Engrossments
Introduction		Posted on 03/16/2023
1st Engrossment		Posted on 04/12/2023
2nd Engrossment		Posted on 04/18/2023
3rd Engrossment		Posted on 04/20/2023
4th Engrossment		Posted on 05/22/2023

Unofficial Engrossments
1st Unofficial Engrossment		Posted on 04/24/2023
2nd Unofficial Engrossment		Posted on 04/27/2023

Conference Committee Reports
CCR-SF2995		Posted on 05/21/2023

Delete everything after the enacting clause and insert:

"ARTICLE 1

HEALTH CARE

Section 1.

Minnesota Statutes 2022, section 256.01, is amended by adding a subdivision
to read:

new text begin Subd. 43.new text end

new text begin Education on contraceptive options.new text end

new text begin The commissioner shall require hospitals
and primary care providers serving medical assistance and MinnesotaCare enrollees to
develop and implement protocols to provide enrollees, when appropriate, with comprehensive
and scientifically accurate information on the full range of contraceptive options, in a
medically ethical, culturally competent, and noncoercive manner. The information provided
must be designed to assist enrollees in identifying the contraceptive method that best meets
their needs and the needs of their families. The protocol must specify the enrollee categories
to which this requirement will be applied, the process to be used, and the information and
resources to be provided. Hospitals and providers must make this protocol available to the
commissioner upon request.
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. 2.

Minnesota Statutes 2022, section 256.0471, subdivision 1, is amended to read:

Subdivision 1.

Qualifying overpayment.

Any overpayment for assistance granted under
deleted text begin chapter 119B,deleted text end the MFIP program formerly codified under sections 256.031 to 256.0361deleted text begin ,deleted text end
and the AFDC program formerly codified under sections 256.72 to 256.871;new text begin for assistance
granted undernew text end chapters deleted text begin 256B for state-funded medical assistancedeleted text end new text begin 119Bnew text end , 256D, 256I, 256J,new text begin
andnew text end 256Kdeleted text begin , and 256Ldeleted text end new text begin ;new text end fornew text begin assistance granted pursuant to section 256.045, subdivision 10,
for state-funded medical assistance andnew text end state-funded MinnesotaCarenew text begin under chapters 256B
and 256Lnew text end ; andnew text begin for assistance granted undernew text end the Supplemental Nutrition Assistance Program
(SNAP), except agency error claims, become a judgment by operation of law 90 days after
the notice of overpayment is personally served upon the recipient in a manner that is sufficient
under rule 4.03(a) of the Rules of Civil Procedure for district courts, or by certified mail,
return receipt requested. This judgment shall be entitled to full faith and credit in this and
any other state.

new text begin EFFECTIVE DATE.new text end

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

Sec. 3.

Minnesota Statutes 2022, section 256.9655, is amended by adding a subdivision
to read:

new text begin Subd. 3.new text end

new text begin Prompt payment required.new text end

new text begin (a) In paying claims under medical assistance, the
commissioner shall comply with Code of Federal Regulations, title 42, section 447.45.
new text end

new text begin (b) If the commissioner does not pay or deny a clean claim within the period provided
in paragraph (a), the commissioner must pay interest on the claim for the period beginning
on the day after the required payment date specified in paragraph (a) and ending on the date
on which the commissioner makes the payment or denies the claim.
new text end

new text begin (c) The rate of interest paid by the commissioner under this subdivision must be 1.5
percent per month or any part of a month.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 4.

Minnesota Statutes 2022, section 256.969, subdivision 2b, is amended to read:

Subd. 2b.

Hospital payment rates.

(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:

(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;

(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;

(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and

(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.

(b) For the period beginning January 1, 2011, through October 31, 2014, rates shall not
be rebased, except that a Minnesota long-term hospital shall be rebased effective January
1, 2011, based on its most recent Medicare cost report ending on or before September 1,
2008, with the provisions under subdivisions 9 and 23, based on the rates in effect on
December 31, 2010. For rate setting periods after November 1, 2014, in which the base
years are updated, a Minnesota long-term hospital's base year shall remain within the same
period as other hospitals.

(c) Effective for discharges occurring on and after November 1, 2014, payment rates
for hospital inpatient services provided by hospitals located in Minnesota or the local trade
area, except for the hospitals paid under the methodologies described in paragraph (a),
clauses (2) and (3), shall be rebased, incorporating cost and payment methodologies in a
manner similar to Medicare. The base year or years for the rates effective November 1,
2014, shall be calendar year 2012. The rebasing under this paragraph shall be budget neutral,
ensuring that the total aggregate payments under the rebased system are equal to the total
aggregate payments that were made for the same number and types of services in the base
year. Separate budget neutrality calculations shall be determined for payments made to
critical access hospitals and payments made to hospitals paid under the DRG system. Only
the rate increases or decreases under subdivision 3a or 3c that applied to the hospitals being
rebased during the entire base period shall be incorporated into the budget neutrality
calculation.

(d) For discharges occurring on or after November 1, 2014, through the next rebasing
that occurs, the rebased rates under paragraph (c) that apply to hospitals under paragraph
(a), clause (4), shall include adjustments to the projected rates that result in no greater than
a five percent increase or decrease from the base year payments for any hospital. Any
adjustments to the rates made by the commissioner under this paragraph and paragraph (e)
shall maintain budget neutrality as described in paragraph (c).

(e) For discharges occurring on or after November 1, 2014, the commissioner may make
additional adjustments to the rebased rates, and when evaluating whether additional
adjustments should be made, the commissioner shall consider the impact of the rates on the
following:

(1) pediatric services;

(2) behavioral health services;

(3) trauma services as defined by the National Uniform Billing Committee;

(4) transplant services;

(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;

(6) outlier admissions;

(7) low-volume providers; and

(8) services provided by small rural hospitals that are not critical access hospitals.

(f) Hospital payment rates established under paragraph (c) must incorporate the following:

(1) for hospitals paid under the DRG methodology, the base year payment rate per
admission is standardized by the applicable Medicare wage index and adjusted by the
hospital's disproportionate population adjustment;

(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;

(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and

(4) in determining hospital payment rates for discharges occurring on or after the rate
year beginning January 1, 2011, through December 31, 2012, the hospital payment rate per
discharge shall be based on the cost-finding methods and allowable costs of the Medicare
program in effect during the base year or years. In determining hospital payment rates for
discharges in subsequent base years, the per discharge rates shall be based on the cost-finding
methods and allowable costs of the Medicare program in effect during the base year or
years.

(g) The commissioner shall validate the rates effective November 1, 2014, by applying
the rates established under paragraph (c), and any adjustments made to the rates under
paragraph (d) or (e), to hospital claims paid in calendar year 2013 to determine whether the
total aggregate payments for the same number and types of services under the rebased rates
are equal to the total aggregate payments made during calendar year 2013.

(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base year or years and the next base year or years. In
any year that inpatient claims volume falls below the threshold required to ensure a
statistically valid sample of claims, the commissioner may combine claims data from two
consecutive years to serve as the base year. Years in which inpatient claims volume is
reduced or altered due to a pandemic or other public health emergency shall not be used as
a base year or part of a base year if the base year includes more than one year. Changes in
costs between base years shall be measured using the lower of the hospital cost index defined
in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
claim. The commissioner shall establish the base year for each rebasing period considering
the most recent year or years for which filed Medicare cost reports are availablenew text begin , except
that the base years for the rebasing effective July 1, 2023, are calendar years 2018 and 2019new text end .
The estimated change in the average payment per hospital discharge resulting from a
scheduled rebasing must be calculated and made available to the legislature by January 15
of each year in which rebasing is scheduled to occur, and must include by hospital the
differential in payment rates compared to the individual hospital's costs.

(i) Effective for discharges occurring on or after July 1, 2015, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area shall be determined
using a new cost-based methodology. The commissioner shall establish within the
methodology tiers of payment designed to promote efficiency and cost-effectiveness.
Payment rates for hospitals under this paragraph shall be set at a level that does not exceed
the total cost for critical access hospitals as reflected in base year cost reports. Until the
next rebasing that occurs, the new methodology shall result in no greater than a five percent
decrease from the base year payments for any hospital, except a hospital that had payments
that were greater than 100 percent of the hospital's costs in the base year shall have their
rate set equal to 100 percent of costs in the base year. The rates paid for discharges on and
after July 1, 2016, covered under this paragraph shall be increased by the inflation factor
in subdivision 1, paragraph (a). The new cost-based rate shall be the final rate and shall not
be settled to actual incurred costs. Hospitals shall be assigned a payment tier based on the
following criteria:

(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;

(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and

(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.

(j) The commissioner may refine the payment tiers and criteria for critical access hospitals
to coincide with the next rebasing under paragraph (h). The factors used to develop the new
methodology may include, but are not limited to:

(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;

(2) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);

(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and

(6) geographic location.

new text begin EFFECTIVE DATE.new text end

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

Sec. 5.

Minnesota Statutes 2022, section 256.969, subdivision 9, is amended to read:

Subd. 9.

Disproportionate numbers of low-income patients served.

(a) For admissions
occurring on or after July 1, 1993, the medical assistance disproportionate population
adjustment shall comply with federal law and shall be paid to a hospital, excluding regional
treatment centers and facilities of the federal Indian Health Service, with a medical assistance
inpatient utilization rate in excess of the arithmetic mean. The adjustment must be determined
as follows:

(1) for a hospital with a medical assistance inpatient utilization rate above the arithmetic
mean for all hospitals excluding regional treatment centers and facilities of the federal Indian
Health Service but less than or equal to one standard deviation above the mean, the
adjustment must be determined by multiplying the total of the operating and property
payment rates by the difference between the hospital's actual medical assistance inpatient
utilization rate and the arithmetic mean for all hospitals excluding regional treatment centers
and facilities of the federal Indian Health Service; and

(2) for a hospital with a medical assistance inpatient utilization rate above one standard
deviation above the mean, the adjustment must be determined by multiplying the adjustment
that would be determined under clause (1) for that hospital by 1.1. The commissioner shall
report annually on the number of hospitals likely to receive the adjustment authorized by
this paragraph. The commissioner shall specifically report on the adjustments received by
public hospitals and public hospital corporations located in cities of the first class.

(b) Certified public expenditures made by Hennepin County Medical Center shall be
considered Medicaid disproportionate share hospital payments. Hennepin County and
Hennepin County Medical Center shall report by June 15, 2007, on payments made beginning
July 1, 2005, or another date specified by the commissioner, that may qualify for
reimbursement under federal law. Based on these reports, the commissioner shall apply for
federal matching funds.

(c) Upon federal approval of the related state plan amendment, paragraph (b) is effective
retroactively from July 1, 2005, or the earliest effective date approved by the Centers for
Medicare and Medicaid Services.

(d) Effective July 1, 2015, disproportionate share hospital (DSH) payments shall be paid
in accordance with a new methodology using 2012 as the base year. Annual payments made
under this paragraph shall equal the total amount of payments made for 2012. A licensed
children's hospital shall receive only a single DSH factor for children's hospitals. Other
DSH factors may be combined to arrive at a single factor for each hospital that is eligible
for DSH payments. The new methodology shall make payments only to hospitals located
in Minnesota and include the following factors:

(1) a licensed children's hospital with at least 1,000 fee-for-service discharges in the
base year shall receive a factor of 0.868. A licensed children's hospital with less than 1,000
fee-for-service discharges in the base year shall receive a factor of 0.7880;

(2) a hospital that has in effect for the initial rate year a contract with the commissioner
to provide extended psychiatric inpatient services under section 256.9693 shall receive a
factor of 0.0160;

(3) a hospital that has received medical assistance payment for at least 20 transplant
services in the base year shall receive a factor of 0.0435;

(4) a hospital that has a medical assistance utilization rate in the base year between 20
percent up to one standard deviation above the statewide mean utilization rate shall receive
a factor of 0.0468;

(5) a hospital that has a medical assistance utilization rate in the base year that is at least
one standard deviation above the statewide mean utilization rate but is less than two and
one-half standard deviations above the mean shall receive a factor of 0.2300; and

(6) a hospital that is a level one trauma center and that has a medical assistance utilization
rate in the base year that is at least two and deleted text begin one-halfdeleted text end new text begin one-quarternew text end standard deviations above
the statewide mean utilization rate shall receive a factor of 0.3711.

(e) For the purposes of determining eligibility for the disproportionate share hospital
factors in paragraph (d), clauses (1) to (6), the medical assistance utilization rate and
discharge thresholds shall be measured using only one year when a two-year base period
is used.

(f) Any payments or portion of payments made to a hospital under this subdivision that
are subsequently returned to the commissioner because the payments are found to exceed
the hospital-specific DSH limit for that hospital shall be redistributed, proportionate to the
number of fee-for-service discharges, to other DSH-eligible non-children's hospitals that
have a medical assistance utilization rate that is at least one standard deviation above the
mean.

(g) An additional payment adjustment shall be established by the commissioner under
this subdivision for a hospital that provides high levels of administering high-cost drugs to
enrollees in fee-for-service medical assistance. The commissioner shall consider factors
including fee-for-service medical assistance utilization rates and payments made for drugs
purchased through the 340B drug purchasing program and administered to fee-for-service
enrollees. If any part of this adjustment exceeds a hospital's hospital-specific disproportionate
share hospital limit, the commissioner shall make a payment to the hospital that equals the
nonfederal share of the amount that exceeds the limit. The total nonfederal share of the
amount of the payment adjustment under this paragraph shall not exceed $1,500,000.

Sec. 6.

Minnesota Statutes 2022, section 256.969, subdivision 25, is amended to read:

Subd. 25.

Long-term hospital rates.

(a) Long-term hospitals shall be paid on a per diem
basis.

(b) For admissions occurring on or after April 1, 1995, a long-term hospital as designated
by Medicare that does not have admissions in the base year shall have inpatient rates
established at the average of other hospitals with the same designation. For subsequent
rate-setting periods in which base years are updated, the hospital's base year shall be the
first Medicare cost report filed with the long-term hospital designation and shall remain in
effect until it falls within the same period as other hospitals.

new text begin (c) For admissions occurring on or after July 1, 2023, long-term hospitals must be paid
the higher of a per diem amount computed using the methodology described in subdivision
2b, paragraph (i), or the per diem rate as of July 1, 2021.
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. 7.

Minnesota Statutes 2022, section 256.969, is amended by adding a subdivision to
read:

new text begin Subd. 31.new text end

new text begin Long-acting reversible contraceptives.new text end

new text begin (a) The commissioner must provide
separate reimbursement to hospitals for long-acting reversible contraceptives provided
immediately postpartum in the inpatient hospital setting. This payment must be in addition
to the diagnostic related group reimbursement for labor and delivery and shall be made
consistent with section 256B.0625, subdivision 13e, paragraph (e).
new text end

new text begin (b) The commissioner must require managed care and county-based purchasing plans
to comply with this subdivision when providing services to medical assistance enrollees.
If, for any contract year, federal approval is not received for this paragraph, the commissioner
must adjust the capitation rates paid to managed care plans and county-based purchasing
plans for that contract year to reflect the removal of this provision. Contracts between
managed care plans and county-based purchasing plans and providers to whom this paragraph
applies must allow recovery of payments from those providers if capitation rates are adjusted
in accordance with this paragraph. Payment recoveries must not exceed the amount equal
to any increase in rates that results from this provision. This paragraph expires if federal
approval is not received for this paragraph at any time.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 8.

Minnesota Statutes 2022, section 256B.04, subdivision 14, is amended to read:

Subd. 14.

Competitive bidding.

(a) When determined to be effective, economical, and
feasible, the commissioner may utilize volume purchase through competitive bidding and
negotiation under the provisions of chapter 16C, to provide items under the medical assistance
program including but not limited to the following:

(1) eyeglasses;

(2) oxygen. The commissioner shall provide for oxygen needed in an emergency situation
on a short-term basis, until the vendor can obtain the necessary supply from the contract
dealer;

(3) hearing aids and supplies;

(4) durable medical equipment, including but not limited to:

(i) hospital beds;

(ii) commodes;

(iii) glide-about chairs;

(iv) patient lift apparatus;

(v) wheelchairs and accessories;

(vi) oxygen administration equipment;

(vii) respiratory therapy equipment;

(viii) electronic diagnostic, therapeutic and life-support systems; and

(ix) allergen-reducing products as described in section 256B.0625, subdivision 67,
paragraph (c) or (d);

(5) nonemergency medical transportation level of need determinations, disbursement of
public transportation passes and tokens, and volunteer and recipient mileage and parking
reimbursements; deleted text begin and
deleted text end

(6) drugsdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (7) quitline services as described in section 256B.0625, subdivision 68, paragraph (c).
new text end

(b) Rate changes and recipient cost-sharing under this chapter and chapter 256L do not
affect contract payments under this subdivision unless specifically identified.

(c) The commissioner may not utilize volume purchase through competitive bidding
and negotiation under the provisions of chapter 16C for special transportation services or
incontinence products and related supplies.

new text begin EFFECTIVE DATE.new text end

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

Sec. 9.

Minnesota Statutes 2022, section 256B.055, subdivision 17, is amended to read:

Subd. 17.

