratio: 10.37 percent, updated as specified in
subdivision 5b;

(7) general administrative support ratio: 13.25 percent;

(8) program-related expense ratio: 1.8 percent; and

(9) absence and utilization factor ratio: 9.4 percent.

(b) A unit of service for prevocational services is either a day or 15 minutes. A day unit
of service is six or more hours of time spent providing direct service.

(c) Payments for prevocational services must be calculated as follows:

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

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

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

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

(5) multiply the number of day program direct staffing hours and nursing hours by the
appropriate staff wage;

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

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

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

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

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

(11) for program facility costs, add $19.30 per week with consideration of staffing ratios
to meet individual needs, updated as specified in subdivision 5b;

(12) this is the subtotal rate;

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

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

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

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. 39.

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


Subd. 8.

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

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

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

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) program plan support ratio: 15.5 percent;

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

(7) general administrative support ratio: 13.25 percent;

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

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

(c) A unit of service for unit-based services with programming is 15 minutes.

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

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

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

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

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

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

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

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

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

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

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

(11) this is the subtotal rate;

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

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

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

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

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

(iii) for individualized home supports with training and individualized home supports
with family training, divide by the number of service recipients, not to exceed deleted text begin twodeleted text end new text begin threenew text end ;
and

new text begin (iv) for night supervision, divide by the number of service recipients, not to exceed two;
and
new text end

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

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. 40.

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


Subd. 9.

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

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

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

(1) competitive workforce factor: deleted text begin 4.7deleted text end new text begin 6.7new text end percent;

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

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

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

(5) program plan support ratio: 7.0 percent;

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

(7) general administrative support ratio: 13.25 percent;

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

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

(c) A unit of service for unit-based services without programming is 15 minutes.

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

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

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

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

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

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

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

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

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

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

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

(11) this is the subtotal rate;

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

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

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

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

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. 41.

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


Subd. 10.

Evaluation of information and data.

(a) The commissioner shall, within
available resources, conduct research and gather data and information from existing state
systems or other outside sources on the following items:

(1) differences in the underlying cost to provide services and care across the state;

(2) mileage, vehicle type, lift requirements, incidents of individual and shared rides, and
units of transportation for all day services, which must be collected from providers using
the rate management worksheet and entered into the rates management system; and

(3) the distinct underlying costs for services provided by a license holder under sections
245D.05, 245D.06, 245D.07, 245D.071, 245D.081, and 245D.09, and for services provided
by a license holder certified under section 245D.33.

(b) The commissioner, in consultation with stakeholders, shall review and evaluate the
following values already in subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end , or issues that impact all services, including,
but not limited to:

(1) values for transportation rates;

(2) values for services where monitoring technology replaces staff time;

(3) values for indirect services;

(4) values for nursing;

(5) values for the facility use rate in day services, and the weightings used in the day
service ratios and adjustments to those weightings;

(6) values for workers' compensation as part of employee-related expenses;

(7) values for unemployment insurance as part of employee-related expenses;

(8) direct care workforce labor market measures;

(9) any changes in state or federal law with a direct impact on the underlying cost of
providing home and community-based services;

(10) outcome measures, determined by the commissioner, for home and community-based
services rates determined under this section; and

(11) different competitive workforce factors by service, as determined under subdivision
10b.

(c) The commissioner shall report to the chairs and the ranking minority members of
the legislative committees and divisions with jurisdiction over health and human services
policy and finance with the information and data gathered under paragraphs (a) and (b) on
January 15, 2021, with a full report, and a full report once every four years thereafter.

(d) Beginning July 1, 2022, the commissioner shall renew analysis and implement
changes to the regional adjustment factors once every six years. Prior to implementation,
the commissioner shall consult with stakeholders on the methodology to calculate the
adjustment.

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. 42.

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 deleted text begin 9adeleted text end new text begin 9new text end 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, except that the
amendment striking the cross-reference to subdivision 9a 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. 43.

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


Subd. 10c.

Reporting and analysis of competitive workforce factor.

(a) Beginning
February 1, deleted text begin 2021deleted text end new text begin 2025new text end , 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 policy and finance an analysis of the competitive
workforce factor.

(b) The report must include deleted text begin recommendations to update the competitive workforce factor
using
deleted text end :

(1) the most recently available wage data by SOC code for the weighted average wage
for direct care staff for residential services and direct care staff for day services;

(2) the most recently available wage data by SOC code of the weighted average wage
of comparable occupations; and

(3) workforce data as required under subdivision 10b.

(c) deleted text begin The commissioner shall not recommend an increase or decrease of the competitive
workforce factor from the current value by more than two percentage points. If, after a
biennial analysis for the next report, the competitive workforce factor is less than or equal
to zero, the commissioner shall recommend a competitive workforce factor of zero.
deleted text end new text begin This
subdivision expires June 30, 2031.
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. 44.

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. 45.

Minnesota Statutes 2022, section 256B.4914, subdivision 12, is amended to read:


Subd. 12.

Customization of rates for individuals.

(a) For persons determined to have
higher needs based on being deaf or hard-of-hearing, the direct-care costs must be increased
by an adjustment factor prior to calculating the rate under subdivisions 6 to deleted text begin 9adeleted text end new text begin 9new text end . The
customization rate with respect to deaf or hard-of-hearing persons shall be $2.50 per hour
for waiver recipients who meet the respective criteria as determined by the commissioner.

(b) For the purposes of this section, "deaf and hard-of-hearing" means:

(1) the person has a developmental disability and:

(i) an assessment score which indicates a hearing impairment that is severe or that the
person has no useful hearing;

(ii) an expressive communications score that indicates the person uses single signs or
gestures, uses an augmentative communication aid, or does not have functional
communication, or the person's expressive communications is unknown; and

(iii) a communication score which indicates the person comprehends signs, gestures,
and modeling prompts or does not comprehend verbal, visual, or gestural communication,
or that the person's receptive communication score is unknown; or

(2) the person receives long-term care services and has an assessment score that indicates
the person hears only very loud sounds, the person has no useful hearing, or a determination
cannot be made; and the person receives long-term care services and has an assessment that
indicates the person communicates needs with sign language, symbol board, written
messages, gestures, or an interpreter; communicates with inappropriate content, makes
garbled sounds or displays echolalia, or does not communicate needs.

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. 46.

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 deleted text begin 9adeleted text end new text begin 9new text end 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 deleted text begin 9adeleted text end new text begin 9new text end ;

(2) the service rate requested and the difference from the rate determined in subdivisions
6 to deleted text begin 9adeleted text end new text begin 9new text end ;

(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, 2024, or upon federal approval,
whichever is later, except that paragraph (m) 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. 47.

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. 48.

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 increase effective January 1, 2024.new text end

new text begin (a) Effective January 1,
2024, the daily operating payment rate for a class A intermediate care facility for persons
with developmental disabilities is increased by $40.
new text end

new text begin (b) Effective January 1, 2024, the daily operating payment rate for a class B intermediate
care facility for persons with developmental disabilities is increased by $40.
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. 49.

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


new text begin Subd. 20.new text end

new text begin ICF/DD minimum daily operating payment rates.new text end

new text begin (a) The minimum daily
operating payment rate for a class A intermediate care facility for persons with developmental
disabilities is $275.
new text end

new text begin (b) The minimum daily operating payment rate for a class B intermediate care facility
for persons with developmental disabilities is $316.
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. 50.

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


new text begin Subd. 21.new text end

new text begin ICF/DD rate increases after January 1, 2025.new text end

new text begin Beginning January 1, 2025,
and every year thereafter, the rates under this section must be updated for the percentage
change in the Consumer Price Index (CPI-U) from the previous July 1 to the data available
12 months and one day prior.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 51.

Minnesota Statutes 2022, section 256B.85, subdivision 7, is amended to read:


Subd. 7.

Community first services and supports; covered services.

Services and
supports covered under CFSS include:

(1) assistance to accomplish activities of daily living (ADLs), instrumental activities of
daily living (IADLs), and health-related procedures and tasks through hands-on assistance
to accomplish the task or constant supervision and cueing to accomplish the task;

(2) assistance to acquire, maintain, or enhance the skills necessary for the participant to
accomplish activities of daily living, instrumental activities of daily living, or health-related
tasks;

(3) expenditures for items, services, supports, environmental modifications, or goods,
including assistive technology. These expenditures must:

(i) relate to a need identified in a participant's CFSS service delivery plan; and

(ii) increase independence or substitute for human assistance, to the extent that
expenditures would otherwise be made for human assistance for the participant's assessed
needs;

(4) observation and redirection for behavior or symptoms where there is a need for
assistance;

(5) back-up systems or mechanisms, such as the use of pagers or other electronic devices,
to ensure continuity of the participant's services and supports;

(6) services provided by a consultation services provider as defined under subdivision
17, that is under contract with the department and enrolled as a Minnesota health care
program provider;

(7) services provided by an FMS provider as defined under subdivision 13a, that is an
enrolled provider with the department;

(8) CFSS services provided by a support worker who is a parent, stepparent, or legal
guardian of a participant under age 18, or who is the participant's spouse. deleted text begin These support
workers shall not:
deleted text end new text begin Covered services under this clause are subject to the limitations described
in subdivision 7b; and
new text end

deleted text begin (i) provide any medical assistance home and community-based services in excess of 40
hours per seven-day period regardless of the number of parents providing services,
combination of parents and spouses providing services, or number of children who receive
medical assistance services; and
deleted text end

deleted text begin (ii) have a wage that exceeds the current rate for a CFSS support worker including the
wage, benefits, and payroll taxes; and
deleted text end

(9) worker training and development services as described in subdivision 18a.

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. 52.

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


new text begin Subd. 7b.new text end

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

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

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

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

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

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

new text begin (f) A parent or participant's spouse must not receive a wage that exceeds the current rate
for a CFSS support worker, including wages, benefits, and payroll taxes.
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. 53.

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 Marchnew 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 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. 54.

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 75.45deleted text end new text begin 88.19new text end percent;

(2) enhanced rate personal care assistance services and enhanced rate CFSS: deleted text begin 75.45deleted text end new text begin 88.19new text end
percent; and

(3) qualified professional services and CFSS worker training and development: deleted text begin 75.45deleted text end new text begin
88.19
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 90 days after federal approval, whichever is later. Paragraph (b) expires January 1, 2025,
or 90 days after federal approval of paragraph (c), whichever is later. Paragraphs (c) to (e)
are 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. 55.

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 adjusteddeleted text end new text begin finalnew 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. 56.

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. 57.

Minnesota Statutes 2022, section 256S.2101, subdivision 1, is amended to read:


Subdivision 1.

Phase-in for disability waiver customized living rates.

All rates and
rate components for community access for disability inclusion customized living and brain
injury customized living under section 256B.4914 deleted text begin shalldeleted text end new text begin mustnew text end be the sum of deleted text begin tendeleted text end new text begin 29.6new text end percent
of the rates calculated under sections 256S.211 to 256S.215 and deleted text begin 90deleted text end new text begin 70.4new text end percent of the rates
calculated using the rate methodology in effect as of June 30, 2017.

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.

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. 59.

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. 60. new text begin NEW AMERICAN LEGAL, SOCIAL SERVICES, AND LONG-TERM
CARE WORKFORCE GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Definition.new text end

new text begin "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 new American legal, social services, and long-term care workforce grant program
for organizations that serve and support new Americans:
new text end

new text begin (1) in seeking or maintaining legal or citizenship status to legally obtain or retain
employment in any field or industry; or
new text end

new text begin (2) to provide specialized services and supports to new Americans to enter the long-term
care workforce.
new text end

new text begin Subd. 3.new text end

new text begin Eligible grantees.new text end

new text begin (a) The commissioner shall select grantees as provided in
this subdivision.
new text end

new text begin (b) Eligible applicants for a grant under this section must demonstrate the qualifications,
legal or other expertise, cultural competency, and experience in working with new Americans
necessary to perform the activities required under subdivision 4 statewide or in discreet
portions of the state.
new text end

new text begin (c) Eligible applicants seeking to provide services include governmental units, federally
recognized Tribal Nations, nonprofit organizations as defined under section 501(c)(3) of
the Internal Revenue Code, for-profit organizations, and legal services organizations
specializing in obtaining visas for health care workers.
new text end

new text begin (d) Eligible applicants seeking to provide supports for new Americans to obtain or
maintain employment must demonstrate expertise and capacity to provide training, peer
mentoring, supportive services, workforce development, and other services to develop and
implement strategies for recruiting and retaining qualified employees.
new text end

new text begin (e) The commissioner shall prioritize:
new text end

new text begin (1) for applicants providing legal or social services, organizations that serve populations
in areas of the state where worker shortages are most acute or for whom existing legal
services and social services during the legal process or while seeking qualified legal
assistance are unavailable or insufficient; and
new text end

new text begin (2) for applicants providing supports for new Americans to obtain or maintain
employment in the long-term care workforce, applications from joint labor management
programs.
new text end

new text begin Subd. 4.new text end

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

new text begin (a) Organizations receiving grant money
under this section must provide one or more of the following:
new text end