Adults who were in foster care at the age of 18.

new text begin (a) new text end Medical assistance may
be paid for a person under 26 years of age who was in foster care under the commissioner's
responsibility on the date of attaining 18new text begin , 19, or 20new text end years of age, and who was enrolled in
medical assistance under the state plan or a waiver of the plan while in foster care, in
accordance with section 2004 of the Affordable Care Act.

new text begin (b) Medical assistance may be paid for a person under 26 years of age who was in foster
care and enrolled in any state's Medicaid program as provided by Public Law 115-271,
section 1002.
new text end

new text begin (c) The commissioner shall seek federal waiver approval under United States Code, title
42, section 1315, to include youth who were in a state's foster care program and who turned
age 18 prior to January 1, 2023, without regard to potential eligibility under a Medicaid
mandatory group.
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. 10.

Minnesota Statutes 2022, section 256B.0622, subdivision 8, is amended to read:

Subd. 8.

Medical assistance payment for assertive community treatment and
intensive residential treatment services.

(a) Payment for intensive residential treatment
services and assertive community treatment in this section shall be based on one daily rate
per provider inclusive of the following services received by an eligible client in a given
calendar day: all rehabilitative services under this section, staff travel time to provide
rehabilitative services under this section, and nonresidential crisis stabilization services
under section 256B.0624.

(b) Except as indicated in paragraph (c), payment will not be made to more than one
entity for each client for services provided under this section on a given day. If services
under this section are provided by a team that includes staff from more than one entity, the
team must determine how to distribute the payment among the members.

(c) The commissioner shall determine one rate for each provider that will bill medical
assistance for residential services under this section and one rate for each assertive community
treatment provider. If a single entity provides both services, one rate is established for the
entity's residential services and another rate for the entity's nonresidential services under
this section. A provider is not eligible for payment under this section without authorization
from the commissioner. The commissioner shall develop rates using the following criteria:

(1) the provider's cost for services shall include direct services costs, other program
costs, and other costs determined as follows:

(i) the direct services costs must be determined using actual costs of salaries, benefits,
payroll taxes, and training of direct service staff and service-related transportation;

(ii) other program costs not included in item (i) must be determined as a specified
percentage of the direct services costs as determined by item (i). The percentage used shall
be determined by the commissioner based upon the average of percentages that represent
the relationship of other program costs to direct services costs among the entities that provide
similar services;

(iii) physical plant costs calculated based on the percentage of space within the program
that is entirely devoted to treatment and programming. This does not include administrative
or residential space;

(iv) assertive community treatment physical plant costs must be reimbursed as part of
the costs described in item (ii); and

(v) subject to federal approval, up to an additional five percent of the total rate may be
added to the program rate as a quality incentive based upon the entity meeting performance
criteria specified by the commissioner;

(2) actual cost is defined as costs which are allowable, allocable, and reasonable, and
consistent with federal reimbursement requirements under Code of Federal Regulations,
title 48, chapter 1, part 31, relating to for-profit entities, and Office of Management and
Budget Circular Number A-122, relating to nonprofit entities;

(3) the number of service units;

(4) the degree to which clients will receive services other than services under this section;
and

(5) the costs of other services that will be separately reimbursed.

(d) The rate for intensive residential treatment services and assertive community treatment
must exclude room and board, as defined in section 256I.03, subdivision 6, and services
not covered under this section, such as partial hospitalization, home care, and inpatient
services.

(e) Physician services that are not separately billed may be included in the rate to the
extent that a psychiatrist, or other health care professional providing physician services
within their scope of practice, is a member of the intensive residential treatment services
treatment team. Physician services, whether billed separately or included in the rate, may
be delivered by telehealth. For purposes of this paragraph, "telehealth" has the meaning
given to "mental health telehealth" in section 256B.0625, subdivision 46, when telehealth
is used to provide intensive residential treatment services.

(f) When services under this section are provided by an assertive community treatment
provider, case management functions must be an integral part of the team.

(g) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payors.

(h) The rates for existing programs must be established prospectively based upon the
expenditures and utilization over a prior 12-month period using the criteria established in
paragraph (c). The rates for new programs must be established based upon estimated
expenditures and estimated utilization using the criteria established in paragraph (c).

new text begin (i) Effective for the rate years beginning on and after January 1, 2024, rates for assertive
community treatment, adult residential crisis stabilization services, and intensive residential
treatment services must be annually adjusted for inflation using the Centers for Medicare
and Medicaid Services Medicare Economic Index, as forecasted in the fourth quarter of the
calendar year before the rate year. The inflation adjustment must be based on the 12-month
period from the midpoint of the previous rate year to the midpoint of the rate year for which
the rate is being determined.
new text end

deleted text begin (i)deleted text end new text begin (j)new text end Entities who discontinue providing services must be subject to a settle-up process
whereby actual costs and reimbursement for the previous 12 months are compared. In the
event that the entity was paid more than the entity's actual costs plus any applicable
performance-related funding due the provider, the excess payment must be reimbursed to
the department. If a provider's revenue is less than actual allowed costs due to lower
utilization than projected, the commissioner may reimburse the provider to recover its actual
allowable costs. The resulting adjustments by the commissioner must be proportional to the
percent of total units of service reimbursed by the commissioner and must reflect a difference
of greater than five percent.

deleted text begin (j)deleted text end new text begin (k)new text end A provider may request of the commissioner a review of any rate-setting decision
made under this subdivision.

new text begin EFFECTIVE DATE.new text end

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

Sec. 11.

Minnesota Statutes 2022, section 256B.0625, subdivision 9, is amended to read:

Subd. 9.

Dental services.

(a) Medical assistance coversnew text begin medically necessarynew text end dental
services.

deleted text begin (b) Medical assistance dental coverage for nonpregnant adults is limited to the following
services:
deleted text end

deleted text begin (1) comprehensive exams, limited to once every five years;
deleted text end

deleted text begin (2) periodic exams, limited to one per year;
deleted text end

deleted text begin (3) limited exams;
deleted text end

deleted text begin (4) bitewing x-rays, limited to one per year;
deleted text end

deleted text begin (5) periapical x-rays;
deleted text end

deleted text begin (6) panoramic x-rays, limited to one every five years except (1) when medically necessary
for the diagnosis and follow-up of oral and maxillofacial pathology and trauma or (2) once
every two years for patients who cannot cooperate for intraoral film due to a developmental
disability or medical condition that does not allow for intraoral film placement;
deleted text end

deleted text begin (7) prophylaxis, limited to one per year;
deleted text end

deleted text begin (8) application of fluoride varnish, limited to one per year;
deleted text end

deleted text begin (9) posterior fillings, all at the amalgam rate;
deleted text end

deleted text begin (10) anterior fillings;
deleted text end

deleted text begin (11) endodontics, limited to root canals on the anterior and premolars only;
deleted text end

deleted text begin (12) removable prostheses, each dental arch limited to one every six years;
deleted text end

deleted text begin (13) oral surgery, limited to extractions, biopsies, and incision and drainage of abscesses;
deleted text end

deleted text begin (14) palliative treatment and sedative fillings for relief of pain;
deleted text end

deleted text begin (15) full-mouth debridement, limited to one every five years; and
deleted text end

deleted text begin (16) nonsurgical treatment for periodontal disease, including scaling and root planing
once every two years for each quadrant, and routine periodontal maintenance procedures.
deleted text end

deleted text begin (c) In addition to the services specified in paragraph (b), medical assistance covers the
following services for adults, if provided in an outpatient hospital setting or freestanding
ambulatory surgical center as part of outpatient dental surgery:
deleted text end

deleted text begin (1) periodontics, limited to periodontal scaling and root planing once every two years;
deleted text end

deleted text begin (2) general anesthesia; and
deleted text end

deleted text begin (3) full-mouth survey once every five years.
deleted text end

deleted text begin (d) Medical assistance covers medically necessary dental services for children and
pregnant women.deleted text end new text begin (b)new text end The following guidelines applynew text begin to dental servicesnew text end :

(1) posterior fillings are paid at the amalgam rate;

(2) application of sealants are covered once every five years per permanent molar deleted text begin for
children onlydeleted text end ; new text begin and
new text end

(3) application of fluoride varnish is covered once every six monthsdeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (4) orthodontia is eligible for coverage for children only.
deleted text end

deleted text begin (e)deleted text end new text begin (c)new text end In addition to the services specified in deleted text begin paragraphsdeleted text end new text begin paragraphnew text end (b) deleted text begin and (c)deleted text end , medical
assistance covers the following services deleted text begin for adultsdeleted text end :

(1) house calls or extended care facility calls for on-site delivery of covered services;

(2) behavioral management when additional staff time is required to accommodate
behavioral challenges and sedation is not used;

(3) oral or IV sedation, if the covered dental service cannot be performed safely without
it or would otherwise require the service to be performed under general anesthesia in a
hospital or surgical center; and

(4) prophylaxis, in accordance with an appropriate individualized treatment plan, but
no more than four times per year.

deleted text begin (f)deleted text end new text begin (d)new text end The commissioner shall not require prior authorization for the services included
in paragraph deleted text begin (e)deleted text end new text begin (c)new text end , clauses (1) to (3), and shall prohibit managed care and county-based
purchasing plans from requiring prior authorization for the services included in paragraph
deleted text begin (e)deleted text end new text begin (c)new text end , clauses (1) to (3), when provided under sections 256B.69, 256B.692, and 256L.12.

new text begin EFFECTIVE DATE.new text end

Sec. 12.

Minnesota Statutes 2022, section 256B.0625, subdivision 13, is amended to read:

Subd. 13.

Drugs.

(a) Medical assistance covers drugs, except for fertility drugs when
specifically used to enhance fertility, if prescribed by a licensed practitioner and dispensed
by a licensed pharmacist, by a physician enrolled in the medical assistance program as a
dispensing physician, or by a physician, a physician assistant, or an advanced practice
registered nurse employed by or under contract with a community health board as defined
in section 145A.02, subdivision 5, for the purposes of communicable disease control.

(b) The dispensed quantity of a prescription drug must not exceed a 34-day supplydeleted text begin ,deleted text end
unless authorized by the commissioner new text begin or as provided in paragraph (h) new text end or the drug appears
on the 90-day supply list published by the commissioner. The 90-day supply list shall be
published by the commissioner on the department's website. The commissioner may add
to, delete from, and otherwise modify the 90-day supply list after providing public notice
and the opportunity for a 15-day public comment period. The 90-day supply list may include
cost-effective generic drugs and shall not include controlled substances.

(c) For the purpose of this subdivision and subdivision 13d, an "active pharmaceutical
ingredient" is defined as a substance that is represented for use in a drug and when used in
the manufacturing, processing, or packaging of a drug becomes an active ingredient of the
drug product. An "excipient" is defined as an inert substance used as a diluent or vehicle
for a drug. The commissioner shall establish a list of active pharmaceutical ingredients and
excipients which are included in the medical assistance formulary. Medical assistance covers
selected active pharmaceutical ingredients and excipients used in compounded prescriptions
when the compounded combination is specifically approved by the commissioner or when
a commercially available product:

(1) is not a therapeutic option for the patient;

(2) does not exist in the same combination of active ingredients in the same strengths
as the compounded prescription; and

(3) cannot be used in place of the active pharmaceutical ingredient in the compounded
prescription.

(d) Medical assistance covers the following over-the-counter drugs when prescribed by
a licensed practitioner or by a licensed pharmacist who meets standards established by the
commissioner, in consultation with the board of pharmacy: antacids, acetaminophen, family
planning products, aspirin, insulin, products for the treatment of lice, vitamins for adults
with documented vitamin deficiencies, vitamins for children under the age of seven and
pregnant or nursing women, and any other over-the-counter drug identified by the
commissioner, in consultation with the Formulary Committee, as necessary, appropriate,
and cost-effective for the treatment of certain specified chronic diseases, conditions, or
disorders, and this determination shall not be subject to the requirements of chapter 14. A
pharmacist may prescribe over-the-counter medications as provided under this paragraph
for purposes of receiving reimbursement under Medicaid. When prescribing over-the-counter
drugs under this paragraph, licensed pharmacists must consult with the recipient to determine
necessity, provide drug counseling, review drug therapy for potential adverse interactions,
and make referrals as needed to other health care professionals.

(e) Effective January 1, 2006, medical assistance shall not cover drugs that are coverable
under Medicare Part D as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-2(e), for individuals eligible
for drug coverage as defined in the Medicare Prescription Drug, Improvement, and
Modernization Act of 2003, Public Law 108-173, section 1860D-1(a)(3)(A). For these
individuals, medical assistance may cover drugs from the drug classes listed in United States
Code, title 42, section 1396r-8(d)(2), subject to this subdivision and subdivisions 13a to
13g, except that drugs listed in United States Code, title 42, section 1396r-8(d)(2)(E), shall
not be covered.

(f) Medical assistance covers drugs acquired through the federal 340B Drug Pricing
Program and dispensed by 340B covered entities and ambulatory pharmacies under common
ownership of the 340B covered entity. Medical assistance does not cover drugs acquired
through the federal 340B Drug Pricing Program and dispensed by 340B contract pharmacies.

(g) Notwithstanding paragraph (a), medical assistance covers self-administered hormonal
contraceptives prescribed and dispensed by a licensed pharmacist in accordance with section
151.37, subdivision 14; nicotine replacement medications prescribed and dispensed by a
licensed pharmacist in accordance with section 151.37, subdivision 15; and opiate antagonists
used for the treatment of an acute opiate overdose prescribed and dispensed by a licensed
pharmacist in accordance with section 151.37, subdivision 16.

new text begin (h) Medical assistance coverage for a prescription contraceptive must provide a 12-month
supply for any prescription contraceptive if a 12-month supply is prescribed by the
prescribing health care provider. The prescribing health care provider must determine the
appropriate duration for which to prescribe the prescription contraceptives, up to 12 months.
For purposes of this paragraph, "prescription contraceptive" means any drug or device that
requires a prescription and is approved by the Food and Drug Administration to prevent
pregnancy. Prescription contraceptive does not include an emergency contraceptive drug
approved to prevent pregnancy when administered after sexual contact. For purposes of this
paragraph, "health plan" has the meaning provided in section 62Q.01, subdivision 3.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 13.

Minnesota Statutes 2022, section 256B.0625, subdivision 13c, is amended to
read:

Subd. 13c.

Formulary Committee.

The commissioner, after receiving recommendations
from professional medical associations and professional pharmacy associations, and consumer
groups shall designate a Formulary Committee to carry out duties as described in subdivisions
13 to 13g. The Formulary Committee shall be comprised of deleted text begin fourdeleted text end new text begin at least fivenew text end licensed
physicians actively engaged in the practice of medicine in Minnesota, one of whom deleted text begin must
be actively engaged in the treatment of persons with mental illnessdeleted text end new text begin is an actively practicing
psychiatrist, one of whom specializes in the diagnosis and treatment of rare diseases, one
of whom specializes in pediatrics, and one of whom actively treats persons with disabilitiesnew text end ;
at least three licensed pharmacists actively engaged in the practice of pharmacy in Minnesotanew text begin ,
one of whom practices outside the metropolitan counties listed in section 473.121, subdivision
4, one of whom practices in the metropolitan counties listed in section 473.121, subdivision
4, and one of whom is a practicing hospital pharmacistnew text end ; deleted text begin and onedeleted text end new text begin at least twonew text end consumer
deleted text begin representativedeleted text end new text begin representatives, all of whom must have a personal or professional connection
to medical assistancenew text end ; new text begin and one representative designated by the Minnesota Rare Disease
Advisory Council established under section 256.4835; new text end the remainder to be made up of health
care professionals who are licensed in their field and have recognized knowledge in the
clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs.
Members of the Formulary Committee shall not be employed by the Department of Human
Servicesnew text begin or have a personal interest in a pharmaceutical company, pharmacy benefits
manager, health plan company, or their affiliate organizationsnew text end , but the committee shall be
staffed by an employee of the department who shall serve as an ex officio, nonvoting member
of the committee. new text begin For the purposes of this subdivision, "personal interest" means that a
person owns at least five percent of the voting interest or equity interest in the entity, the
equity interest owned by a person represents at least five percent of that person's net worth,
or more than five percent of a person's gross income for the preceding year was derived
from the entity. A committee member must notify the committee of any potential conflict
of interest and recuse themselves from any communications, discussion, or vote on any
matter where a conflict of interest exists. A conflict of interest alone, without a personal
interest, does not preclude an applicant from serving as a member of the Formulary
Committee. Members may be removed from the committee for cause after a recommendation
for removal by a majority of the committee membership. For the purposes of this subdivision,
"cause" does not include offering a differing or dissenting clinical opinion on a drug or drug
class. new text end The department's medical director shall also serve as an ex officio, nonvoting member
for the committee. Committee members shall serve three-year terms and may be reappointed
new text begin twice new text end by the commissioner. new text begin The committee members shall vote on a chair and vice chair
from among their membership. The chair shall preside over all committee meetings, and
the vice chair shall preside over the meetings if the chair is not present. new text end The Formulary
Committee shall meet at least deleted text begin twicedeleted text end new text begin three timesnew text end per year. The commissioner may require
more frequent Formulary Committee meetings as needed. An honorarium of $100 per
meeting and reimbursement for mileage shall be paid to each committee member in
attendance. The Formulary Committee expires June 30, deleted text begin 2023deleted text end new text begin 2027new text end .new text begin The Formulary
Committee is subject to the Open Meeting Law under chapter 13D. For purposes of
establishing a quorum to transact business, vacant committee member positions do not count
in the calculation as long as at least 60 percent of the committee member positions are filled.
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. 14.

Minnesota Statutes 2022, section 256B.0625, subdivision 13e, is amended to
read:

Subd. 13e.

Payment rates.