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

new text begin (3) specialized activities targeted to individuals to support recruitment and connection
to long-term care employment opportunities including:
new text end

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

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

new text begin (iii) providing 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 (iv) paying for program expenses related to long-term care professions, 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 (A) course fees;
new text end

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

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

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

new text begin (E) financial coaching fees;
new text end

new text begin (F) mental health supports; and
new text end

new text begin (G) uniform costs incurred as a direct result of participating in classroom instruction or
training; or
new text end

new text begin (v) 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. 5.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

new text begin Subd. 6.new text end

new text begin Impact study and evaluation.new text end

new text begin (a) The commissioner shall conduct a study of
the long-term care workforce portion of the grant program under this section to assess the
impacts on new Americans served by the grant program and may evaluate the following:
new text end

new text begin (1) employee retention;
new text end

new text begin (2) employee compensation;
new text end

new text begin (3) career advancement and mobility;
new text end

new text begin (4) career satisfaction; and
new text end

new text begin (5) safety in the workplace.
new text end

new text begin (b) By June 30, 2027, the commissioner shall submit a report to the chairs and ranking
minority members of the legislative committees and divisions with jurisdiction over human
services finance and policy on the impacts on new Americans engaged in the grant program,
based on the results of the evaluation under paragraph (a). Where feasible, the report must
include recommendations to improve the experience of new Americans in the long-term
care workforce.
new text end

Sec. 61.

new text begin SUPPORTED-DECISION-MAKING PROGRAMS.
new text end

new text begin Subdivision 1.new text end

new text begin Authorization.new text end

new text begin The commissioner of human services shall award general
operating grants to public and private nonprofit organizations, counties, and Tribes to provide
and promote supported decision making.
new text end

new text begin Subd. 2.new text end

new text begin Definitions.new text end

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

new text begin (b) "Supported decision making" has the meaning given in section 524.5-102, subdivision
16a.
new text end

new text begin (c) "Supported-decision-making services" means services provided to help an individual
consider, access, or develop supported decision making, potentially as an alternative to
more restrictive forms of decision making, including guardianship and conservatorship.
The services may be provided to the individual, family members, or trusted support people.
The individual may currently be a person subject to guardianship or conservatorship, but
the services must not be used to help a person access a guardianship or conservatorship.
new text end

new text begin Subd. 3.new text end

new text begin Grants.new text end

new text begin (a) The grants must be distributed as follows:
new text end

new text begin (1) at least 75 percent of the grant money must be used to fund programs or organizations
that provide supported-decision-making services;
new text end

new text begin (2) no more than 20 percent of the grant money may be used to fund county or Tribal
programs that provide supported-decision-making services; and
new text end

new text begin (3) no more than five percent of the grant money may be used to fund programs or
organizations that do not provide supported-decision-making services but do promote the
use and advancement of supported decision making.
new text end

new text begin (b) The grants must be distributed in a manner to promote racial and geographic diversity
in the populations receiving services as determined by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Evaluation and report.new text end

new text begin By December 1, 2024, the commissioner must submit
to the chairs and ranking minority members of the legislative committees with jurisdiction
over human services finance and policy an interim report on the impact and outcomes of
the grants, including the number of grants awarded and the organizations receiving the
grants. The interim report must include any available evidence of how grantees were able
to increase utilization of supported decision making and reduce or avoid more restrictive
forms of decision making such as guardianship and conservatorship. By December 1, 2025,
the commissioner must submit to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services finance and policy a final report on the
impact and outcomes of the grants, including any updated information from the interim
report and the total number of people served by the grants. The final report must also detail
how the money was used to achieve the requirements in subdivision 3, paragraph (b).
new text end

new text begin Subd. 5.new text end

new text begin Applications.new text end

new text begin Any public or private nonprofit agency may apply to the
commissioner for a grant under subdivision 3, paragraph (a), clause (1) or (3). Any county
or Tribal agency in Minnesota may apply to the commissioner for a grant under subdivision
3, paragraph (a), clause (2). The application must be submitted in a form approved by the
commissioner.
new text end

new text begin Subd. 6.new text end

new text begin Duties of grantees.new text end

new text begin Every public or private nonprofit agency, county, or Tribal
agency that receives a grant to provide or promote supported decision making must comply
with rules related to the administration of the grants.
new text end

Sec. 62. 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. 63. 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. 64. new text begin MEMORANDUMS OF UNDERSTANDING.
new text end

new text begin The memorandums of understanding with 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. 65. 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. 66. 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. 67. new text begin DIRECT CARE SERVICE CORPS PILOT PROJECT.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The Metropolitan Center for Independent Living must
develop a pilot project establishing the Minnesota Direct Care Service Corps. The pilot
project must utilize financial incentives to attract postsecondary students to work as personal
care assistants or direct support professionals. The Metropolitan Center for Independent
Living must establish the financial incentives and minimum work requirements to be eligible
for incentive payments. The financial incentive must increase with each semester that the
student participates in the Minnesota Direct Care Service Corps.
new text end

new text begin Subd. 2.new text end

new text begin Pilot sites.new text end

new text begin (a) Pilot sites must include one postsecondary institution in the
seven-county metropolitan area and at least one postsecondary institution outside of the
seven-county metropolitan area. If more than one postsecondary institution outside the
metropolitan area is selected, one must be located in northern Minnesota and the other must
be located in southern Minnesota.
new text end

new text begin (b) After satisfactorily completing the work requirements for a semester, the pilot site
or its fiscal agent must pay students the financial incentive developed for the pilot project.
new text end

new text begin Subd. 3.new text end

new text begin Evaluation and report.new text end

new text begin (a) The Metropolitan Center for Independent Living
must contract with a third party to evaluate the pilot project's impact on health care costs,
retention of personal care assistants, and patients' and providers' satisfaction of care. The
evaluation must include the number of participants, the hours of care provided by participants,
and the retention of participants from semester to semester.
new text end

new text begin (b) By January 15, 2025, the Metropolitan Center for Independent Living must report
the findings under paragraph (a) to the chairs and ranking minority members of the legislative
committees with jurisdiction over human services finance and policy.
new text end

Sec. 68. new text begin RATE INCREASE FOR HOME CARE SERVICES.
new text end

new text begin (a) The commissioner of human services shall increase payment rates for home health
agency services under Minnesota Statutes, section 256B.0653, by 14.99 percent from the
rates in effect on December 31, 2023.
new text end

new text begin (b) The commissioner shall increase payment rates for home care nursing under
Minnesota Statutes, section 256B.0651, subdivision 2, clause (2), by 25 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. 69. 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. 70. new text begin DIRECTION TO COMMISSIONER; APPLICATION OF INTERMEDIATE
CARE FACILITIES FOR PERSONS WITH DEVELOPMENTAL DISABILITIES
RATE INCREASES.
new text end

new text begin The commissioner of human services shall apply the rate increases under Minnesota
Statutes, section 256B.5012, subdivisions 19 and 20, as follows:
new text end

new text begin (1) apply Minnesota Statutes, section 256B.5012, subdivision 19; and
new text end

new text begin (2) apply any required rate increase as required under Minnesota Statutes, section
256B.5012, subdivision 20, to the results of clause (1).
new text end

Sec. 71. 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
and home-delivered meals provided under Minnesota Statutes, sections 256B.092 and
256B.49, by 14.99 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. 72. 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 14.99 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. 73. 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 14.99 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. 74. 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 surveying community providers as to the barriers to
meeting people's needs and 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. 75. new text begin TEMPORARY GRANT FOR SMALL CUSTOMIZED LIVING
PROVIDERS.
new text end

new text begin (a) The commissioner of human services must establish a temporary grant for:
new text end

new text begin (1) customized living providers that serve six or fewer people in a single-family home;
and
new text end

new text begin (2) community residential service providers and integrated community supports providers
who transitioned from providing customized living or 24-hour customized living on or after
June 30, 2021.
new text end

new text begin (b) Allowable uses of grant money include physical plant updates required for community
residential services or integrated community supports licensure, technical assistance to adapt
business models and meet policy and regulatory guidance, and other uses approved by the
commissioner. Allowable uses of grant money also include reimbursement for eligible costs
incurred by a community residential service provider or integrated community supports
provider directly related to the provider's transition from providing customized living or
24-hour customized living. 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 $50,000 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. 76. new text begin DIRECTION TO COMMISSIONER; SUPPORTED-DECISION-MAKING
REIMBURSEMENT STUDY.
new text end

new text begin By December 15, 2024, the commissioner shall issue a report to the governor and the
chairs and ranking minority members of the legislative committees with jurisdiction over
human services finance and policy detailing how medical assistance service providers could
be reimbursed for providing supported-decision-making services. The report must detail
recommendations for all medical assistance programs, including all home and
community-based programs, to provide for reimbursement for supported-decision-making
services. The report must develop detailed provider requirements for reimbursement,
including the criteria necessary to provide high-quality services. In developing provider
requirements, the commissioner shall consult with all relevant stakeholders, including
organizations currently providing supported-decision-making services. The report must also
include strategies to promote equitable access to supported-decision-making services to
individuals who are Black, Indigenous, or People of Color; people from culturally specific
communities; people from rural communities; and other people who may experience barriers
to accessing medical assistance home and community-based services.
new text end

Sec. 77. new text begin DIRECTION TO COMMISSIONER; SHARED SERVICES.
new text end

new text begin (a) By December 31, 2023, the commissioner of human services shall seek any necessary
changes to home and community-based services waiver plans regarding sharing services in
order to:
new text end

new text begin (1) permit shared services for chore, homemaker, and night supervision;
new text end

new text begin (2) permit existing shared services at higher ratios, including individualized home
supports without training, individualized home supports with training, and individualized
home supports with family training at a ratio of one staff person to three recipients;
new text end

new text begin (3) ensure that individuals who are seeking to share services permitted under the waiver
plans in an own-home setting are not required to live in a licensed setting in order to share
services so long as all other requirements are met; and
new text end

new text begin (4) issue guidance for shared services, including:
new text end

new text begin (i) informed choice for all individuals sharing the services;
new text end

new text begin (ii) guidance on how lead agencies and individuals shall determine that shared service
is appropriate to meet the needs, health, and safety of each individual for whom the lead
agency provides case management or care coordination; and
new text end

new text begin (iii) guidance clarifying that an individual's decision to share services does not reduce
any determination of the individual's overall or assessed needs for services.
new text end

new text begin (b) The commissioner shall develop or provide guidance outlining:
new text end

new text begin (1) instructions for shared services support planning;
new text end

new text begin (2) person-centered approaches and informed choice in shared services support planning;
and
new text end

new text begin (3) required contents of shared services agreements.
new text end

new text begin (c) The commissioner shall seek and utilize stakeholder input for any proposed changes
to waiver plans and any shared services guidance.
new text end

Sec. 78. new text begin DIRECTION TO COMMISSIONER; DISABILITY WAIVER SHARED
SERVICES RATES.
new text end

new text begin The commissioner of human services shall establish a rate system for shared homemaker
services and shared chore services provided under Minnesota Statutes, sections 256B.092
and 256B.49. For two persons sharing services, the rate paid to a provider must not exceed
1-1/2 times the rate paid for serving a single individual, and for three persons sharing
services, the rate paid to a provider must not exceed two times the rate paid for serving a
single individual. These rates apply only when all of the criteria for the shared service have
been met.
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 approval is obtained.
new text end

Sec. 79. 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. 80. 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 finance and
policy 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. 81. 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 financial and 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 finance and policy.
new text end

Sec. 82. new text begin ACUTE CARE TRANSITIONS ADVISORY COUNCIL.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of human services shall establish an
Acute Care Transitions Advisory Council to advise and assist the commissioner in
establishing and implementing a statewide vision and systemic approach to acute care
transitions in Minnesota.
new text end

new text begin Subd. 2.new text end

new text begin Membership.new text end

new text begin (a) The Acute Care Transitions Advisory Council consists of
the following members:
new text end

new text begin (1) two individuals or their representatives who have lived experiences with acute care
transitions;
new text end

new text begin (2) two members representing home and community-based services providers;
new text end

new text begin (3) two members representing the Minnesota Hospital Association;
new text end

new text begin (4) one member representing the Minnesota Association of County Social Service
Administrators;
new text end

new text begin (5) one member representing the Local Public Health Association;
new text end

new text begin (6) one member representing a Tribal government;
new text end

new text begin (7) one member representing the University of Minnesota;
new text end

new text begin (8) one member representing the State Advisory Council on Mental Health and
Subcommittee on Children's Mental Health;
new text end

new text begin (9) one member representing a public sector labor union;
new text end

new text begin (10) one member representing the Minnesota County Attorney's Association;
new text end

new text begin (11) one individual who has had an acute hospital stay initiated during a crisis;
new text end

new text begin (12) one parent of a child who has had an acute hospital stay initiated during a crisis;
new text end

new text begin (13) one individual who meets the definition of a caring professional;
new text end