(a) The basis for determining the amount of payment shall
be the lower of the ingredient costs of the drugs plus the professional dispensing fee; or the
usual and customary price charged to the public. The usual and customary price means the
lowest price charged by the provider to a patient who pays for the prescription by cash,
check, or charge account and includes prices the pharmacy charges to a patient enrolled in
a prescription savings club or prescription discount club administered by the pharmacy or
pharmacy chain. The amount of payment basis must be reduced to reflect all discount
amounts applied to the charge by any third-party provider/insurer agreement or contract for
submitted charges to medical assistance programs. The net submitted charge may not be
greater than the patient liability for the service. The professional dispensing fee shall be
$10.77 for prescriptions filled with legend drugs meeting the definition of "covered outpatient
drugs" according to United States Code, title 42, section 1396r-8(k)(2). The dispensing fee
for intravenous solutions that must be compounded by the pharmacist shall be $10.77 per
claim. The professional dispensing fee for prescriptions filled with over-the-counter drugs
meeting the definition of covered outpatient drugs shall be $10.77 for dispensed quantities
equal to or greater than the number of units contained in the manufacturer's original package.
The professional dispensing fee shall be prorated based on the percentage of the package
dispensed when the pharmacy dispenses a quantity less than the number of units contained
in the manufacturer's original package. The pharmacy dispensing fee for prescribed
over-the-counter drugs not meeting the definition of covered outpatient drugs shall be $3.65
for quantities equal to or greater than the number of units contained in the manufacturer's
original package and shall be prorated based on the percentage of the package dispensed
when the pharmacy dispenses a quantity less than the number of units contained in the
manufacturer's original package. The National Average Drug Acquisition Cost (NADAC)
shall be used to determine the ingredient cost of a drug. For drugs for which a NADAC is
not reported, the commissioner shall estimate the ingredient cost at the wholesale acquisition
cost minus two percent. The ingredient cost of a drug for a provider participating in the
federal 340B Drug Pricing Program shall be either the 340B Drug Pricing Program ceiling
price established by the Health Resources and Services Administration or NADAC,
whichever is lower. Wholesale acquisition cost is defined as the manufacturer's list price
for a drug or biological to wholesalers or direct purchasers in the United States, not including
prompt pay or other discounts, rebates, or reductions in price, for the most recent month for
which information is available, as reported in wholesale price guides or other publications
of drug or biological pricing data. The maximum allowable cost of a multisource drug may
be set by the commissioner and it shall be comparable to the actual acquisition cost of the
drug product and no higher than the NADAC of the generic product. Establishment of the
amount of payment for drugs shall not be subject to the requirements of the Administrative
Procedure Act.

(b) Pharmacies dispensing prescriptions to residents of long-term care facilities using
an automated drug distribution system meeting the requirements of section 151.58, or a
packaging system meeting the packaging standards set forth in Minnesota Rules, part
6800.2700, that govern the return of unused drugs to the pharmacy for reuse, may employ
retrospective billing for prescription drugs dispensed to long-term care facility residents. A
retrospectively billing pharmacy must submit a claim only for the quantity of medication
used by the enrolled recipient during the defined billing period. A retrospectively billing
pharmacy must use a billing period not less than one calendar month or 30 days.

(c) A pharmacy provider using packaging that meets the standards set forth in Minnesota
Rules, part 6800.2700, is required to credit the department for the actual acquisition cost
of all unused drugs that are eligible for reuse, unless the pharmacy is using retrospective
billing. The commissioner may permit the drug clozapine to be dispensed in a quantity that
is less than a 30-day supply.

(d) If a pharmacy dispenses a multisource drug, the ingredient cost shall be the NADAC
of the generic product or the maximum allowable cost established by the commissioner
unless prior authorization for the brand name product has been granted according to the
criteria established by the Drug Formulary Committee as required by subdivision 13f,
paragraph (a), and the prescriber has indicated "dispense as written" on the prescription in
a manner consistent with section 151.21, subdivision 2.

(e) The basis for determining the amount of payment for drugs administered in an
outpatient setting shall be the lower of the usual and customary cost submitted by the
provider, 106 percent of the average sales price as determined by the United States
Department of Health and Human Services pursuant to title XVIII, section 1847a of the
federal Social Security Act, the specialty pharmacy rate, or the maximum allowable cost
set by the commissioner. If average sales price is unavailable, the amount of payment must
be lower of the usual and customary cost submitted by the provider, the wholesale acquisition
cost, the specialty pharmacy rate, or the maximum allowable cost set by the commissioner.
The commissioner shall discount the payment rate for drugs obtained through the federal
340B Drug Pricing Program by 28.6 percent. The payment for drugs administered in an
outpatient setting shall be made to the administering facility or practitioner. A retail or
specialty pharmacy dispensing a drug for administration in an outpatient setting is not
eligible for direct reimbursement.

(f) The commissioner may establish maximum allowable cost rates for specialty pharmacy
products that are lower than the ingredient cost formulas specified in paragraph (a). The
commissioner may require individuals enrolled in the health care programs administered
by the department to obtain specialty pharmacy products from providers with whom the
commissioner has negotiated lower reimbursement rates. Specialty pharmacy products are
defined as those used by a small number of recipients or recipients with complex and chronic
diseases that require expensive and challenging drug regimens. Examples of these conditions
include, but are not limited to: multiple sclerosis, HIV/AIDS, transplantation, hepatitis C,
growth hormone deficiency, Crohn's Disease, rheumatoid arthritis, and certain forms of
cancer. Specialty pharmaceutical products include injectable and infusion therapies,
biotechnology drugs, antihemophilic factor products, high-cost therapies, and therapies that
require complex care. The commissioner shall consult with the Formulary Committee to
develop a list of specialty pharmacy products subject to maximum allowable cost
reimbursement. In consulting with the Formulary Committee in developing this list, the
commissioner shall take into consideration the population served by specialty pharmacy
products, the current delivery system and standard of care in the state, and access to care
issues. The commissioner shall have the discretion to adjust the maximum allowable cost
to prevent access to care issues.

(g) Home infusion therapy services provided by home infusion therapy pharmacies must
be paid at rates according to subdivision 8d.

(h) The commissioner shall contract with a vendor to conduct a cost of dispensing survey
for all pharmacies that are physically located in the state of Minnesota that dispense outpatient
drugs under medical assistance. The commissioner shall ensure that the vendor has prior
experience in conducting cost of dispensing surveys. Each pharmacy enrolled with the
department to dispense outpatient prescription drugs to fee-for-service members must
respond to the cost of dispensing survey. The commissioner may sanction a pharmacy under
section 256B.064 for failure to respond. The commissioner shall require the vendor to
measure a single statewide cost of dispensing for specialty prescription drugs and a single
statewide cost of dispensing for nonspecialty prescription drugs for all responding pharmacies
to measure the mean, mean weighted by total prescription volume, mean weighted by
medical assistance prescription volume, median, median weighted by total prescription
volume, and median weighted by total medical assistance prescription volume. The
commissioner shall post a copy of the final cost of dispensing survey report on the
department's website. The initial survey must be completed no later than January 1, 2021,
and repeated every three years. The commissioner shall provide a summary of the results
of each cost of dispensing survey and provide recommendations for any changes to the
dispensing fee to the chairs and ranking members of the legislative committees with
jurisdiction over medical assistance pharmacy reimbursement.new text begin Notwithstanding section
256.01, subdivision 42, this paragraph does not expire.
new text end

(i) The commissioner shall increase the ingredient cost reimbursement calculated in
paragraphs (a) and (f) by 1.8 percent for prescription and nonprescription drugs subject to
the wholesale drug distributor tax under section 295.52.

new text begin EFFECTIVE DATE.new text end

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

Sec. 15.

Minnesota Statutes 2022, section 256B.0625, subdivision 13f, is amended to read:

Subd. 13f.

Prior authorization.

(a) The Formulary Committee shall review and
recommend drugs which require prior authorization. The Formulary Committee shall
establish general criteria to be used for the prior authorization of brand-name drugs for
which generically equivalent drugs are available, but the committee is not required to review
each brand-name drug for which a generically equivalent drug is available.

(b) Prior authorization may be required by the commissioner before certain formulary
drugs are eligible for payment. The Formulary Committee may recommend drugs for prior
authorization directly to the commissioner. The commissioner may also request that the
Formulary Committee review a drug for prior authorization. Before the commissioner may
require prior authorization for a drug:

(1) the commissioner must provide information to the Formulary Committee on the
impact that placing the drug on prior authorization may have on the quality of patient care
and on program costs, information regarding whether the drug is subject to clinical abuse
or misuse, and relevant data from the state Medicaid program if such data is available;

(2) the Formulary Committee must review the drug, taking into account medical and
clinical data and the information provided by the commissioner; and

(3) the Formulary Committee must hold a public forum and receive public comment for
an additional 15 days.

The commissioner must provide a 15-day notice period before implementing the prior
authorization.

(c) Except as provided in subdivision 13j, prior authorization shall not be required or
utilized for any atypical antipsychotic drug prescribed for the treatment of mental illness
if:

(1) there is no generically equivalent drug available; and

(2) the drug was initially prescribed for the recipient prior to July 1, 2003; or

(3) the drug is part of the recipient's current course of treatment.

This paragraph applies to any multistate preferred drug list or supplemental drug rebate
program established or administered by the commissioner. Prior authorization shall
automatically be granted for 60 days for brand name drugs prescribed for treatment of mental
illness within 60 days of when a generically equivalent drug becomes available, provided
that the brand name drug was part of the recipient's course of treatment at the time the
generically equivalent drug became available.

(d) new text begin Prior authorization must not be required for liquid methadone if only one version of
liquid methadone is available. If more than one version of liquid methadone is available,
the commissioner shall ensure that at least one version of liquid methadone is available
without prior authorization.
new text end

new text begin (e) Prior authorization may be required for an oral liquid form of a drug, except as
described in paragraph (d). A prior authorization request under this paragraph must be
automatically approved within 24 hours if the drug is being prescribed for a Food and Drug
Administration-approved condition for a patient who utilizes an enteral tube for feedings
or medication administration, even if the patient has current or prior claims for pills for that
condition. If more than one version of the oral liquid form of a drug is available, the
commissioner may select the version that is able to be approved for a Food and Drug
Administration-approved condition for a patient who utilizes an enteral tube for feedings
or medication administration. This paragraph applies to any multistate preferred drug list
or supplemental drug rebate program established or administered by the commissioner. The
commissioner shall design and implement a streamlined prior authorization form for patients
who utilize an enteral tube for feedings or medication administration and are prescribed an
oral liquid form of a drug. new text end The commissioner may require prior authorization for brand
name drugs whenever a generically equivalent product is available, even if the prescriber
specifically indicates "dispense as written-brand necessary" on the prescription as required
by section 151.21, subdivision 2.

deleted text begin (e)deleted text end new text begin (f)new text end Notwithstanding this subdivision, the commissioner may automatically require
prior authorization, for a period not to exceed 180 days, for any drug that is approved by
the United States Food and Drug Administration on or after July 1, 2005. The 180-day
period begins no later than the first day that a drug is available for shipment to pharmacies
within the state. The Formulary Committee shall recommend to the commissioner general
criteria to be used for the prior authorization of the drugs, but the committee is not required
to review each individual drug. In order to continue prior authorizations for a drug after the
180-day period has expired, the commissioner must follow the provisions of this subdivision.

deleted text begin (f)deleted text end new text begin (g)new text end Prior authorization under this subdivision shall comply with section 62Q.184.

deleted text begin (g)deleted text end new text begin (h)new text end Any step therapy protocol requirements established by the commissioner must
comply with section 62Q.1841.

new text begin EFFECTIVE DATE.new text end

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

Sec. 16.

Minnesota Statutes 2022, section 256B.0625, subdivision 13g, is amended to
read:

Subd. 13g.

Preferred drug list.

(a) The commissioner shall adopt and implement a
preferred drug list by January 1, 2004. The commissioner may enter into a contract with a
vendor for the purpose of participating in a preferred drug list and supplemental rebate
program. new text begin The terms of the contract with the vendor must be publicly disclosed on the website
of the Department of Human Services. new text end The commissioner shall ensure that any contract
meets all federal requirements and maximizes federal financial participation. The
commissioner shall publish the preferred drug list annually in the State Register and shall
maintain an accurate and up-to-date list on the agency website.new text begin The commissioner shall
implement and maintain an accurate archive of previous versions of the preferred drug list,
and make this archive available to the public on the website of the Department of Human
Services beginning January 1, 2024.
new text end

(b) The commissioner may add to, delete from, and otherwise modify the preferred drug
list, after consulting with the Formulary Committee and appropriate medical specialists deleted text begin anddeleted text end new text begin ,new text end
providing public notice and the opportunity for public commentnew text begin , and complying with the
requirements of paragraph (f)new text end .

(c) The commissioner shall adopt and administer the preferred drug list as part of the
administration of the supplemental drug rebate program. Reimbursement for prescription
drugs not on the preferred drug list may be subject to prior authorization.

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

new text begin (1) "appropriate medical specialist" means a medical professional who prescribes the
relevant class of drug as part of their practice; and
new text end

new text begin (2) new text end "preferred drug list" means a list of prescription drugs within designated therapeutic
classes selected by the commissioner, for which prior authorization based on the identity
of the drug or class is not required.

(e) The commissioner shall seek any federal waivers or approvals necessary to implement
this subdivision.

(f) deleted text begin Notwithstanding paragraph (b),deleted text end Before the commissioner may delete a drug from the
preferred drug list or modify the inclusion of a drug on the preferred drug list, the
commissioner shall consider any implications that the deletion or modification may have
on state public health policies or initiatives and any impact that the deletion or modification
may have on increasing health disparities in the state. Prior to deleting a drug or modifying
the inclusion of a drug, the commissioner shall also conduct a public hearing. The
commissioner shall provide adequate notice to the public and the commissioner of health
prior to the hearing that specifies the drug that the commissioner is proposing to delete or
modify, new text begin and shall disclose new text end any public medical or clinical analysis that the commissioner
has relied on in proposing the deletion or modificationdeleted text begin ,deleted text end and evidence that the commissioner
has evaluated the impact of the proposed deletion or modification on public health and
health disparities.new text begin Notwithstanding section 331A.05, a public notice of a Formulary
Committee meeting must be published at least 30 days in advance of the meeting. The list
of drugs to be discussed at the meeting must be announced at least 30 days before the meeting
and must include the name and class of drug, the proposed action, and the proposed prior
authorization requirements, if applicable.
new text end

Sec. 17.

Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 13k.new text end

new text begin Value-based purchasing arrangements.new text end

new text begin (a) The commissioner may enter
into a value-based purchasing arrangement under medical assistance or MinnesotaCare, by
written arrangement with a drug manufacturer based on agreed-upon metrics. The
commissioner may contract with a vendor to implement and administer the value-based
purchasing arrangement. A value-based purchasing arrangement may include but is not
limited to rebates, discounts, price reductions, risk sharing, reimbursements, guarantees,
shared savings payments, withholds, or bonuses. A value-based purchasing arrangement
must provide at least the same value or discount in the aggregate as would claiming the
mandatory federal drug rebate under the Federal Social Security Act, section 1927.
new text end

new text begin (b) Nothing in this section shall be interpreted as requiring a drug manufacturer or the
commissioner to enter into an arrangement as described in paragraph (a).
new text end

new text begin (c) Nothing in this section shall be interpreted as altering or modifying medical assistance
coverage requirements under the federal Social Security Act, section 1927.
new text end

new text begin (d) If the commissioner determines that a state plan amendment is necessary before
implementing a value-based purchasing arrangement, the commissioner shall request the
amendment and may delay implementing this provision until the amendment is approved.
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. 18.

Minnesota Statutes 2022, section 256B.0625, subdivision 16, is amended to read:

Subd. 16.

Abortion services.

Medical assistance covers abortion servicesdeleted text begin , but only if
one of the following conditions is met:deleted text end new text begin determined to be medically necessary by the treating
provider and delivered in accordance with all applicable Minnesota laws.
new text end

deleted text begin (a) The abortion is a medical necessity. "Medical necessity" means (1) the signed written
statement of two physicians indicating the abortion is medically necessary to prevent the
death of the mother, and (2) the patient has given her consent to the abortion in writing
unless the patient is physically or legally incapable of providing informed consent to the
procedure, in which case consent will be given as otherwise provided by law;
deleted text end

deleted text begin (b) The pregnancy is the result of criminal sexual conduct as defined in section 609.342,
subdivision 1, clauses (a), (b), (c)(i) and (ii), and (e), and subdivision 1a, clauses (a), (b),
(c)(i) and (ii), and (d), and the incident is reported within 48 hours after the incident occurs
to a valid law enforcement agency for investigation, unless the victim is physically unable
to report the criminal sexual conduct, in which case the report shall be made within 48 hours
after the victim becomes physically able to report the criminal sexual conduct; or
deleted text end

deleted text begin (c) The pregnancy is the result of incest, but only if the incident and relative are reported
to a valid law enforcement agency for investigation prior to the abortion.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 19.

Minnesota Statutes 2022, section 256B.0625, subdivision 28b, is amended to
read:

Subd. 28b.

Doula services.

Medical assistance covers doula services provided by a
certified doula as defined in section 148.995, subdivision 2, of the mother's choice. For
purposes of this section, "doula services" means childbirth education and support services,
including emotional and physical support provided during pregnancy, labor, birth, and
postpartum.new text begin The commissioner shall enroll doula agencies and individual treating doulas
to provide direct reimbursement.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 20.