new text begin (14) the commissioner of human services or a designee;
new text end

new text begin (15) the commissioner of health or a designee; and
new text end

new text begin (16) the commissioner of education or a designee.
new text end

new text begin (b) To the extent possible, the advisory council members must represent diverse
populations and different areas of the state.
new text end

new text begin (c) A member of the legislature may not serve as a member of the advisory council.
new text end

new text begin Subd. 3.new text end

new text begin Cochairs; convening first meeting.new text end

new text begin The commissioner of human services shall
convene the first meeting. Advisory council members must select advisory council cochairs
at the first meeting.
new text end

new text begin Subd. 4.new text end

new text begin Compensation; expenses; reimbursement.new text end

new text begin Advisory council members must
be compensated and reimbursed for expenses as provided in Minnesota Statutes, section
15.059, subdivision 3.
new text end

new text begin Subd. 5.new text end

new text begin Administrative support.new text end

new text begin The commissioner of human services shall provide
meeting space and administrative support to the advisory council.
new text end

new text begin Subd. 6.new text end

new text begin Public and community engagement.new text end

new text begin The commissioner of human services
shall conduct public and community engagement to obtain information about barriers and
potential solutions to transitioning patients from acute care settings to more appropriate
nonacute care settings and must provide the information collected through public and
community engagement to the advisory council.
new text end

new text begin Subd. 7.new text end

new text begin Duties.new text end

new text begin (a) By October 1, 2024, the advisory council shall develop and present
to the chairs and ranking minority members of the legislative committees and divisions with
jurisdiction over health and human services finance and policy and the commissioner of
human services an action plan for creating a systemic approach to acute care transitions for
Minnesotans. The action plan must include but is not limited to the following:
new text end

new text begin (1) recommendations to improve regional capacity for acute care transitions, including
examining the roles and experience of counties and Tribes in delivering services and
identifying any conflicting and duplicative roles and responsibilities among health and
human services agencies, counties, and Tribes;
new text end

new text begin (2) recommendations to create a measurement and evaluation system using
implementation science to analyze regional and statewide data in transitions and make
ongoing recommendations for policy and program improvement; and
new text end

new text begin (3) statewide strategies for improving access to transitioning from acute care settings
with a focus on addressing geographic, racial, and ethnic disparities.
new text end

new text begin (b) The advisory council may contract with a private entity or consultant as necessary
to complete its duties under this section, and is exempt from state procurement process
requirements under Minnesota Statutes, chapter 16C.
new text end

new text begin Subd. 8.new text end

new text begin Limitations.new text end

new text begin (a) In developing the action plan, the advisory council shall take
into consideration the impact of its recommendations on:
new text end

new text begin (1) the existing capacity of state agencies, including staffing needs, technology resources,
and existing agency responsibilities; and
new text end

new text begin (2) the capacity of county and Tribal partners.
new text end

new text begin (b) The advisory council shall not include in the action plan recommendations that may
result in loss of benefits for the individuals eligible for state health and human services
public programs or exacerbate health disparities and inequities in access to health care and
human services.
new text end

new text begin Subd. 9.new text end

new text begin Expiration.new text end

new text begin The Acute Care Transitions Advisory Council expires October 2,
2024, or the day after submitting the action plan required under subdivision 7, whichever
is earlier.
new text end

Sec. 83. new text begin OVERPAYMENTS FOR DISABILITY WAIVER CUSTOMIZED LIVING
SERVICES.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 256B.064, or any other law to the
contrary, providers that received ineligible payments for customized living services under
the community access for disability inclusion or brain injury waivers for people under age
55 who were not residing in the setting before January 11, 2021, must not be required to
repay ineligible payments related to the age restrictions for customized living services
delivered between January 11, 2021, and July 1, 2023. The state must not sanction providers
for receipt of these ineligible payments or otherwise seek recovery of these payments.
new text end

new text begin (b) The state must repay with state money any amount owed to the Centers for Medicare
and Medicaid Services for the federal financial participation amount received by the state
for ineligible payments identified in paragraph (a).
new text end

new text begin (c) Nothing in this section prohibits the commissioner from recouping past claims due
to false claims or for reasons other than ineligible payments related to age restrictions for
disability waiver customized living services for people who were not residing in the setting
between January 11, 2021, and July 1, 2023, or from recouping future ineligible payments
for disability customized living services, including from providers who received the ineligible
payments described in paragraph (a).
new text end

new text begin (d) The commissioner must update guidance and communicate with lead agencies and
customized living service providers to ensure that lead agencies and providers understand
the requirements for medical assistance disability waiver customized living service payments.
new text end

Sec. 84. new text begin PERSONAL CARE ASSISTANCE COMPENSATION FOR SERVICES
PROVIDED BY A PARENT OR SPOUSE.
new text end

new text begin (a) Notwithstanding Minnesota Statutes, section 256B.0659, subdivisions 3, paragraph
(a), clause (a); 11, paragraph (c); and 19, paragraph (b), clause (3), a parent, stepparent, or
legal guardian of a minor who is a personal care assistance recipient or the spouse of a
personal care assistance recipient may provide and be paid for providing personal care
assistance services under medical assistance. The commissioner shall seek federal approval
for these payments. If federal approval is not received, the commissioner shall make payments
for services rendered, prior to federal disapproval, without federal financial participation.
new text end

new text begin (b) This section expires November 11, 2023, or upon the expiration of federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval expires.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective retroactively from May 12, 2023.
new text end

Sec. 85. new text begin REPEALER.
new text end

new text begin (a)new text end new text begin Minnesota Statutes 2022, section 256B.4914, subdivision 9a,new text end new text begin is repealed.
new text end

new text begin (b)new text end new text begin Minnesota Statutes 2022, section 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 Paragraph (a) is effective January 1, 2024, or upon federal
approval, whichever is later, and paragraph (b) 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 Indiandeleted text end new text begin Native Americannew text end eldersnew text begin coordinatornew text end position.

new text begin (a) new text end The Minnesota
Board on Aging shall create deleted text begin an Indiandeleted text end new text begin a Native Americannew text end elders coordinator positiondeleted 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 comprehensivedeleted text end statewidenew text begin Tribal-basednew text end service system for deleted text begin Indiandeleted 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 statewidenew text begin Tribal-basednew text end service system deleted text begin mustdeleted text end new text begin maynew 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 woulddeleted text end new text begin plan tonew text end grantnew text begin ,new text end or make recommendations for grantingnew text begin ,new text end
federal and state funding fornew text begin statewide Tribal-based Native American programs andnew 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 fornew text begin statewide Tribal-basednew text end service focal pointsdeleted text begin , senior centers, or community
centers
deleted text end for socialization and service accessibility for deleted text begin Indiandeleted text end new text begin Native Americannew text end elders;