Minnesota Statutes 2022, section 256B.0625, subdivision 30, is amended to read:

Subd. 30.

Other clinic services.

(a) Medical assistance covers rural health clinic services,
federally qualified health center services, nonprofit community health clinic services, and
public health clinic services. Rural health clinic services and federally qualified health center
services mean services defined in United States Code, title 42, section 1396d(a)(2)(B) and
(C). Payment for rural health clinic and federally qualified health center services shall be
made according to applicable federal law and regulation.

(b) A federally qualified health center (FQHC) that is beginning initial operation shall
submit an estimate of budgeted costs and visits for the initial reporting period in the form
and detail required by the commissioner. An FQHC that is already in operation shall submit
an initial report using actual costs and visits for the initial reporting period. Within 90 days
of the end of its reporting period, an FQHC shall submit, in the form and detail required by
the commissioner, a report of its operations, including allowable costs actually incurred for
the period and the actual number of visits for services furnished during the period, and other
information required by the commissioner. FQHCs that file Medicare cost reports shall
provide the commissioner with a copy of the most recent Medicare cost report filed with
the Medicare program intermediary for the reporting year which support the costs claimed
on their cost report to the state.

(c) In order to continue cost-based payment under the medical assistance program
according to paragraphs (a) and (b), an FQHC or rural health clinic must apply for designation
as an essential community provider within six months of final adoption of rules by the
Department of Health according to section 62Q.19, subdivision 7. For those FQHCs and
rural health clinics that have applied for essential community provider status within the
six-month time prescribed, medical assistance payments will continue to be made according
to paragraphs (a) and (b) for the first three years after application. For FQHCs and rural
health clinics that either do not apply within the time specified above or who have had
essential community provider status for three years, medical assistance payments for health
services provided by these entities shall be according to the same rates and conditions
applicable to the same service provided by health care providers that are not FQHCs or rural
health clinics.

(d) Effective July 1, 1999, the provisions of paragraph (c) requiring an FQHC or a rural
health clinic to make application for an essential community provider designation in order
to have cost-based payments made according to paragraphs (a) and (b) no longer apply.

(e) Effective January 1, 2000, payments made according to paragraphs (a) and (b) shall
be limited to the cost phase-out schedule of the Balanced Budget Act of 1997.

(f) Effective January 1, 2001, through December 31, 2020, each FQHC and rural health
clinic may elect to be paid either under the prospective payment system established in United
States Code, title 42, section 1396a(aa), or under an alternative payment methodology
consistent with the requirements of United States Code, title 42, section 1396a(aa), and
approved by the Centers for Medicare and Medicaid Services. The alternative payment
methodology shall be 100 percent of cost as determined according to Medicare cost
principles.

(g) Effective for services provided on or after January 1, 2021, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner, according to an annual election by the FQHC or rural health clinic, under
the current prospective payment system described in paragraph (f) or the alternative payment
methodology described in paragraph (l)new text begin , or, upon federal approval, for FQHCs that are also
urban Indian organizations under Title V of the federal Indian Health Improvement Act, as
provided under paragraph (k)new text end .

(h) For purposes of this section, "nonprofit community clinic" is a clinic that:

(1) has nonprofit status as specified in chapter 317A;

(2) has tax exempt status as provided in Internal Revenue Code, section 501(c)(3);

(3) is established to provide health services to low-income population groups, uninsured,
high-risk and special needs populations, underserved and other special needs populations;

(4) employs professional staff at least one-half of which are familiar with the cultural
background of their clients;

(5) charges for services on a sliding fee scale designed to provide assistance to
low-income clients based on current poverty income guidelines and family size; and

(6) does not restrict access or services because of a client's financial limitations or public
assistance status and provides no-cost care as needed.

(i) Effective for services provided on or after January 1, 2015, all claims for payment
of clinic services provided by FQHCs and rural health clinics shall be paid by the
commissioner. the commissioner shall determine the most feasible method for paying claims
from the following options:

(1) FQHCs and rural health clinics submit claims directly to the commissioner for
payment, and the commissioner provides claims information for recipients enrolled in a
managed care or county-based purchasing plan to the plan, on a regular basis; or

(2) FQHCs and rural health clinics submit claims for recipients enrolled in a managed
care or county-based purchasing plan to the plan, and those claims are submitted by the
plan to the commissioner for payment to the clinic.

(j) For clinic services provided prior to January 1, 2015, the commissioner shall calculate
and pay monthly the proposed managed care supplemental payments to clinics, and clinics
shall conduct a timely review of the payment calculation data in order to finalize all
supplemental payments in accordance with federal law. Any issues arising from a clinic's
review must be reported to the commissioner by January 1, 2017. Upon final agreement
between the commissioner and a clinic on issues identified under this subdivision, and in
accordance with United States Code, title 42, section 1396a(bb), no supplemental payments
for managed care plan or county-based purchasing plan claims for services provided prior
to January 1, 2015, shall be made after June 30, 2017. If the commissioner and clinics are
unable to resolve issues under this subdivision, the parties shall submit the dispute to the
arbitration process under section 14.57.

deleted text begin (k) The commissionerdeleted text end deleted text begin shall deleted text end deleted text begin seekdeleted text end deleted text begin a deleted text end deleted text begin federal deleted text end deleted text begin waiver, authorized under section 1115 of the
Social Security Act, to obtain federal financial deleted text end deleted text begin participation at the 100 percent federal
matching percentage available to facilities of the deleted text end deleted text begin Indian Health Service or tribal organization
in accordance with section 1905(b) of the Social deleted text end deleted text begin Security Act for expenditures made to
organizations dually certified under Title V of the deleted text end deleted text begin Indian Health Care Improvement Act,
Public Law 94-437, and as a federally qualified health deleted text end deleted text begin center under paragraph (a) that
deleted text end

deleted text begin provides services to American Indian and deleted text end deleted text begin Alaskandeleted text end deleted text begin Native individuals eligible deleted text end deleted text begin for services
under this subdivisiondeleted text end deleted text begin .
deleted text end

new text begin (k) The commissioner shall establish an encounter payment rate that is equivalent to the
all inclusive rate (AIR) payment established by the Indian Health Service and published in
the Federal Register. The encounter rate must be updated annually and must reflect the
changes in the AIR established by the Indian Health Service each calendar year. FQHCs
that are also urban Indian organizations under Title V of the federal Indian Health
Improvement Act may elect to be paid: (1) at the encounter rate established under this
paragraph; (2) under the alternative payment methodology described in paragraph (l); or
(3) under the federally required prospective payment system described in paragraph (f).
FQHCs that elect to be paid at the encounter rate established under this paragraph must
continue to meet all state and federal requirements related to FQHCs and urban Indian
organizations, and must maintain their statuses as FQHCs and urban Indian organizations.
new text end

(l) All claims for payment of clinic services provided by FQHCs and rural health clinics,
that have elected to be paid under this paragraph, shall be paid by the commissioner according
to the following requirements:

(1) the commissioner shall establish a single medical and single dental organization
encounter rate for each FQHC and rural health clinic when applicable;

(2) each FQHC and rural health clinic is eligible for same day reimbursement of one
medical and one dental organization encounter rate if eligible medical and dental visits are
provided on the same day;

(3) the commissioner shall reimburse FQHCs and rural health clinics, in accordance
with current applicable Medicare cost principles, their allowable costs, including direct
patient care costs and patient-related support services. Nonallowable costs include, but are
not limited to:

(i) general social services and administrative costs;

(ii) retail pharmacy;

(iii) patient incentives, food, housing assistance, and utility assistance;

(iv) external lab and x-ray;

(v) navigation services;

(vi) health care taxes;

(vii) advertising, public relations, and marketing;

(viii) office entertainment costs, food, alcohol, and gifts;

(ix) contributions and donations;

(x) bad debts or losses on awards or contracts;

(xi) fines, penalties, damages, or other settlements;

(xii) fundraising, investment management, and associated administrative costs;

(xiii) research and associated administrative costs;

(xiv) nonpaid workers;

(xv) lobbying;

(xvi) scholarships and student aid; and

(xvii) nonmedical assistance covered services;

(4) the commissioner shall review the list of nonallowable costs in the years between
the rebasing process established in clause (5), in consultation with the Minnesota Association
of Community Health Centers, FQHCs, and rural health clinics. The commissioner shall
publish the list and any updates in the Minnesota health care programs provider manual;

(5) the initial applicable base year organization encounter rates for FQHCs and rural
health clinics shall be computed for services delivered on or after January 1, 2021, and:

(i) must be determined using each FQHC's and rural health clinic's Medicare cost reports
from 2017 and 2018;

(ii) must be according to current applicable Medicare cost principles as applicable to
FQHCs and rural health clinics without the application of productivity screens and upper
payment limits or the Medicare prospective payment system FQHC aggregate mean upper
payment limit;

(iii) must be subsequently rebased every two years thereafter using the Medicare cost
reports that are three and four years prior to the rebasing year. Years in which organizational
cost or claims volume is reduced or altered due to a pandemic, disease, or other public health
emergency shall not be used as part of a base year when the base year includes more than
one year. The commissioner may use the Medicare cost reports of a year unaffected by a
pandemic, disease, or other public health emergency, or previous two consecutive years,
inflated to the base year as established under item (iv);

(iv) must be inflated to the base year using the inflation factor described in clause (6);
and

(v) the commissioner must provide for a 60-day appeals process under section 14.57;

(6) the commissioner shall annually inflate the applicable organization encounter rates
for FQHCs and rural health clinics from the base year payment rate to the effective date by
using the CMS FQHC Market Basket inflator established under United States Code, title
42, section 1395m(o), less productivity;

(7) FQHCs and rural health clinics that have elected the alternative payment methodology
under this paragraph shall submit all necessary documentation required by the commissioner
to compute the rebased organization encounter rates no later than six months following the
date the applicable Medicare cost reports are due to the Centers for Medicare and Medicaid
Services;

(8) the commissioner shall reimburse FQHCs and rural health clinics an additional
amount relative to their medical and dental organization encounter rates that is attributable
to the tax required to be paid according to section 295.52, if applicable;

(9) FQHCs and rural health clinics may submit change of scope requests to the
commissioner if the change of scope would result in an increase or decrease of 2.5 percent
or higher in the medical or dental organization encounter rate currently received by the
FQHC or rural health clinic;

(10) for FQHCs and rural health clinics seeking a change in scope with the commissioner
under clause (9) that requires the approval of the scope change by the federal Health
Resources Services Administration:

(i) FQHCs and rural health clinics shall submit the change of scope request, including
the start date of services, to the commissioner within seven business days of submission of
the scope change to the federal Health Resources Services Administration;

(ii) the commissioner shall establish the effective date of the payment change as the
federal Health Resources Services Administration date of approval of the FQHC's or rural
health clinic's scope change request, or the effective start date of services, whichever is
later; and

(iii) within 45 days of one year after the effective date established in item (ii), the
commissioner shall conduct a retroactive review to determine if the actual costs established
under clause (3) or encounters result in an increase or decrease of 2.5 percent or higher in
the medical or dental organization encounter rate, and if this is the case, the commissioner
shall revise the rate accordingly and shall adjust payments retrospectively to the effective
date established in item (ii);

(11) for change of scope requests that do not require federal Health Resources Services
Administration approval, the FQHC and rural health clinic shall submit the request to the
commissioner before implementing the change, and the effective date of the change is the
date the commissioner received the FQHC's or rural health clinic's request, or the effective
start date of the service, whichever is later. The commissioner shall provide a response to
the FQHC's or rural health clinic's request within 45 days of submission and provide a final
approval within 120 days of submission. This timeline may be waived at the mutual
agreement of the commissioner and the FQHC or rural health clinic if more information is
needed to evaluate the request;

(12) the commissioner, when establishing organization encounter rates for new FQHCs
and rural health clinics, shall consider the patient caseload of existing FQHCs and rural
health clinics in a 60-mile radius for organizations established outside of the seven-county
metropolitan area, and in a 30-mile radius for organizations in the seven-county metropolitan
area. If this information is not available, the commissioner may use Medicare cost reports
or audited financial statements to establish base rates;

(13) the commissioner shall establish a quality measures workgroup that includes
representatives from the Minnesota Association of Community Health Centers, FQHCs,
and rural health clinics, to evaluate clinical and nonclinical measures; and

(14) the commissioner shall not disallow or reduce costs that are related to an FQHC's
or rural health clinic's participation in health care educational programs to the extent that
the costs are not accounted for in the alternative payment methodology encounter rate
established in this paragraph.

new text begin (m) Effective July 1, 2023, an enrolled Indian health service facility or a Tribal health
center operating under a 638 contract or compact may elect to also enroll as a Tribal FQHC.
Requirements that otherwise apply to an FQHC covered in this subdivision do not apply to
a Tribal FQHC enrolled under this paragraph, except that any requirements necessary to
comply with federal regulations do apply to a Tribal FQHC. The commissioner shall establish
an alternative payment method for a Tribal FQHC enrolled under this paragraph that uses
the same method and rates applicable to a Tribal facility or health center that does not enroll
as a Tribal FQHC.
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 (m) 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. 21.

Minnesota Statutes 2022, section 256B.0625, subdivision 31, is amended to read:

Subd. 31.

Medical supplies and equipment.

(a) Medical assistance covers medical
supplies and equipment. Separate payment outside of the facility's payment rate shall be
made for wheelchairs and wheelchair accessories for recipients who are residents of
intermediate care facilities for the developmentally disabled. Reimbursement for wheelchairs
and wheelchair accessories for ICF/DD recipients shall be subject to the same conditions
and limitations as coverage for recipients who do not reside in institutions. A wheelchair
purchased outside of the facility's payment rate is the property of the recipient.

(b) Vendors of durable medical equipment, prosthetics, orthotics, or medical supplies
must enroll as a Medicare provider.

(c) When necessary to ensure access to durable medical equipment, prosthetics, orthotics,
or medical supplies, the commissioner may exempt a vendor from the Medicare enrollment
requirement if:

(1) the vendor supplies only one type of durable medical equipment, prosthetic, orthotic,
or medical supply;

(2) the vendor serves ten or fewer medical assistance recipients per year;

(3) the commissioner finds that other vendors are not available to provide same or similar
durable medical equipment, prosthetics, orthotics, or medical supplies; and

(4) the vendor complies with all screening requirements in this chapter and Code of
Federal Regulations, title 42, part 455. The commissioner may also exempt a vendor from
the Medicare enrollment requirement if the vendor is accredited by a Centers for Medicare
and Medicaid Services approved national accreditation organization as complying with the
Medicare program's supplier and quality standards and the vendor serves primarily pediatric
patients.

(d) Durable medical equipment means a device or equipment that:

(1) can withstand repeated use;

(2) is generally not useful in the absence of an illness, injury, or disability; and

(3) is provided to correct or accommodate a physiological disorder or physical condition
or is generally used primarily for a medical purpose.

(e) Electronic tablets may be considered durable medical equipment if the electronic
tablet will be used as an augmentative and alternative communication system as defined
under subdivision 31a, paragraph (a). To be covered by medical assistance, the device must
be locked in order to prevent use not related to communication.

(f) Notwithstanding the requirement in paragraph (e) that an electronic tablet must be
locked to prevent use not as an augmentative communication device, a recipient of waiver
services may use an electronic tablet for a use not related to communication when the
recipient has been authorized under the waiver to receive one or more additional applications
that can be loaded onto the electronic tablet, such that allowing the additional use prevents
the purchase of a separate electronic tablet with waiver funds.

(g) An order or prescription for medical supplies, equipment, or appliances must meet
the requirements in Code of Federal Regulations, title 42, part 440.70.

(h) Allergen-reducing products provided according to subdivision 67, paragraph (c) or
(d), shall be considered durable medical equipment.

new text begin (i) Seizure detection devices are covered as durable medical equipment under this
subdivision if:
new text end

new text begin (1) the seizure detection device is medically appropriate based on the recipient's medical
condition or status; and
new text end

new text begin (2) the recipient's health care provider has identified that a seizure detection device
would:
new text end

new text begin (i) likely assist in reducing bodily harm to or death of the recipient as a result of the
recipient experiencing a seizure; or
new text end

new text begin (ii) provide data to the health care provider necessary to appropriately diagnose or treat
a health condition of the recipient that causes the seizure activity.
new text end

new text begin (j) For purposes of paragraph (i), "seizure detection device" means a United States Food
and Drug Administration-approved monitoring device and related service or subscription
supporting the prescribed use of the device, including technology that provides ongoing
patient monitoring and alert services that detect seizure activity and transmit notification
of the seizure activity to a caregiver for appropriate medical response or collects data of the
seizure activity of the recipient that can be used by a health care provider to diagnose or
appropriately treat a health care condition that causes the seizure activity. The medical
assistance reimbursement rate for a subscription supporting the prescribed use of a seizure
detection device is 60 percent of the rate for monthly remote monitoring under the medical
assistance telemonitoring benefit.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 22.

Minnesota Statutes 2022, section 256B.0625, subdivision 34, is amended to read:

Subd. 34.

Indian health services facilities.

deleted text begin (a)deleted text end Medical assistance payments and
MinnesotaCare payments to facilities of the Indian health service and facilities operated by
a Tribe or Tribal organization under funding authorized by United States Code, title 25,
sections 450f to 450n, or title III of the Indian Self-Determination and Education Assistance
Act, Public Law 93-638, for enrollees who are eligible for federal financial participation,
shall be at the option of the facility in accordance with the rate published by the United
States Assistant Secretary for Health under the authority of United States Code, title 42,
sections 248(a) and 249(b). MinnesotaCare payments for enrollees who are not eligible for
federal financial participation at facilities of the Indian health service and facilities operated
by a Tribe or Tribal organization for the provision of outpatient medical services must be
in accordance with the medical assistance rates paid for the same services when provided
in a facility other than a facility of the Indian health service or a facility operated by a Tribe
or Tribal organization.

deleted text begin (b) Effective upon federal approvaldeleted text end deleted text begin , the medical assistance payments to a dually certified
facility deleted text end deleted text begin as defined in subdivision 30, paragraph deleted text end deleted text begin (j)deleted text end deleted text begin , shall be the encounter rate described in
deleted text end deleted text begin paragraph (a) or a rate that is substantially equivalent for services provided to American
deleted text end deleted text begin Indians and deleted text end deleted text begin Alaskandeleted text end deleted text begin Native populationsdeleted text end deleted text begin . The rate established under this paragraph for dually
certified facilities deleted text end deleted text begin shall not apply to MinnesotaCare payments.
deleted 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. 23.

Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 68.new text end

new text begin Tobacco and nicotine cessation.new text end

new text begin (a) Medical assistance covers tobacco and
nicotine cessation services, drugs to treat tobacco and nicotine addiction or dependence,
and drugs to help individuals discontinue use of tobacco and nicotine products. Medical
assistance must cover services and drugs as provided in this subdivision consistent with
evidence-based or evidence-informed best practices.
new text end

new text begin (b) Medical assistance must cover in-person individual and group tobacco and nicotine
cessation education and counseling services if provided by a health care practitioner whose
scope of practice encompasses tobacco and nicotine cessation education and counseling.
Service providers include but are not limited to the following:
new text end

new text begin (1) mental health practitioners under section 245.462, subdivision 17;
new text end

new text begin (2) mental health professionals under section 245.462, subdivision 18;
new text end

new text begin (3) mental health certified peer specialists under section 256B.0615;
new text end

new text begin (4) alcohol and drug counselors licensed under chapter 148F;
new text end

new text begin (5) recovery peers as defined in section 245F.02, subdivision 21;
new text end

new text begin (6) certified tobacco treatment specialists;
new text end

new text begin (7) community health workers;
new text end

new text begin (8) physicians;
new text end

new text begin (9) physician assistants;
new text end

new text begin (10) advanced practice registered nurses; or
new text end

new text begin (11) other licensed or nonlicensed professionals or paraprofessionals with training in
providing tobacco and nicotine cessation education and counseling services.
new text end

new text begin (c) Medical assistance covers telephone cessation counseling services provided through
a quitline. Notwithstanding section 256B.0625, subdivision 3b, quitline services may be
provided through audio-only communications. The commissioner of human services may
utilize volume purchasing for quitline services consistent with section 256B.04, subdivision
14.
new text end

new text begin (d) Medical assistance must cover all prescription and over-the-counter pharmacotherapy
drugs approved by the United States Food and Drug Administration for cessation of tobacco
and nicotine use or treatment of tobacco and nicotine dependence, and that are subject to a
Medicaid drug rebate agreement.
new text end

new text begin (e) Services covered under this subdivision may be provided by telemedicine.
new text end

new text begin (f) The commissioner must not:
new text end

new text begin (1) restrict or limit the type, duration, or frequency of tobacco and nicotine cessation
services;
new text end

new text begin (2) prohibit the simultaneous use of multiple cessation services, including but not limited
to simultaneous use of counseling and drugs;
new text end

new text begin (3) require counseling before receiving drugs or as a condition of receiving drugs;
new text end

new text begin (4) limit pharmacotherapy drug dosage amounts for a dosing regimen for treatment of
a medically accepted indication as defined in United States Code, title 14, section
1396r-8(K)(6); limit dosing frequency; or impose duration limits;
new text end

new text begin (5) prohibit simultaneous use of multiple drugs, including prescription and
over-the-counter drugs;
new text end

new text begin (6) require or authorize step therapy; or
new text end

new text begin (7) require or utilize prior authorization for any tobacco and nicotine cessation services
and drugs covered under this subdivision.
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. 24.

Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 69.new text end

new text begin Biomarker testing.new text end

new text begin Medical assistance covers biomarker testing to diagnose,
treat, manage, and monitor illness or disease. Medical assistance coverage must meet the
requirements that would otherwise apply to a health plan under section 62Q.473.
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. 25.

Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 70.new text end

new text begin Recuperative care services.new text end

new text begin Medical assistance covers recuperative care
services according to section 256B.0701.
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. 26.

Minnesota Statutes 2022, section 256B.0625, is amended by adding a subdivision
to read:

new text begin Subd. 71.new text end

new text begin Coverage of services for the diagnosis, monitoring, and treatment of rare
diseases.new text end

new text begin (a) Medical assistance covers services related to the diagnosis, monitoring, and
treatment of a rare disease or condition. Medical assistance coverage for these services must
meet the requirements in section 62Q.451, subdivisions 1 to 3 and 6. Providers must still
meet all applicable program requirements.
new text end

new text begin (b) Coverage for a service must not be denied solely on the basis that it was provided
by, referred for, or ordered by an out-of-network provider.
new text end

new text begin (c) Any prior authorization requirements for a service that is provided by, referred for,
or ordered by an out-of-network provider must be the same as any prior authorization
requirements for a service that is provided by, referred for, or ordered by an in-network
provider.
new text end

new text begin (d) Nothing in this subdivision requires medical assistance to cover additional services.
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. 27.

new text begin [256B.0701] RECUPERATIVE CARE SERVICES.
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.
new text end

new text begin (b) "Provider" means a recuperative care provider as defined by the standards established
by the National Institute for Medical Respite Care.
new text end

new text begin (c) "Recuperative care" means a model of care that prevents hospitalization or that
provides postacute medical care and support services for recipients experiencing
homelessness who are too ill or frail to recover from a physical illness or injury while living
in a shelter or are otherwise unhoused but who are not sick enough to be hospitalized or
remain hospitalized, or to need other levels of care.
new text end

new text begin Subd. 2.new text end

new text begin Recuperative care settings.new text end

new text begin Recuperative care may be provided in any setting,
including but not limited to homeless shelters, congregate care settings, single room
occupancy settings, or supportive housing, so long as the provider of recuperative care or
provider of housing is able to provide to the recipient within the designated setting, at a
minimum:
new text end

new text begin (1) 24-hour access to a bed and bathroom;
new text end

new text begin (2) access to three meals a day;
new text end

new text begin (3) availability to environmental services;
new text end

new text begin (4) access to a telephone;
new text end

new text begin (5) a secure place to store belongings; and
new text end

new text begin (6) staff available within the setting to provide a wellness check as needed, but at a
minimum, at least once every 24 hours.
new text end

new text begin Subd. 3.new text end

new text begin Eligibility.new text end

new text begin To be eligible for recuperative care service, a recipient must:
new text end

new text begin (1) not be a child;
new text end

new text begin (2) be experiencing homelessness;
new text end

new text begin (3) be in need of short-term acute medical care for a period of no more than 60 days;
new text end

new text begin (4) meet clinical criteria, as established by the commissioner, that indicates that the
recipient needs recuperative care; and
new text end

new text begin (5) not have behavioral health needs that are greater than what can be managed by the
provider within the setting.
new text end

new text begin Subd. 4.new text end

new text begin Total payment rates.new text end

new text begin Total payment rates for recuperative care consist of the
recuperative care services rate and the recuperative care facility rate.
new text end

new text begin Subd. 5.new text end

new text begin Recuperative care services rate.new text end

new text begin The recuperative care services rate is for the
services provided to the recipient and must be a bundled daily per diem payment of at least
$300 per day. Services provided within the bundled payment may include but are not limited
to:
new text end

new text begin (1) basic nursing care, including:
new text end

new text begin (i) monitoring a patient's physical health and pain level;
new text end

new text begin (ii) providing wound care;
new text end

new text begin (iii) medication support;
new text end

new text begin (iv) patient education;
new text end

new text begin (v) immunization review and update; and
new text end

new text begin (vi) establishing clinical goals for the recuperative care period and discharge plan;
new text end

new text begin (2) care coordination, including:
new text end

new text begin (i) initial assessment of medical, behavioral, and social needs;
new text end

new text begin (ii) development of a care plan;
new text end

new text begin (iii) support and referral assistance for legal services, housing, community social services,
case management, health care benefits, health and other eligible benefits, and transportation
needs and services; and
new text end

new text begin (iv) monitoring and follow-up to ensure that the care plan is effectively implemented to
address the medical, behavioral, and social needs;
new text end

new text begin (3) basic behavioral needs, including counseling and peer support, that can be provided
in the recuperative care setting; and
new text end

new text begin (4) services provided by a community health worker as defined under section 256B.0625,
subdivision 49.
new text end

new text begin Subd. 6.new text end

new text begin Recuperative care facility rate.new text end

new text begin (a) The recuperative care facility rate is for
facility costs and must be paid from state money in an amount equal to the medical assistance
room and board rate at the time the recuperative care services were provided. The eligibility
standards in chapter 256I do not apply to the recuperative care facility rate. The recuperative
care facility rate is only paid when the recuperative care services rate is paid to a provider.
Providers may opt to only receive the recuperative care services rate.
new text end

new text begin (b) Before a recipient is discharged from a recuperative care setting, the provider must
ensure that the recipient's medical condition is stabilized or that the recipient is being
discharged to a setting that is able to meet that recipient's needs.
new text end

new text begin Subd. 7.new text end

new text begin Extended stay.new text end

new text begin If a recipient requires care exceeding the 60-day limit described
in subdivision 3, the provider may request in a format prescribed by the commissioner an
extension to continue payments until the recipient is discharged.
new text end

new text begin Subd. 8.new text end

new text begin Report.new text end

new text begin (a) The commissioner must submit an initial report on coverage of
recuperative care services to the chairs and ranking minority members of the legislative
committees having jurisdiction over health and human services finance and policy by
February 1, 2025, and a final report by February 1, 2027. The reports must include but are
not limited to:
new text end

new text begin (1) a list of the recuperative care services in Minnesota and the number of recipients;
new text end

new text begin (2) the estimated return on investment, including health care savings due to reduced
hospitalizations;
new text end

new text begin (3) follow-up information, if available, on whether recipients' hospital visits decreased
since recuperative care services were provided compared to before the services were
provided; and
new text end

new text begin (4) any other information that can be used to determine the effectiveness of the program
and its funding, including recommendations for improvements to the program.
new text end

new text begin (b) This subdivision expires upon submission of the final report.
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. 28.

Minnesota Statutes 2022, section 256B.0941, subdivision 3, is amended to read:

Subd. 3.

Per diem rate.

(a) The commissioner must establish one per diem rate per
provider for psychiatric residential treatment facility services for individuals 21 years of
age or younger. The rate for a provider must not exceed the rate charged by that provider
for the same service to other payers. Payment must not be made to more than one entity for
each individual for services provided under this section on a given day. The commissioner
must set rates prospectively for the annual rate period. The commissioner must require
providers to submit annual cost reports on a uniform cost reporting form and must use
submitted cost reports to inform the rate-setting process. The cost reporting must be done
according to federal requirements for Medicare cost reports.

(b) The following are included in the rate:

(1) costs necessary for licensure and accreditation, meeting all staffing standards for
participation, meeting all service standards for participation, meeting all requirements for
active treatment, maintaining medical records, conducting utilization review, meeting
inspection of care, and discharge planning. The direct services costs must be determined
using the actual cost of salaries, benefits, payroll taxes, and training of direct services staff
and service-related transportation; and

(2) payment for room and board provided by facilities meeting all accreditation and
licensing requirements for participation.

(c) A facility may submit a claim for payment outside of the per diem for professional
services arranged by and provided at the facility by an appropriately licensed professional
who is enrolled as a provider with Minnesota health care programs. Arranged services may
be billed by either the facility or the licensed professional. These services must be included
in the individual plan of care and are subject to prior authorization.

(d) Medicaid must reimburse for concurrent services as approved by the commissioner
to support continuity of care and successful discharge from the facility. "Concurrent services"
means services provided by another entity or provider while the individual is admitted to a
psychiatric residential treatment facility. Payment for concurrent services may be limited
and these services are subject to prior authorization by the state's medical review agent.
Concurrent services may include targeted case management, assertive community treatment,
clinical care consultation, team consultation, and treatment planning.

(e) Payment rates under this subdivision must not include the costs of providing the
following services:

(1) educational services;

(2) acute medical care or specialty services for other medical conditions;

(3) dental services; and

(4) pharmacy drug costs.

(f) For purposes of this section, "actual cost" means costs that are allowable, allocable,
reasonable, and consistent with federal reimbursement requirements in Code of Federal
Regulations, title 48, chapter 1, part 31, relating to for-profit entities, and the Office of
Management and Budget Circular Number A-122, relating to nonprofit entities.

new text begin (g) The commissioner shall annually adjust psychiatric residential treatment facility
services per diem rates to reflect the change in the Centers for Medicare and Medicaid
Services Inpatient Psychiatric Facility Market Basket. The commissioner shall use the
indices as forecasted for the midpoint of the prior rate year to the midpoint of the current
rate year.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 29.

Minnesota Statutes 2022, section 256B.0947, subdivision 7, is amended to read:

Subd. 7.

Medical assistance payment and rate setting.

(a) Payment for services in this
section must be based on one daily encounter rate per provider inclusive of the following
services received by an eligible client in a given calendar day: all rehabilitative services,
supports, and ancillary activities under this section, staff travel time to provide rehabilitative
services under this section, and crisis response services under section 256B.0624.

(b) Payment must not be made to more than one entity for each client for services
provided under this section on a given day. If services under this section are provided by a
team that includes staff from more than one entity, the team shall determine how to distribute
the payment among the members.

(c) The commissioner shall establish regional cost-based rates for entities that will bill
medical assistance for nonresidential intensive rehabilitative mental health services. In
developing these rates, the commissioner shall consider:

(1) the cost for similar services in the health care trade area;

(2) actual costs incurred by entities providing the services;

(3) the intensity and frequency of services to be provided to each client;

(4) the degree to which clients will receive services other than services under this section;
and

(5) the costs of other services that will be separately reimbursed.

(d) The rate for a provider must not exceed the rate charged by that provider for the
same service to other payers.

new text begin (e) Effective for the rate years beginning on and after January 1, 2024, rates must be
annually adjusted for inflation using the Centers for Medicare and Medicaid Services
Medicare Economic Index, as forecasted in the fourth quarter of the calendar year before
the rate year. The inflation adjustment must be based on the 12-month period from the
midpoint of the previous rate year to the midpoint of the rate year for which the rate is being
determined.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 30.

Minnesota Statutes 2022, section 256B.69, subdivision 5a, is amended to read:

Subd. 5a.

Managed care contracts.

(a) Managed care contracts under this section and
section 256L.12 shall be entered into or renewed on a calendar year basis. The commissioner
may issue separate contracts with requirements specific to services to medical assistance
recipients age 65 and older.

(b) A prepaid health plan providing covered health services for eligible persons pursuant
to chapters 256B and 256L is responsible for complying with the terms of its contract with
the commissioner. Requirements applicable to managed care programs under chapters 256B
and 256L established after the effective date of a contract with the commissioner take effect
when the contract is next issued or renewed.

(c) The commissioner shall withhold five percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program pending completion of performance targets. Each
performance target must be quantifiable, objective, measurable, and reasonably attainable,
except in the case of a performance target based on a federal or state law or rule. Criteria
for assessment of each performance target must be outlined in writing prior to the contract
effective date. Clinical or utilization performance targets and their related criteria must
consider evidence-based research and reasonable interventions when available or applicable
to the populations served, and must be developed with input from external clinical experts
and stakeholders, including managed care plans, county-based purchasing plans, and
providers. The managed care or county-based purchasing plan must demonstrate, to the
commissioner's satisfaction, that the data submitted regarding attainment of the performance
target is accurate. The commissioner shall periodically change the administrative measures
used as performance targets in order to improve plan performance across a broader range
of administrative services. The performance targets must include measurement of plan
efforts to contain spending on health care services and administrative activities. The
commissioner may adopt plan-specific performance targets that take into account factors
affecting only one plan, including characteristics of the plan's enrollee population. The
withheld funds must be returned no sooner than July of the following year if performance
targets in the contract are achieved. The commissioner may exclude special demonstration
projects under subdivision 23.