(4) a plan to develop and implementnew text begin statewidenew text end education and public awareness deleted text begin campaignsdeleted text end new text begin
promotions,
new text end including deleted text begin awareness programs, sensitivitydeleted text end culturalnew text begin sensitivitynew text end trainingdeleted text begin ,deleted text end and
public education on deleted text begin Indian elder needsdeleted text end new text begin Native American eldersnew text end ;

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

(6) a plan for a coordinatednew text begin statewide Tribal-basednew text end health care system including health
deleted text begin promotion/preventiondeleted text end new text begin promotion and preventionnew 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 organizationsnew text begin ,new text end includingnew text begin but not limited
to the state of Minnesota,
new text end the deleted text begin Council ofdeleted text end new text begin Minnesotanew text end Indian Affairsnew text begin Councilnew 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 andnew text begin Minnesotanew text end
Tribal governments.

Sec. 2.

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


256.9754 deleted text begin COMMUNITY SERVICES DEVELOPMENTdeleted text end new text begin LIVE WELL AT HOMEnew text end
GRANTS deleted text begin PROGRAMdeleted 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 the older adults' 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 older adults 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.

Creationnew text begin ; purposenew text end .

new text begin (a) new text end The deleted text begin community services developmentdeleted text end new text begin live well at homenew text end
grants deleted text begin program isdeleted text end new text begin arenew 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 older adults' 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 older adults' 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 older adults who have their own money to pay for services.
new text end

Subd. 3.

deleted text begin Provision ofdeleted text end new text begin Community services developmentnew text end grants.

The commissioner
shall makenew text begin community services developmentnew text end grants available to communities, providers of
older adult services deleted text begin identified in subdivision 1deleted text end , or deleted text begin todeleted text end a consortium of providers of older
adult servicesdeleted text begin ,deleted text end 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 rulesnew text begin for grantees under subdivision 3new 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
older adults 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, participants 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 older adults 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

new text begin Subd. 3f.new text end

new text begin Live Well at Home grant extensions. new text end

new text begin (a) A current grantee under subdivision
3, 3c, 3d, or 3e may apply to the commissioner to receive on a noncompetitive basis up to
two years of additional funding.
new text end

new text begin (b) To be eligible for a grant extension, a grant extension applicant must have been
awarded a grant under this section within the previous five years and provide at least one
eligible service in an underserved community. The grantee must submit to the commissioner
a letter of intent to continue providing the eligible service after the expiration of a grant
extension provided under this subdivision.
new text end

new text begin (c) The commissioner of human services must give priority to submitted letters of intent
from grantees who have demonstrated success in providing chore services, homemaker
services, transportation services, grocery services, caregiver supports, service coordination,
or other home and community-based services to older adults in underserved communities.
new text end

new text begin (d) Notwithstanding section 16B.98, subdivision 5, paragraph (b), the commissioner
may from within available appropriations extend a grant agreement up to two additional
years, not to exceed seven years, for grantees the commissioner determines can successfully
sustain the grantee's Live Well at Home project with the additional funds made available
through the grant agreement extension.
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 Minnesota
Board on Aging 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 board 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 board 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, the board 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 and divisions with jurisdiction over human services finance
and policy. The progress report must include metrics of the use of grant program money.
This subdivision expires upon submission of the report. The board shall notify the revisor
of statutes when the report is submitted.
new text end

Sec. 4.

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


Subd. 4.

Eligibility for funding for services for nonmedical assistance recipients.

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

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

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

(3) the person is age 65 or older;

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

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

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

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

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

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

(i) the appointment of a representative payee;

(ii) automatic payment from a financial account;

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

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 5.

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


Subd. 5.

Services covered under alternative care.

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

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

(2) home care;

(3) homemaker services;

(4) personal care;

(5) case management and conversion case management;

(6) respite care;

(7) specialized supplies and equipment;

(8) home-delivered meals;

(9) nonmedical transportation;

(10) nursing services;

(11) chore services;

(12) companion services;

(13) nutrition services;

(14) family caregiver training and education;

(15) coaching and counseling;

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

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

(18) environmental accessibility and adaptations; and

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

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

new text begin 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 approval is obtained.
new text end

Sec. 6.

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.

(b) deleted text begin "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 "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. 7.

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 protectionnew 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
formulanew text begin after the award of the amounts in paragraph (c)new text end :

(1) 25 percent must be allocated new text begin to the responsible agency new text end on the basis of the number
of reports of suspected vulnerable adult maltreatment under sections 626.557 and 626.5572,
deleted text begin when the county or tribe is responsibledeleted text end as determined by the most recent data of the
commissioner; and

(2) 75 percent must be allocated new text begin to the responsible agency new text end on the basis of the number
of screened-in reports for adult protective services or vulnerable adult maltreatment
investigations under sections 626.557 and 626.5572, deleted text begin when the county or tribe is responsibledeleted text end
as determined by the most recent data of the commissioner.

(b) deleted text begin The commissioner is precluded from changing the formula under this subdivision
or recommending a change to the legislature without public review and input.
deleted text end new text begin
Notwithstanding paragraph (a), the commissioner must not award a county 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 that has
applied to the commissioner and has 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 2019deleted text end new text begin 2023new text end , and to each county board or Tribal government on or before
October 10, deleted text begin 2019deleted text end new text begin 2023new text end . The commissioner shall make allocations under subdivision 1 to
each county board or Tribal government each year thereafter on or before July 10.

Subd. 3.

deleted text begin Prohibition on supplanting existing moneydeleted text end new text begin Purpose of expendituresnew 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 andnew text end to expand adult protective servicesnew 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. A county receiving money under this
section must maintain a level of yearly county expenditures for adult protection services
under chapter 626 at least equal to that county's average expenditures for those services for
calendar years 2022 and 2023.
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 receiving money under
this section must 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. 8.

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 144.0724new text end .

(b) An index maximization approach shall be used to classify residents. "Index
maximization" has the meaning given in section 144.0724, subdivision 2, paragraph (c).

Sec. 9.

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

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. 10.

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 facilitiesdeleted text begin :deleted text end new text begin , the commissioner shall allow a supplemental
payment above a facility's operating payment rate as determined to be necessary by the
commissioner to maintain access to nursing 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 benefitsdeleted text end new text begin benefitnew text end allowed under paragraph (c) shall be removed.
Designated facilities may apply for continued designation.

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

new text begin (e) The memorandum of understanding required by paragraph (c) 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

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. 11.