(d) The commissioner shall require that managed care plans:

(1) use the assessment and authorization processes, forms, timelines, standards,
documentation, and data reporting requirements, protocols, billing processes, and policies
consistent with medical assistance fee-for-service or the Department of Human Services
contract requirements for all personal care assistance services under section 256B.0659 and
community first services and supports under section 256B.85; and

(2) by January 30 of each year that follows a rate increase for any aspect of services
under section 256B.0659 or 256B.85, inform the commissioner and the chairs and ranking
minority members of the legislative committees with jurisdiction over rates determined
under section 256B.851 of the amount of the rate increase that is paid to each personal care
assistance provider agency with which the plan has a contract.

deleted text begin (e) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the health
plan's emergency department utilization rate for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. For 2012, the reduction shall be based on
the health plan's utilization in 2009. To earn the return of the withhold each subsequent
year, the managed care plan or county-based purchasing plan must achieve a qualifying
reduction of no less than ten percent of the plan's emergency department utilization rate for
medical assistance and MinnesotaCare enrollees, excluding enrollees in programs described
in subdivisions 23 and 28, compared to the previous measurement year until the final
performance target is reached. When measuring performance, the commissioner must
consider the difference in health risk in a managed care or county-based purchasing plan's
membership in the baseline year compared to the measurement year, and work with the
managed care or county-based purchasing plan to account for differences that they agree
are significant.
deleted text end

deleted text begin The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a reduction in the utilization rate
was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
deleted text end

deleted text begin The withhold described in this paragraph shall continue for each consecutive contract
period until the plan's emergency room utilization rate for state health care program enrollees
is reduced by 25 percent of the plan's emergency room utilization rate for medical assistance
and MinnesotaCare enrollees for calendar year 2009. Hospitals shall cooperate with the
health plans in meeting this performance target and shall accept payment withholds that
may be returned to the hospitals if the performance target is achieved.
deleted text end

deleted text begin (f) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rate for medical assistance and MinnesotaCare enrollees, as
determined by the commissioner. To earn the return of the withhold each year, the managed
care plan or county-based purchasing plan must achieve a qualifying reduction of no less
than five percent of the plan's hospital admission rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, compared to the previous calendar year until the final performance target is reached.
When measuring performance, the commissioner must consider the difference in health risk
in a managed care or county-based purchasing plan's membership in the baseline year
compared to the measurement year, and work with the managed care or county-based
purchasing plan to account for differences that they agree are significant.
deleted text end

deleted text begin The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that this reduction in the hospitalization
rate was achieved. The commissioner shall structure the withhold so that the commissioner
returns a portion of the withheld funds in amounts commensurate with achieved reductions
in utilization less than the targeted amount.
deleted text end

deleted text begin The withhold described in this paragraph shall continue until there is a 25 percent
reduction in the hospital admission rate compared to the hospital admission rates in calendar
year 2011, as determined by the commissioner. The hospital admissions in this performance
target do not include the admissions applicable to the subsequent hospital admission
performance target under paragraph (g). Hospitals shall cooperate with the plans in meeting
this performance target and shall accept payment withholds that may be returned to the
hospitals if the performance target is achieved.
deleted text end

deleted text begin (g) Effective for services rendered on or after January 1, 2012, the commissioner shall
include as part of the performance targets described in paragraph (c) a reduction in the plan's
hospitalization admission rates for subsequent hospitalizations within 30 days of a previous
hospitalization of a patient regardless of the reason, for medical assistance and MinnesotaCare
enrollees, as determined by the commissioner. To earn the return of the withhold each year,
the managed care plan or county-based purchasing plan must achieve a qualifying reduction
of the subsequent hospitalization rate for medical assistance and MinnesotaCare enrollees,
excluding enrollees in programs described in subdivisions 23 and 28, of no less than five
percent compared to the previous calendar year until the final performance target is reached.
deleted text end

deleted text begin The withheld funds must be returned no sooner than July 1 and no later than July 31 of
the following calendar year if the managed care plan or county-based purchasing plan
demonstrates to the satisfaction of the commissioner that a qualifying reduction in the
subsequent hospitalization rate was achieved. The commissioner shall structure the withhold
so that the commissioner returns a portion of the withheld funds in amounts commensurate
with achieved reductions in utilization less than the targeted amount.
deleted text end

deleted text begin The withhold described in this paragraph must continue for each consecutive contract
period until the plan's subsequent hospitalization rate for medical assistance and
MinnesotaCare enrollees, excluding enrollees in programs described in subdivisions 23 and
28, is reduced by 25 percent of the plan's subsequent hospitalization rate for calendar year
2011. Hospitals shall cooperate with the plans in meeting this performance target and shall
accept payment withholds that must be returned to the hospitals if the performance target
is achieved.
deleted text end

deleted text begin (h)deleted text end new text begin (e)new text end Effective for services rendered on or after January 1, 2013, through December
31, 2013, the commissioner shall withhold 4.5 percent of managed care plan payments under
this section and county-based purchasing plan payments under section 256B.692 for the
prepaid medical assistance program. The withheld funds must be returned no sooner than
July 1 and no later than July 31 of the following year. The commissioner may exclude
special demonstration projects under subdivision 23.

deleted text begin (i)deleted text end new text begin (f) new text end Effective for services rendered on or after January 1, 2014, the commissioner shall
withhold three percent of managed care plan payments under this section and county-based
purchasing plan payments under section 256B.692 for the prepaid medical assistance
program. The withheld funds must be returned no sooner than July 1 and no later than July
31 of the following year. The commissioner may exclude special demonstration projects
under subdivision 23.

deleted text begin (j)deleted text end new text begin (g)new text end A managed care plan or a county-based purchasing plan under section 256B.692
may include as admitted assets under section 62D.044 any amount withheld under this
section that is reasonably expected to be returned.

deleted text begin (k)deleted text end new text begin (h)new text end Contracts between the commissioner and a prepaid health plan are exempt from
the set-aside and preference provisions of section 16C.16, subdivisions 6, paragraph (a),
and 7.

deleted text begin (l)deleted text end new text begin (i)new text end The return of the withhold under paragraphs (h) and (i) is not subject to the
requirements of paragraph (c).

deleted text begin (m)deleted text end new text begin (j)new text end Managed care plans and county-based purchasing plans shall maintain current
and fully executed agreements for all subcontractors, including bargaining groups, for
administrative services that are expensed to the state's public health care programs.
Subcontractor agreements determined to be material, as defined by the commissioner after
taking into account state contracting and relevant statutory requirements, must be in the
form of a written instrument or electronic document containing the elements of offer,
acceptance, consideration, payment terms, scope, duration of the contract, and how the
subcontractor services relate to state public health care programs. Upon request, the
commissioner shall have access to all subcontractor documentation under this paragraph.
Nothing in this paragraph shall allow release of information that is nonpublic data pursuant
to section 13.02.

new text begin EFFECTIVE DATE.new text end

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

Sec. 31.

Minnesota Statutes 2022, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 19a.new text end

new text begin Limitation on reimbursement; rare disease services provided in Minnesota
by out-of-network providers.new text end

new text begin (a) If a managed care or county-based purchasing plan has
an established contractual payment under medical assistance with an out-of-network provider
for a service provided in Minnesota related to the diagnosis, monitoring, and treatment of
a rare disease or condition, the provider must accept the established contractual payment
for that service as payment in full.
new text end

new text begin (b) If a plan does not have an established contractual payment under medical assistance
with an out-of-network provider for a service provided in Minnesota related to the diagnosis,
monitoring, and treatment of a rare disease or condition, the provider must accept the
provider's established rate for uninsured patients for that service as payment in full. If the
provider does not have an established rate for uninsured patients for that service, the provider
must accept the fee-for-service rate.
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. 32.

Minnesota Statutes 2022, section 256B.69, is amended by adding a subdivision
to read:

new text begin Subd. 19b.new text end

new text begin Limitation on reimbursement; rare disease services provided outside of
Minnesota by an out-of-network provider.new text end

new text begin (a) If a managed care or county-based
purchasing plan has an established contractual payment under medical assistance with an
out-of-network provider for a service provided in another state related to diagnosis,
monitoring, and treatment of a rare disease or condition, the plan must pay the established
contractual payment for that service.
new text end

new text begin (b) If a plan does not have an established contractual payment under medical assistance
with an out-of-network provider for a service provided in another state related to diagnosis,
monitoring, and treatment of a rare disease or condition, the plan must pay the provider's
established rate for uninsured patients for that service. If the provider does not have an
established rate for uninsured patients for that service, the plan must pay the provider the
fee-for-service rate in that state.
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. 33.

Minnesota Statutes 2022, section 256B.758, is amended to read:

256B.758 REIMBURSEMENT FOR DOULA SERVICES.

new text begin (a) new text end Effective for services provided on or after July 1, 2019new text begin , through December 31, 2023new text end ,
payments for doula services provided by a certified doula shall be $47 per prenatal or
postpartum visit and $488 for attending and providing doula services at a birth.

new text begin (b) Effective for services provided on or after January 1, 2024, payments for doula
services provided by a certified doula are $100 per prenatal or postpartum visit and $1,400
for attending and providing doula services at birth.
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. 34.

Minnesota Statutes 2022, section 256B.76, subdivision 1, as amended by Laws
2023, chapter 25, section 145, is amended to read:

Subdivision 1.

Physician new text begin and professional services new text end reimbursement.

(a) Effective for
services rendered on or after October 1, 1992, the commissioner shall make payments for
physician services as follows:

(1) payment for level one Centers for Medicare and Medicaid Services' common
procedural coding system codes titled "office and other outpatient services," "preventive
medicine new and established patient," "delivery, antepartum, and postpartum care," "critical
care," cesarean delivery and pharmacologic management provided to psychiatric patients,
and level three codes for enhanced services for prenatal high risk, shall be paid at the lower
of (i) submitted charges, or (ii) 25 percent above the rate in effect on June 30, 1992;

(2) payments for all other services shall be paid at the lower of (i) submitted charges,
or (ii) 15.4 percent above the rate in effect on June 30, 1992; and

(3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
percentile of 1989, less the percent in aggregate necessary to equal the above increases
except that payment rates for home health agency services shall be the rates in effect on
September 30, 1992.

(b) Effective for services rendered on or after January 1, 2000, payment rates for physician
and professional services shall be increased by three percent over the rates in effect on
December 31, 1999, except for home health agency and family planning agency services.
The increases in this paragraph shall be implemented January 1, 2000, for managed care.

(c) Effective for services rendered on or after July 1, 2009, payment rates for physician
and professional services shall be reduced by five percent, except that for the period July
1, 2009, through June 30, 2010, payment rates shall be reduced by 6.5 percent for the medical
assistance and general assistance medical care programs, over the rates in effect on June
30, 2009. This reduction and the reductions in paragraph (d) do not apply to office or other
outpatient visits, preventive medicine visits and family planning visits billed by physicians,
advanced practice registered nurses, or physician assistants in a family planning agency or
in one of the following primary care practices: general practice, general internal medicine,
general pediatrics, general geriatrics, and family medicine. This reduction and the reductions
in paragraph (d) do not apply to federally qualified health centers, rural health centers, and
Indian health services. Effective October 1, 2009, payments made to managed care plans
and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall
reflect the payment reduction described in this paragraph.

(d) Effective for services rendered on or after July 1, 2010, payment rates for physician
and professional services shall be reduced an additional seven percent over the five percent
reduction in rates described in paragraph (c). This additional reduction does not apply to
physical therapy services, occupational therapy services, and speech pathology and related
services provided on or after July 1, 2010. This additional reduction does not apply to
physician services billed by a psychiatrist or an advanced practice registered nurse with a
specialty in mental health. Effective October 1, 2010, payments made to managed care plans
and county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall
reflect the payment reduction described in this paragraph.

(e) Effective for services rendered on or after September 1, 2011, through June 30, 2013,
payment rates for physician and professional services shall be reduced three percent from
the rates in effect on August 31, 2011. This reduction does not apply to physical therapy
services, occupational therapy services, and speech pathology and related services.

(f) Effective for services rendered on or after September 1, 2014, payment rates for
physician and professional services, including physical therapy, occupational therapy, speech
pathology, and mental health services shall be increased by five percent from the rates in
effect on August 31, 2014. In calculating this rate increase, the commissioner shall not
include in the base rate for August 31, 2014, the rate increase provided under section
256B.76, subdivision 7. This increase does not apply to federally qualified health centers,
rural health centers, and Indian health services. Payments made to managed care plans and
county-based purchasing plans shall not be adjusted to reflect payments under this paragraph.

(g) Effective for services rendered on or after July 1, 2015, payment rates for physical
therapy, occupational therapy, and speech pathology and related services provided by a
hospital meeting the criteria specified in section 62Q.19, subdivision 1, paragraph (a), clause
(4), shall be increased by 90 percent from the rates in effect on June 30, 2015. Payments
made to managed care plans and county-based purchasing plans shall not be adjusted to
reflect payments under this paragraph.

(h) Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

new text begin (i) The commissioner may reimburse physicians and other licensed professionals for
costs incurred to pay the fee for testing newborns who are medical assistance enrollees for
heritable and congenital disorders under section 144.125, subdivision 1, paragraph (c), when
the sample is collected outside of an inpatient hospital or freestanding birth center and the
cost is not recognized by another payment source.
new text end

Sec. 35.

Minnesota Statutes 2022, section 256B.761, is amended to read:

256B.761 REIMBURSEMENT FOR MENTAL HEALTH SERVICES.

(a) Effective for services rendered on or after July 1, 2001, payment for medication
management provided to psychiatric patients, outpatient mental health services, day treatment
services, home-based mental health services, and family community support services shall
be paid at the lower of (1) submitted charges, or (2) 75.6 percent of the 50th percentile of
1999 charges.

(b) Effective July 1, 2001, the medical assistance rates for outpatient mental health
services provided by an entity that operates: (1) a Medicare-certified comprehensive
outpatient rehabilitation facility; and (2) a facility that was certified prior to January 1, 1993,
with at least 33 percent of the clients receiving rehabilitation services in the most recent
calendar year who are medical assistance recipients, will be increased by 38 percent, when
those services are provided within the comprehensive outpatient rehabilitation facility and
provided to residents of nursing facilities owned by the entity.

(c) In addition to rate increases otherwise provided, the commissioner may restructure
coverage policy and rates to improve access to adult rehabilitative mental health services
under section 256B.0623 and related mental health support services under section 256B.021,
subdivision 4, paragraph (f), clause (2). For state fiscal years 2015 and 2016, the projected
state share of increased costs due to this paragraph is transferred from adult mental health
grants under sections 245.4661 and 256E.12. The transfer for fiscal year 2016 is a permanent
base adjustment for subsequent fiscal years. Payments made to managed care plans and
county-based purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect
the rate changes described in this paragraph.

(d) Any ratables effective before July 1, 2015, do not apply to early intensive
developmental and behavioral intervention (EIDBI) benefits described in section 256B.0949.

new text begin (e) Effective for services rendered on or after January 1, 2024, payment rates for
behavioral health services included in the rate analysis required by Laws 2021, First Special
Session chapter 7, article 17, section 18, except for adult day treatment services under section
256B.0671, subdivision 3; early intensive developmental and behavioral intervention services
under section 256B.0949; and substance use disorder services under chapter 254B, must be
increased by three percent from the rates in effect on December 31, 2023. Effective for
services rendered on or after January 1, 2025, payment rates for behavioral health services
included in the rate analysis required by Laws 2021, First Special Session chapter 7, article
17, section 18, except for adult day treatment services under section 256B.0671, subdivision
3; early intensive developmental behavioral intervention services under section 256B.0949;
and substance use disorder services under chapter 254B, must be annually adjusted according
to the change from the midpoint of the previous rate year to the midpoint of the rate year
for which the rate is being determined using the Centers for Medicare and Medicaid Services
Medicare Economic Index as forecasted in the fourth quarter of the calendar year before
the rate year. For payments made in accordance with this paragraph, if and to the extent
that the commissioner identifies that the state has received federal financial participation
for behavioral health services in excess of the amount allowed under United States Code,
title 42, section 447.321, the state shall repay the excess amount to the Centers for Medicare
and Medicaid Services with state money and maintain the full payment rate under this
paragraph. This paragraph does not apply to federally qualified health centers, rural health
centers, Indian health services, certified community behavioral health clinics, cost-based
rates, and rates that are negotiated with the county. This paragraph expires upon legislative
implementation of the new rate methodology resulting from the rate analysis required by
Laws 2021, First Special Session chapter 7, article 17, section 18.
new text end

new text begin (f) Effective January 1, 2024, the commissioner shall increase capitation payments made
to managed care plans and county-based purchasing plans to reflect the behavioral health
service rate increase provided in paragraph (e). Managed care and county-based purchasing
plans must use the capitation rate increase provided under this paragraph to increase payment
rates to behavioral health services providers. The commissioner must monitor the effect of
this rate increase on enrollee access to behavioral health services. If for any contract year
federal approval is not received for this paragraph, the commissioner must adjust the
capitation rates paid to managed care plans and county-based purchasing plans for that
contract year to reflect the removal of this provision. Contracts between managed care plans
and county-based purchasing plans and providers to whom this paragraph applies must
allow recovery of payments from those providers if capitation rates are adjusted in accordance
with this paragraph. Payment recoveries must not exceed the amount equal to any increase
in rates that results from this provision.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 36.

Minnesota Statutes 2022, section 256B.763, is amended to read:

256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.

new text begin Subdivision 1.new text end

new text begin Rate add-on.new text end

(a) For services defined in paragraph (b) and rendered on
or after July 1, 2007, payment rates shall be increased by 23.7 percent over the rates in effect
on January 1, 2006, for:

(1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;

(2) community mental health centers under section 256B.0625, subdivision 5; and

(3) mental health clinics certified under section 245I.20, or hospital outpatient psychiatric
departments that are designated as essential community providers under section 62Q.19.

(b) This increase applies to group skills training when provided as a component of
children's therapeutic services and support, psychotherapy, medication management,
evaluation and management, diagnostic assessment, explanation of findings, psychological
testing, neuropsychological services, direction of behavioral aides, and inpatient consultation.

(c) This increase does not apply to rates that are governed by section 256B.0625,
subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are negotiated
with the county, rates that are established by the federal government, or rates that increased
between January 1, 2004, and January 1, 2005.