Minnesota Statutes 2022, section 256R.53, is amended by adding a subdivision
to read:


new text begin Subd. 3.new text end

new text begin Nursing facility in Red Wing.new text end

new text begin (a) The operating payment rate for a facility
located in the city of Red Wing at 1412 West 4th Street is the sum of its direct care costs
per standardized day, its other care-related costs per resident day, and its other operating
costs per day.
new text end

new text begin (b) This subdivision expires June 30, 2025.
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. 12.

new text begin [256R.55] FINANCIALLY DISTRESSED NURSING FACILITY LOAN
PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Financially distressed nursing facility loans.new text end

new text begin The commissioner of
human services shall establish a competitive financially distressed nursing facility loan
program to provide operating loans to eligible nursing facilities. The commissioner shall
initiate the application process for the loan described in this section at least once annually.
A second application process may be initiated each year at the discretion of the commissioner.
new text end

new text begin Subd. 2.new text end

new text begin Eligibility.new text end

new text begin To be an eligible applicant for a loan under this section, a nursing
facility must submit to the commissioner of human services a loan application in the form
and according to the timelines established by the commissioner. In its loan application, a
loan applicant must demonstrate that:
new text end

new text begin (1) the total net income of the nursing facility is not generating sufficient revenue to
cover the nursing facility's operating expenses;
new text end

new text begin (2) the nursing facility is at risk of closure; and
new text end

new text begin (3) additional operating revenue is necessary to either preserve access to nursing facility
services within the community or support people with complex, high-acuity support needs.
new text end

new text begin Subd. 3.new text end

new text begin Approving loans.new text end

new text begin The commissioner must evaluate all loan applications on a
competitive basis and award loans to successful applicants within available appropriations
for this purpose. The commissioner's decisions are final and not subject to appeal.
new text end

new text begin Subd. 4.new text end

new text begin Disbursement schedule.new text end

new text begin Successful loan applicants under this section may
receive loan disbursements as a lump sum, on an agreed upon disbursement schedule, or as
a time-limited line of credit. The commissioner shall approve disbursements to successful
loan applicants through a memorandum of understanding. Memoranda of understanding
must specify the amount and schedule of loan disbursements.
new text end

new text begin Subd. 5.new text end

new text begin Loan administration.new text end

new text begin The commissioner may contract with an independent
third party to administer the loan program under this section.
new text end

new text begin Subd. 6.new text end

new text begin Loan payments.new text end

new text begin The commissioner shall negotiate the terms of the loan
repayment, including the start of the repayment plan, the due date of the repayment, and
the frequency of the repayment installments. Repayment installments must not begin until
at least 18 months after the first disbursement date. The memoranda of understanding must
specify the amount and schedule of loan payments. The repayment term must not exceed
72 months. If any loan payment to the commissioner is not paid within the time specified
by the memoranda of understanding, the late payment must be assessed a penalty rate of
0.01 percent of the original loan amount each month the payment is past due. This late fee
is not an allowable cost on the department's cost report. The commissioner shall have the
power to abate penalties when discrepancies occur resulting from but not limited to
circumstances of error and mail delivery.
new text end

new text begin Subd. 7.new text end

new text begin Loan repayment.new text end

new text begin (a) If a borrower is more than 60 calendar days delinquent
in the timely payment of a contractual payment under this section, the provisions in
paragraphs (b) to (e) apply.
new text end

new text begin (b) The commissioner may withhold some or all of the amount of the delinquent loan
payment, together with any penalties due and owing on those amounts, from any money
the department owes to the borrower. The commissioner may, at the commissioner's
discretion, also withhold future contractual payments from any money the commissioner
owes the provider as those contractual payments become due and owing. The commissioner
may continue this withholding until the commissioner determines there is no longer any
need to do so.
new text end

new text begin (c) The commissioner shall give prior notice of the commissioner's intention to withhold
by mail, facsimile, or email at least ten business days before the date of the first payment
period for which the withholding begins. The notice must be deemed received as of the date
of mailing or receipt of the facsimile or electronic notice. The notice must:
new text end

new text begin (1) state the amount of the delinquent contractual payment;
new text end

new text begin (2) state the amount of the withholding per payment period;
new text end

new text begin (3) state the date on which the withholding is to begin;
new text end

new text begin (4) state whether the commissioner intends to withhold future installments of the
provider's contractual payments; and
new text end

new text begin (5) state other contents as the commissioner deems appropriate.
new text end

new text begin (d) The commissioner, or the commissioner's designee, may enter into written settlement
agreements with a provider to resolve disputes and other matters involving unpaid loan
contractual payments or future loan contractual payments.
new text end

new text begin (e) Notwithstanding any law to the contrary, all unpaid loans, plus any accrued penalties,
are overpayments for the purposes of section 256B.0641, subdivision 1. The current owner
of a nursing home or boarding care home is liable for the overpayment amount owed by a
former owner for any facility sold, transferred, or reorganized.
new text end

new text begin Subd. 8.new text end

new text begin Audit.new text end

new text begin Loan money allocated under this section are subject to audit to determine
whether the money was spent as authorized under this section.
new text end

new text begin Subd. 9.new text end

new text begin Carryforward.new text end

new text begin Notwithstanding section 16A.28, subdivision 3, any
appropriation for the purposes under this section carry forward and do not lapse until the
close of the fiscal year in which this section expires.
new text end

new text begin Subd. 10.new text end

new text begin Expiration.new text end

new text begin This section expires June 30, 2029.
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. 13.

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


Subd. 2.

Foster care limit.

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

Sec. 14.

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


new text begin Subd. 3a.new text end

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

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

new text begin 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 approval is obtained.
new text end

Sec. 15.

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


Subd. 3.

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 16.

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


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

new text begin Subdivision 1.new text end

new text begin Application of rate setting.new text end

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

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

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

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

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

new text begin Subd. 2.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 finance and policy with a full report on
the information and data gathered under paragraph (a).
new text end

new text begin Subd. 3.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 are 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 is 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 section
256S.2101, subdivision 3, through the reports directed by subdivision 2.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin Subdivisions 1 and 2 are effective January 1, 2024, or upon
federal approval, whichever is later. Subdivision 3 is effective January 1, 2025. The
commissioner of human services shall notify the revisor of statutes when approval is obtained.
new text end

Sec. 17.

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


256S.211 RATE SETTING; deleted text begin RATE ESTABLISHMENTdeleted text end new text begin UPDATING RATES;
SPENDING REQUIREMENTS
new text end .

Subdivision 1.

Establishing base wages.