(d) Payment rates shall be increased by 23.7 percent over the rates in effect on December
31, 2007, for:

(1) medication education services provided on or after January 1, 2008, by adult
rehabilitative mental health services providers certified under section 256B.0623; and

(2) mental health behavioral aide services provided on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943.

(e) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943 and
not already included in paragraph (a), payment rates shall be increased by 23.7 percent over
the rates in effect on December 31, 2007.

(f) Payment rates shall be increased by 2.3 percent over the rates in effect on December
31, 2007, for individual and family skills training provided on or after January 1, 2008, by
children's therapeutic services and support providers certified under section 256B.0943.

(g) For services described in paragraphs (b), (d), and (f) and rendered on or after July
1, 2017, payment rates for mental health clinics certified under section 245I.20 that are not
designated as essential community providers under section 62Q.19 shall be equal to payment
rates for mental health clinics certified under section 245I.20 that are designated as essential
community providers under section 62Q.19. In order to receive increased payment rates
under this paragraph, a provider must demonstrate a commitment to serve low-income and
underserved populations by:

(1) charging for services on a sliding-fee schedule based on current poverty income
guidelines; and

(2) not restricting access or services because of a client's financial limitation.

(h) For services identified under this section that are rendered by providers identified
under this section, managed care plans and county-based purchasing plans shall reimburse
the providers at a rate that is at least equal to the fee-for-service payment rate. The
commissioner shall monitor the effect of this requirement on the rate of access to the services
delivered by mental health providers.

new text begin Subd. 2.new text end

new text begin Phaseout.new text end

new text begin The critical access mental health rate add-on under this section must
be reduced according to the following schedule:
new text end

new text begin (1) effective for services provided on or after January 1, 2025, the rate add-on is reduced
to 11.85 percent;
new text end

new text begin (2) effective for services provided on or after January 1, 2026, the rate add-on is reduced
to 5.92 percent; and
new text end

new text begin (3) effective for services provided on or after January 1, 2027, the rate add-on is 0
percent.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 37.

Minnesota Statutes 2022, section 256B.764, is amended to read:

256B.764 REIMBURSEMENT FOR FAMILY PLANNING SERVICES.

(a) Effective for services rendered on or after July 1, 2007, payment rates for family
planning services shall be increased by 25 percent over the rates in effect June 30, 2007,
when these services are provided by a community clinic as defined in section 145.9268,
subdivision 1.

(b) Effective for services rendered on or after July 1, 2013, payment rates for family
planning services shall be increased by 20 percent over the rates in effect June 30, 2013,
when these services are provided by a community clinic as defined in section 145.9268,
subdivision 1. The commissioner shall adjust capitation rates to managed care and
county-based purchasing plans to reflect this increase, and shall require plans to pass on the
full amount of the rate increase to eligible community clinics, in the form of higher payment
rates for family planning services.

new text begin (c) Effective for services provided on or after January 1, 2024, payment rates for family
planning and abortion services shall be increased by 20 percent. This increase does not
apply to federally qualified health centers, rural health centers, or Indian health services.
new text end

Sec. 38.

Minnesota Statutes 2022, section 256L.03, subdivision 1, is amended to read:

Subdivision 1.

Covered health services.

(a) "Covered health services" means the health
services reimbursed under chapter 256B, with the exception of special education services,
home care nursing services, adult dental care services other than services covered under
section 256B.0625, subdivision 9, orthodontic services, nonemergency medical transportation
services, personal care assistance and case management services, community first services
and supports under section 256B.85, behavioral health home services under section
256B.0757, housing stabilization services under section 256B.051, and nursing home or
intermediate care facilities services.

deleted text begin (b) No public funds shall be used for coverage of abortion under MinnesotaCare except
where the life of the female would be endangered or substantial and irreversible impairment
of a major bodily function would result if the fetus were carried to term; or where the
pregnancy is the result of rape or incest.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end Covered health services shall be expanded as provided in this section.

deleted text begin (d)deleted text end new text begin (c)new text end For the purposes of covered health services under this section, "child" means an
individual younger than 19 years of age.

new text begin EFFECTIVE DATE.new text end

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

Sec. 39.

Minnesota Statutes 2022, section 256L.03, subdivision 5, is amended to read:

Subd. 5.

Cost-sharing.

(a) Co-payments, coinsurance, and deductibles do not apply to
children under the age of 21 and to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5.

(b) The commissioner deleted text begin shalldeleted text end new text begin mustnew text end adjust co-payments, coinsurance, and deductibles for
covered services in a manner sufficient to maintain the actuarial value of the benefit to 94
percent. The cost-sharing changes described in this paragraph do not apply to eligible
recipients or services exempt from cost-sharing under state law. The cost-sharing changes
described in this paragraph shall not be implemented prior to January 1, 2016.

(c) The cost-sharing changes authorized under paragraph (b) must satisfy the requirements
for cost-sharing under the Basic Health Program as set forth in Code of Federal Regulations,
title 42, sections 600.510 and 600.520.

new text begin (d) Co-payments, coinsurance, and deductibles do not apply to additional diagnostic
services or testing that a health care provider determines an enrollee requires after a
mammogram, as specified under section 62A.30, subdivision 5.
new text end

new text begin (e) Cost-sharing must not apply to drugs used for tobacco and nicotine cessation or to
tobacco and nicotine cessation services covered under section 256B.0625, subdivision 68.
new text end

new text begin (f) Co-payments, coinsurance, and deductibles do not apply to pre-exposure prophylaxis
(PrEP) and postexposure prophylaxis (PEP) medications when used for the prevention or
treatment of the human immunodeficiency virus (HIV).
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 40.

Laws 2021, First Special Session chapter 7, article 1, section 36, as amended by
Laws 2023, chapter 22, section 2, is amended to read:

Sec. 36. RESPONSE TO COVID-19 PUBLIC HEALTH EMERGENCY.

(a) Notwithstanding Minnesota Statutes, section 256B.057, subdivision 9, or any other
provision to the contrary, the commissioner shall not collect any unpaid premium for a
coverage month that occurred during the COVID-19 public health emergency declared by
the United States Secretary of Health and Human Services and through the month prior to
an enrollee's first renewal following the resumption of medical assistance renewals after
March 31, 2023.

(b) Notwithstanding any provision to the contrary, periodic data matching under
Minnesota Statutes, section 256B.0561, subdivision 2, may be suspended for up to 12 months
following the resumption of medical assistance and MinnesotaCare renewals after March
31, 2023.

(c) Notwithstanding any provision to the contrary, the requirement for the commissioner
of human services to issue an annual report on periodic data matching under Minnesota
Statutes, section 256B.0561, is suspended for one year following the last day of the
COVID-19 public health emergency declared by the United States Secretary of Health and
Human Services.

(d) For individuals enrolled in deleted text begin medical assistancedeleted text end new text begin Minnesota health care programsnew text end as of
March 31, 2023, who are subject to the asset limits established by Minnesota Statutes,
deleted text begin sectiondeleted text end new text begin sectionsnew text end 256B.056, subdivision 3, paragraph (a),new text begin and 256B.057,new text end assets in excess of
the limits deleted text begin established by Minnesota Statutes, section 256B.056, subdivision 3, paragraph
(a),deleted text end new text begin thereinnew text end must be disregarded until the individual's second annual renewal deleted text begin occurringdeleted text end
following the resumption of renewals after March 31, 2023.

(e) The commissioner may temporarily adjust medical assistance eligibility verification
requirements as needed to comply with federal guidance and ensure a timely renewal process
for the period during which enrollees are subject to their first annual renewal following
March 31, 2023. The commissioner must implement sufficient controls to monitor the
effectiveness of verification adjustments and ensure program integrity.

(f) Notwithstanding any provision to the contrary, the commissioner of human services
may temporarily extend the time frame permitted to take final administrative action on fair
hearing requests from medical assistance and MinnesotaCare recipients under Minnesota
Statutes, section 256.045, until the end of the 23rd month after the end of the month in
which the public health emergency for COVID-19, as declared by the United States Secretary
of Health and Human Services, ends. During this period, the commissioner must:

(1) not delay resolving expedited fair hearings described in Code of Federal Regulations,
title 42, chapter IV, subchapter C, part 431, subpart E, section 431.224, paragraph (a);

(2) provide medical assistance benefits, pending the outcome of a fair hearing decision,
to any medical assistance recipient, and provide MinnesotaCare benefits, pending the
outcome of a fair hearing decision, to any MinnesotaCare recipient, who requests a fair
hearing within the time provided under Minnesota Statutes, section 256.045, subdivision
3, paragraph (i), and regardless of whether the recipient has requested benefits pending the
outcome of the recipient's fair hearing;

(3) reinstate medical assistance or MinnesotaCare benefits back to the date of action, if
the recipient requests a fair hearing after the date of action and within the time provided
under Minnesota Statutes, section 256.045, subdivision 3, paragraph (i);

(4) take final administrative action within the maximum 90 days permitted under Code
of Federal Regulations, title 42, chapter IV, subchapter C, part 431, subpart E, section
431.244, paragraph (f)(1), for fair hearing requests where medical assistance or
MinnesotaCare benefits cannot be provided pending the outcome of the fair hearing, such
as a fair hearing challenging a denial of eligibility for an applicant;

(5) not recoup or recover from the recipient the cost of medical assistance or
MinnesotaCare benefits provided pending final administrative action, even if the agency's
action is sustained by the hearing decision; and

(6) not use this authority as justification to delay taking final action, and only exceed
the 90 days permitted for taking final agency action under Code of Federal Regulations,
title 42, section 431.244, paragraph (f)(1), to the extent to which the commissioner is unable
to take timely final agency action on a given fair hearing request.

(g) Notwithstanding Minnesota Statutes, section 256L.06, subdivision 3; 256L.15,
subdivision 2, or any other provision to the contrary, the commissioner must not collect any
unpaid premium for a coverage month that occurred during the COVID-19 public health
emergency declared by the United States Secretary of Health and Human Services.

(h) Notwithstanding Minnesota Statutes, sections 256L.06 and 256L.15, or any other
provision to the contrary, the commissioner must waive MinnesotaCare premiums for all
enrollees beginning May 1, 2023, through June 30, 2024.

(i) Notwithstanding any other law to the contrary, the commissioner shall, as required
by the Centers for Medicare & Medicaid Services, suspend certain procedural terminations
for medical assistance enrollees.

new text begin EFFECTIVE DATE.new text end

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

Sec. 41.

Laws 2021, First Special Session chapter 7, article 6, section 26, is amended to
read:

Sec. 26. COMMISSIONER OF HUMAN SERVICES; EXTENSION OF COVID-19
HUMAN SERVICES PROGRAM MODIFICATIONS.

Notwithstanding Laws 2020, First Special Session chapter 7, section 1, subdivision 2,
as amended by Laws 2020, Third Special Session chapter 1, section 3, when the peacetime
emergency declared by the governor in response to the COVID-19 outbreak expires, is
terminated, or is rescinded by the proper authority, the following modifications issued by
the commissioner of human services pursuant to Executive Orders 20-11 and 20-12, and
including any amendments to the modification issued before the peacetime emergency
expires, shall remain in effect until July 1, deleted text begin 2023deleted text end new text begin 2025new text end :

(1) CV16: expanding access to telemedicine services for Children's Health Insurance
Program, Medical Assistance, and MinnesotaCare enrollees; and

(2) CV21: allowing telemedicine alternative for school-linked mental health services
and intermediate school district mental health services.

Sec. 42. new text begin ELIGIBILITY FOR DEFERRED ACTION FOR CHILDHOOD ARRIVAL
ENROLLEES.
new text end

new text begin (a) The commissioner of human services shall make federally funded medical assistance
and federally funded MinnesotaCare available to Minnesotans who are Deferred Action for
Childhood Arrival recipients considered lawfully present noncitizens in accordance with
regulations finalized by the Centers for Medicare and Medicaid Services and who meet all
other medical assistance and MinnesotaCare eligibility criteria.
new text end

new text begin (b) This section expires June 30, 2025.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective upon the effective date of final regulations
published by the Centers for Medicare and Medicaid Services. The commissioner of human
services shall notify the revisor of statutes when the final regulations published by the
Centers for Medicare and Medicaid Services are effective.
new text end

Sec. 43. new text begin REPEALER.
new text end

new text begin (a)new text end new text begin Minnesota Statutes 2022, section 256B.763,new text end new text begin is repealed.
new text end

new text begin (b)new text end new text begin Minnesota Rules, part 9505.0235,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, 2027. Paragraph (b) is
effective the day following final enactment.
new text end

ARTICLE 2

HEALTH INSURANCE

Section 1.

Minnesota Statutes 2022, section 62A.045, is amended to read:

62A.045 PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT
HEALTH PROGRAMS.

(a) As a condition of doing business in Minnesota or providing coverage to residents of
Minnesota covered by this section, each health insurer shall comply with the requirements
deleted text begin ofdeleted text end new text begin for health insurers undernew text end the federal Deficit Reduction Act of 2005, Public Law 109-171new text begin
and the federal Consolidated Appropriations Act of 2022, Public Law 117-103new text end , including
any federal regulations adopted under deleted text begin that actdeleted text end new text begin those actsnew text end , to the extent that deleted text begin it imposesdeleted text end new text begin they
imposenew text end a requirement that applies in this state and that is not also required by the laws of
this state. This section does not require compliance with any provision of the federal deleted text begin actdeleted text end new text begin
actsnew text end prior to the effective deleted text begin datedeleted text end new text begin datesnew text end provided for deleted text begin that provisiondeleted text end new text begin those provisionsnew text end in the
federal deleted text begin actdeleted text end new text begin actsnew text end . The commissioner shall enforce this section.

For the purpose of this section, "health insurer" includes self-insured plans, group health
plans (as defined in section 607(1) of the Employee Retirement Income Security Act of
1974), service benefit plans, managed care organizations, pharmacy benefit managers, or
other parties that are by contract legally responsible to pay a claim for a health-care item
or service for an individual receiving benefits under paragraph (b).

(b) No plan offered by a health insurer issued or renewed to provide coverage to a
Minnesota resident shall contain any provision denying or reducing benefits because services
are rendered to a person who is eligible for or receiving medical benefits pursuant to title
XIX of the Social Security Act (Medicaid) in this or any other state; chapter 256 or 256B;
or services pursuant to section 252.27; 256L.01 to 256L.10; 260B.331, subdivision 2;
260C.331, subdivision 2; or 393.07, subdivision 1 or 2. No health insurer providing benefits
under plans covered by this section shall use eligibility for medical programs named in this
section as an underwriting guideline or reason for nonacceptance of the risk.

(c) If payment for covered expenses has been made under state medical programs for
health care items or services provided to an individual, and a third party has a legal liability
to make payments, the rights of payment and appeal of an adverse coverage decision for
the individual, or in the case of a child their responsible relative or caretaker, will be
subrogated to the state agency. The state agency may assert its rights under this section
within three years of the date the service was rendered. For purposes of this section, "state
agency" includes prepaid health plans under contract with the commissioner according to
sections 256B.69 and 256L.12; children's mental health collaboratives under section 245.493;
demonstration projects for persons with disabilities under section 256B.77; nursing homes
under the alternative payment demonstration project under section 256B.434; and
county-based purchasing entities under section 256B.692.

(d) Notwithstanding any law to the contrary, when a person covered by a plan offered
by a health insurer receives medical benefits according to any statute listed in this section,
payment for covered services or notice of denial for services billed by the provider must be
issued directly to the provider. If a person was receiving medical benefits through the
Department of Human Services at the time a service was provided, the provider must indicate
this benefit coverage on any claim forms submitted by the provider to the health insurer for
those services. If the commissioner of human services notifies the health insurer that the
commissioner has made payments to the provider, payment for benefits or notices of denials
issued by the health insurer must be issued directly to the commissioner. Submission by the
department to the health insurer of the claim on a Department of Human Services claim
form is proper notice and shall be considered proof of payment of the claim to the provider
and supersedes any contract requirements of the health insurer relating to the form of
submission. Liability to the insured for coverage is satisfied to the extent that payments for
those benefits are made by the health insurer to the provider or the commissioner as required
by this section.

(e) When a state agency has acquired the rights of an individual eligible for medical
programs named in this section and has health benefits coverage through a health insurer,
the health insurer shall not impose requirements that are different from requirements
applicable to an agent or assignee of any other individual covered.

(f) A health insurer must process a clean claim made by a state agency for covered
expenses paid under state medical programs within 90 business days of the claim's
submission. A health insurer must process all other claims made by a state agency for
covered expenses paid under a state medical program within the timeline set forth in Code
of Federal Regulations, title 42, section 447.45(d)(4).

(g) A health insurer may request a refund of a claim paid in error to the Department of
Human Services within two years of the date the payment was made to the department. A
request for a refund shall not be honored by the department if the health insurer makes the
request after the time period has lapsed.

Sec. 2.

Minnesota Statutes 2022, section 62A.30, is amended by adding a subdivision to
read:

new text begin Subd. 5.new text end

new text begin Mammogram; diagnostic services and testing.new text end

new text begin If a health care provider
determines an enrollee requires additional diagnostic services or testing after a mammogram,
a health plan must provide coverage for the additional diagnostic services or testing with
no cost-sharing, including co-pay, deductible, or coinsurance.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2024, and applies to health
plans offered, issued, or sold on or after that date.
new text end

Sec. 3.