When establishing new text begin and updating new text end 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 Establishingdeleted text end new text begin Updatingnew text end rates.

deleted text begin By January 1 of each year,deleted text end new text begin On January 1, 2024,new text end
the commissioner shall deleted text begin establish factors,deleted text end new text begin updatenew text end component ratesdeleted text begin ,deleted text end and rates according to
sections deleted text begin 256S.213 anddeleted text end new text begin 256S.212 tonew text end 256S.215, using deleted text begin base wages established according to
section 256S.212
deleted text end new text begin the data referenced in subdivision 1new text end .

new text begin Subd. 3.new text end

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

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

new text begin Subd. 4.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,
home-delivered meals, and designated disproportionate share facilities under section
256S.205, 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 EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2024, or upon federal approval,
whichever is later, except that subdivision 3 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 256S.212, is amended to read:


256S.212 RATE SETTING; BASE WAGE INDEX.

Subdivision 1.

Updating SOC codes.

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

Subd. 2.

Home management and support services base wage.

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

Subd. 3.

Home care aide base wage.

For customized livingdeleted text begin ,deleted text end new text begin andnew text end foster caredeleted text begin , and
residential care
deleted text end component services, the home care aide base wage equals deleted text begin 50deleted text end new text begin 75new text end percent of
the Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for home healthnew text begin
and personal care
new text end aides (SOC code deleted text begin 31-1011deleted text end new text begin 31-1120new text end ); and deleted text begin 50deleted text end new text begin 25new text end percent of the
Minneapolis-St. Paul-Bloomington, MN-WI MetroSA average wage for nursing assistants
(SOC code deleted text begin 31-1014deleted text end new text begin 31-1131new text end ).

Subd. 4.

Home health aide base wage.

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

Subd. 5.

Medication setups by licensed nurse base wage.

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

Subd. 6.

Chore services base wage.

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

Subd. 7.

Companion services base wage.

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

Subd. 8.

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

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

Subd. 9.

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

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

Subd. 10.

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

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

Subd. 11.

In-home respite care services base wage.

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

Subd. 12.

Out-of-home respite care services base wage.

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

Subd. 13.

Individual community living support base wage.

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

Subd. 14.

Registered nurse base wage.

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

Subd. 15.

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

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

new text begin Subd. 16.new text end

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

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

new text begin 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 approval is obtained.
new text end

Sec. 19.

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


256S.213 RATE SETTING; FACTORS.

Subdivision 1.

Payroll taxes and benefits factor.

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

Subd. 2.

General and administrative factor.

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

Subd. 3.

Program plan support factor.

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

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

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

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

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

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

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

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

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

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

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

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

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

Subd. 4.

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

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

Subd. 5.

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

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

new text begin Subd. 6.new text end

new text begin Facility and equipment factor.new text end

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

new text begin Subd. 7.new text end

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

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

new text begin Subd. 8.new text end

new text begin Supplies and transportation factor.new text end

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

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

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

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

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

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

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

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

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

new text begin Subd. 9.new text end

new text begin Absence factor.new text end

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

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

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

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

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 20.

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;

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

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

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

new text begin (b) If the base wage described in paragraph (a) is below $16.68, the base wage must
equal $16.68.
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 approval is obtained.
new text end

Sec. 21.

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


Subd. 2.

Home management and support services component rate.

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

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

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

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

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 approval is obtained.
new text end

Sec. 22.

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


Subd. 3.

Home care aide services component rate.

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 23.

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


Subd. 4.

Home health aide services component rate.

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 24.

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


Subd. 7.

Chore services rate.

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 25.

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


Subd. 8.

Companion services rate.

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 26.

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


Subd. 9.

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 27.

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


Subd. 10.

Homemaker deleted text begin services anddeleted text end cleaning rate.

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 28.

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


Subd. 11.

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 29.

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


Subd. 12.

In-home respite care services rates.

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 30.

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


Subd. 13.

Out-of-home respite care services rates.

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 31.

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


Subd. 14.

Individual community living support rate.

The individual community living
support rate is calculated as follows:

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 32.

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


Subd. 15.

Home-delivered meals rate.

new text begin Effective January 1, 2024, new text end the home-delivered
meals rate deleted text begin equals $9.30deleted text end new text begin is $8.17, updated as directed in section 256S.211, subdivision 3new text end .
deleted text begin The commissioner shall increase the home delivered meals rate every July 1 by the percent
increase in the nursing facility dietary per diem using the two most recent and available
nursing facility cost reports.
deleted text end

new text begin 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 approval is obtained.
new text end

Sec. 33.

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


Subd. 16.

Adult day services rate.

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

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 34.

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


Subd. 17.

Adult day services bath rate.

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

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

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

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

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

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

new text begin 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 approval is obtained.
new text end

Sec. 35.

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 2024deleted text end new text begin 2027new text end .

Sec. 36.

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 $0 in
fiscal year 2025.

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

(c) This subdivision expires June 30, deleted text begin 2024deleted text end new text begin 2027new 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 $0 in fiscal year 2025.

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

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

Sec. 37. 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 finance on the actuarial
analysis, proposed capitation rate, and estimated administrative costs by March 1, 2024.
The commissioner shall recommend a financing mechanism and administrative framework
by September 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 finance 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. 38. new text begin DIRECTION TO COMMISSIONER; 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. 39. new text begin DIRECTION TO COMMISSIONERS; SMALL PROVIDER REGULATORY
RELIEF.
new text end

new text begin The commissioners of human services and health must consult with assisted living
facility license holders who provide customized living and whose facilities are smaller than
11 beds to compile a list of regulatory requirements, compliance with which is particularly
difficult for small providers. The commissioners must provide the chairs and ranking minority
members of the legislative committees with jurisdiction over assisted living licensure and
customized living with recommendations, including draft legislation, to reduce the regulatory
burden on small providers.
new text end

Sec. 40. 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 14.99 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. 41. new text begin NURSING FACILITY RATE STUDY.
new text end

new text begin (a) The commissioner of human services shall contract with an independent organization
with subject matter expertise in nursing facility accounting to conduct a study of nursing
facility rates that includes:
new text end

new text begin (1) a review of nursing facility rates of all states bordering Minnesota and the states
included in the Centers for Medicare and Medicaid Services Region V;
new text end

new text begin (2) the data necessary to determine the total net income and the operating margin of a
nursing facility;
new text end

new text begin (3) the data necessary to determine whether a nursing facility can generate sufficient
revenue to cover the nursing facility's operating expenses;
new text end

new text begin (4) the average reimbursement rate per resident day in each state and the data used to
compute that rate;
new text end

new text begin (5)