Minnesota Statutes 2022, section 62A.30, is amended by adding a subdivision to
read:

new text begin Subd. 6.new text end

new text begin Application.new text end

new text begin If the application of subdivision 5 before an enrollee has met their
health plan's deductible would result in: (1) health savings account ineligibility under United
States Code, title 26, section 223; or (2) catastrophic health plan ineligibility under United
States Code, title 42, section 18022(e), then subdivision 5 shall apply to diagnostic services
or testing only after the enrollee has met their health plan's deductible.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2024, and applies to health
plans offered, issued, or sold on or after that date.
new text end

Sec. 4.

Minnesota Statutes 2022, section 62A.673, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision
have the meanings given.

(b) "Distant site" means a site at which a health care provider is located while providing
health care services or consultations by means of telehealth.

(c) "Health care provider" means a health care professional who is licensed or registered
by the state to perform health care services within the provider's scope of practice and in
accordance with state law. A health care provider includes a mental health professional
under section 245I.04, subdivision 2; a mental health practitioner under section 245I.04,
subdivision 4; a clinical trainee under section 245I.04, subdivision 6; a treatment coordinator
under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11,
subdivision 5; and a recovery peer under section 245G.11, subdivision 8.

(d) "Health carrier" has the meaning given in section 62A.011, subdivision 2.

(e) "Health plan" has the meaning given in section 62A.011, subdivision 3. Health plan
includes dental plans as defined in section 62Q.76, subdivision 3, but does not include dental
plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed
to pay benefits directly to the policy holder.

(f) "Originating site" means a site at which a patient is located at the time health care
services are provided to the patient by means of telehealth. For purposes of store-and-forward
technology, the originating site also means the location at which a health care provider
transfers or transmits information to the distant site.

(g) "Store-and-forward technology" means the asynchronous electronic transfer or
transmission of a patient's medical information or data from an originating site to a distant
site for the purposes of diagnostic and therapeutic assistance in the care of a patient.

(h) "Telehealth" means the delivery of health care services or consultations through the
use of real time two-way interactive audio and visual communications to provide or support
health care delivery and facilitate the assessment, diagnosis, consultation, treatment,
education, and care management of a patient's health care. Telehealth includes the application
of secure video conferencing, store-and-forward technology, and synchronous interactions
between a patient located at an originating site and a health care provider located at a distant
site. Until July 1, deleted text begin 2023deleted text end new text begin 2025new text end , telehealth also includes audio-only communication between
a health care provider and a patient in accordance with subdivision 6, paragraph (b).
Telehealth does not include communication between health care providers that consists
solely of a telephone conversation, email, or facsimile transmission. Telehealth does not
include communication between a health care provider and a patient that consists solely of
an email or facsimile transmission. Telehealth does not include telemonitoring services as
defined in paragraph (i).

(i) "Telemonitoring services" means the remote monitoring of clinical data related to
the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits
the data electronically to a health care provider for analysis. Telemonitoring is intended to
collect an enrollee's health-related data for the purpose of assisting a health care provider
in assessing and monitoring the enrollee's medical condition or status.

Sec. 5.

new text begin [62J.811] PROVIDER BALANCE BILLING REQUIREMENTS.
new text end

new text begin Subdivision 1.new text end

new text begin Billing requirements.new text end

new text begin (a) Each health care provider and health facility
shall comply with the federal Consolidated Appropriations Act, 2021, Division BB also
known as the "No Surprises Act," including any federal regulations adopted under that act.
new text end

new text begin (b) For the purposes of this section, "provider" or "facility" means any health care
provider or facility pursuant to section 62A.63, subdivision 2, or 62J.03, subdivision 8, that
is subject to relevant provisions of the No Surprises Act.
new text end

new text begin Subd. 2.new text end

new text begin Investigations and compliance.new text end

new text begin (a) The commissioner shall, to the extent
practicable, seek the cooperation of health care providers and facilities, and may provide
any support and assistance as available, in obtaining compliance with this section.
new text end

new text begin (b) The commissioner shall determine the manner and processes for fulfilling any
responsibilities and taking any of the actions in paragraphs (c) to (f).
new text end

new text begin (c) A person who believes a health care provider or facility has not complied with the
requirements of the No Surprises Act or this section may file a complaint with the
commissioner in the manner determined by the commissioner.
new text end

new text begin (d) The commissioner shall conduct compliance reviews and investigate complaints
filed under this section in the manner determined by the commissioner to ascertain whether
health care providers and facilities are complying with this section.
new text end

new text begin (e) The commissioner may report violations under this section to other relevant federal
and state departments and jurisdictions as appropriate, including the attorney general and
relevant licensing boards, and may also coordinate on investigations and enforcement of
this section with other relevant federal and state departments and jurisdictions as appropriate,
including the attorney general and relevant licensing boards.
new text end

new text begin (f) A health care provider or facility may contest whether the finding of facts constitute
a violation of this section according to the contested case proceeding in sections 14.57 to
14.62, subject to appeal according to sections 14.63 to 14.68.
new text end

new text begin (g) Any data collected by the commissioner as part of an active investigation or active
compliance review under this section are classified (1) if the data is not on individuals, it
is classified as protected nonpublic data pursuant to section 13.02 subdivision 13; or (2) if
the data is on individuals, it is classified as confidential pursuant to sections 13.02,
subdivision 3. Data describing the final disposition of an investigative or compliance review
are classified as public.
new text end

new text begin Subd. 3.new text end

new text begin Civil penalty.new text end

new text begin (a) The commissioner, in monitoring and enforcing this section,
may levy a civil monetary penalty against each health care provider or facility found to be
in violation of up to $100 for each violation, but may not exceed $25,000 for identical
violations during a calendar year.
new text end

new text begin (b) No civil monetary penalty shall be imposed under this section for violations that
occur prior to January 1, 2024.
new text end

Sec. 6.

Minnesota Statutes 2022, section 62J.824, is amended to read:

62J.824 FACILITY FEE DISCLOSURE.

(a) Prior to the delivery of nonemergency services, a provider-based clinic that charges
a facility fee shall provide notice to any patientnew text begin , including patients served by telehealth as
defined in section 62A.673, subdivision 2, paragraph (h),new text end stating that the clinic is part of a
hospital and the patient may receive a separate charge or billing for the facility component,
which may result in a higher out-of-pocket expense.

(b) Each health care facility must post prominently in locations easily accessible to and
visible by patients, including on its website, a statement that the provider-based clinic is
part of a hospital and the patient may receive a separate charge or billing for the facility,
which may result in a higher out-of-pocket expense.

(c) This section does not apply to laboratory services, imaging services, or other ancillary
health services that are provided by staff who are not employed by the health care facility
or clinic.

(d) For purposes of this section:

(1) "facility fee" means any separate charge or billing by a provider-based clinic in
addition to a professional fee for physicians' services that is intended to cover building,
electronic medical records systems, billing, and other administrative and operational
expenses; and

(2) "provider-based clinic" means the site of an off-campus clinic or provider office,
located at least 250 yards from the main hospital buildings or as determined by the Centers
for Medicare and Medicaid Services, that is owned by a hospital licensed under chapter 144
or a health system that operates one or more hospitals licensed under chapter 144, and is
primarily engaged in providing diagnostic and therapeutic care, including medical history,
physical examinations, assessment of health status, and treatment monitoring. This definition
does not include clinics that are exclusively providing laboratory, x-ray, testing, therapy,
pharmacy, or educational services and does not include facilities designated as rural health
clinics.

Sec. 7.

new text begin [62J.826] MEDICAL AND DENTAL PRACTICES; CURRENT STANDARD
CHARGES.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

new text begin (a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "CDT code" means a code value drawn from the Code on Dental Procedures and
Nomenclature published by the American Dental Association.
new text end

new text begin (c) "Chargemaster" means the list of all individual items and services maintained by a
medical or dental practice for which the medical or dental practice has established a charge.
new text end

new text begin (d) "Commissioner" means the commissioner of health.
new text end

new text begin (e) "CPT code" means a code value drawn from the Current Procedural Terminology
published by the American Medical Association.
new text end

new text begin (f) "Dental service" means a service charged using a CDT code.
new text end

new text begin (g) "Diagnostic laboratory testing" means a service charged using a CPT code within
the CPT code range of 80047 to 89398.
new text end

new text begin (h) "Diagnostic radiology service" means a service charged using a CPT code within
the CPT code range of 70010 to 79999 and includes the provision of x-rays, computed
tomography scans, positron emission tomography scans, magnetic resonance imaging scans,
and mammographies.
new text end

new text begin (i) "Hospital" means an acute care institution licensed under sections 144.50 to 144.58,
but does not include a health care institution conducted for those who rely primarily upon
treatment by prayer or spiritual means in accordance with the creed or tenets of any church
or denomination.
new text end

new text begin (j) "Medical or dental practice" means a business that:
new text end

new text begin (1) earns revenue by providing medical care or dental services to the public;
new text end

new text begin (2) issues payment claims to health plan companies and other payers; and
new text end

new text begin (3) may be identified by its federal tax identification number.
new text end

new text begin (k) "Outpatient surgical center" means a health care facility other than a hospital offering
elective outpatient surgery under a license issued under sections 144.50 to 144.58.
new text end

new text begin (l) "Standard charge" means the regular rate established by the medical or dental practice
for an item or service provided to a specific group of paying patients. This includes all of
the following:
new text end

new text begin (1) the charge for an individual item or service that is reflected on a medical or dental
practice's chargemaster, absent any discounts;
new text end

new text begin (2) the charge that a medical or dental practice has negotiated with a third-party payer
for an item or service;
new text end

new text begin (3) the lowest charge that a medical or dental practice has negotiated with all third-party
payers for an item or service;
new text end

new text begin (4) the highest charge that a medical or dental practice has negotiated with all third-party
payers for an item or service; and
new text end

new text begin (5) the charge that applies to an individual who pays cash, or cash equivalent, for an
item or service.
new text end

new text begin Subd. 2.new text end

new text begin Requirement; current standard charges.new text end

new text begin The following medical or dental
practices must make available to the public a list of their current standard charges for all
items and services, as reflected in the medical or dental practice's chargemaster, provided
by the medical or dental practice:
new text end

new text begin (1) hospitals;
new text end

new text begin (2) outpatient surgical centers; and
new text end

new text begin (3) any other medical or dental practice that has revenue of greater than $50,000,000
per year and that derives the majority of its revenue by providing one or more of the following
services:
new text end

new text begin (i) diagnostic radiology services;
new text end

new text begin (ii) diagnostic laboratory testing;
new text end

new text begin (iii) orthopedic surgical procedures, including joint arthroplasty procedures within the
CPT code range of 26990 to 27899;
new text end

new text begin (iv) ophthalmologic surgical procedures, including cataract surgery coded using CPT
code 66982 or 66984, or refractive correction surgery to improve visual acuity;
new text end

new text begin (v) anesthesia services commonly provided as an ancillary to services provided at a
hospital, outpatient surgical center, or medical practice that provides orthopedic surgical
procedures or ophthalmologic surgical procedures;
new text end

new text begin (vi) oncology services, including radiation oncology treatments within the CPT code
range of 77261 to 77799 and drug infusions; or
new text end

new text begin (vii) dental services.
new text end

new text begin Subd. 3.new text end

new text begin Required file format and content.new text end

new text begin (a) A medical or dental practice that is
subject to this section must make available to the public current standard charges using the
format and data elements specified in the currently effective version of the Hospital Price
Transparency Sample Format (Tall) (CSV) and related data dictionary recommended for
hospitals by the Centers for Medicare and Medicaid Services (CMS). If CMS modifies or
replaces the specifications for this format, the form of this file must be modified or replaced
to conform with the new CMS specifications by the date specified by CMS for compliance
with its new specifications. All prices included in the file must be expressed as dollar
amounts. The data must be in the form of a comma separated values file which can be
directly imported, without further editing or remediation, into a relational database table
which has been designed to receive these files. The medical or dental practice must make
the file available to the public in a manner specified by the commissioner.
new text end

new text begin (b) A medical or dental practice must test its file for compliance with paragraph (a)
before making the file available to the public.
new text end

new text begin (c) A hospital must comply with this section no later than January 1, 2024. A medical
or dental practice that meets the requirements in subdivision 2, clause (3), or an outpatient
surgical center must comply with this section no later than January 1, 2025.
new text end

Sec. 8.

Minnesota Statutes 2022, section 62J.84, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) For purposes of this section, the terms defined in this subdivision
have the meanings given.

(b) "Biosimilar" means a drug that is produced or distributed pursuant to a biologics
license application approved under United States Code, title 42, section 262(K)(3).

(1) deleted text begin an original,deleted text end new text begin anew text end new drug application approved under United States Code, title 21,
section 355(c), except for a generic drug as defined under Code of Federal Regulations,
title 42, section 447.502; or

(2) a biologics license application approved under United States Code, title deleted text begin 45deleted text end new text begin 42new text end , section
262(a)(c).

(d) "Commissioner" means the commissioner of health.

(e) "Generic drug" means a drug that is marketed or distributed pursuant to:

(1) an abbreviated new drug application approved under United States Code, title 21,
section 355(j);

(2) an authorized generic as defined under Code of Federal Regulations, title deleted text begin 45deleted text end new text begin 42new text end ,
section 447.502; or

(3) a drug that entered the market the year before 1962 and was not originally marketed
under a new drug application.

(f) "Manufacturer" means a drug manufacturer licensed under section 151.252.

(g) "New prescription drug" or "new drug" means a prescription drug approved for
marketing by the United States Food and Drug Administration new text begin (FDA) new text end for which no previous
wholesale acquisition cost has been established for comparison.

(h) "Patient assistance program" means a program that a manufacturer offers to the public
in which a consumer may reduce the consumer's out-of-pocket costs for prescription drugs
by using coupons, discount cards, prepaid gift cards, manufacturer debit cards, or by other
means.

(i) "Prescription drug" or "drug" has the meaning provided in section 151.441, subdivision
8.

(j) "Price" means the wholesale acquisition cost as defined in United States Code, title
42, section 1395w-3a(c)(6)(B).

new text begin (k) "30-day supply" means the total daily dosage units of a prescription drug
recommended by the prescribing label approved by the FDA for 30 days. If the
FDA-approved prescribing label includes more than one recommended daily dosage, the
30-day supply is based on the maximum recommended daily dosage on the FDA-approved
prescribing label.
new text end

new text begin (l) "Course of treatment" means the total dosage of a single prescription for a prescription
drug recommended by the FDA-approved prescribing label. If the FDA-approved prescribing
label includes more than one recommended dosage for a single course of treatment, the
course of treatment is the maximum recommended dosage on the FDA-approved prescribing
label.
new text end

new text begin (m) "Drug product family" means a group of one or more prescription drugs that share
a unique generic drug description or nontrade name and dosage form.
new text end

new text begin (n) "Individual salable unit" means the smallest container of product introduced into
commerce by the manufacturer or repackager that is intended by the manufacturer or
repackager for individual sale to a dispenser.
new text end

new text begin (o) "National drug code" means the three-segment code maintained by the federal Food
and Drug Administration that includes a labeler code, a product code, and a package code
for a drug product and that has been converted to an 11-digit format consisting of five digits
in the first segment, four digits in the second segment, and two digits in the third segment.
A three-segment code shall be considered converted to an 11-digit format when, as necessary,
at least one "0" has been added to the front of each segment containing less than the specified
number of digits such that each segment contains the specified number of digits.
new text end

new text begin (p) "Pharmacy" or "pharmacy provider" means a community/outpatient pharmacy as
defined in Minnesota Rules, part 6800.0100, subpart 2, that is also licensed as a pharmacy
by the Board of Pharmacy under section 151.19.
new text end

new text begin (q) "Pharmacy benefit manager" or "PBM" means an entity licensed to act as a pharmacy
benefit manager under section 62W.03.
new text end

new text begin (r) "Pricing unit" means the smallest dispensable amount of a prescription drug product
that could be dispensed.
new text end

new text begin (s) "Rebate" means a discount, chargeback, or other price concession that affects the
price of a prescription drug product, regardless of whether conferred through regular
aggregate payments, on a claim-by-claim basis at the point of sale, as part of retrospective
financial reconciliations, including reconciliations that also reflect other contractual
arrangements, or by any other method. "Rebate" does not mean a bona fide service fee as
defined in Code of Federal Regulations, title 42, section 447.502.
new text end

new text begin (t) "Reporting entity" means any manufacturer, pharmacy, pharmacy benefit manager,
wholesale drug distributor, or any other entity required to submit data under this section.
new text end

new text begin (u) "Wholesale drug distributor" or "wholesaler" means an entity that:
new text end

new text begin (1) is licensed to act as a wholesale drug distributor under section 151.47; and
new text end

new text begin (2) distributes prescription drugs, for which it is not the manufacturer, to persons or
entities, or both, other than a consumer or patient in the state.
new text end

Sec. 9.

Minnesota Statutes 2022, section 62J.84, subdivision 3, is amended to read:

Subd. 3.

Prescription drug price increases reporting.

(a) Beginning January 1, 2022,
a drug manufacturer must submit to the commissioner the information described in paragraph
(b) for each prescription drug for which the price was $100 or greater for a 30-day supply
or for a course of treatment lasting less than 30 days and:

(1) for brand name drugs where there is an increase of ten percent or greater in the price
over the previous 12-month period or an increase of 16 percent or greater in the price over
the previous 24-month period; and

(2) for generic new text begin or biosimilar new text end drugs where there is an increase of 50 percent or greater in
the price over the previous 12-month period.

(b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
the commissioner no later than 60 days after the price increase goes into effect, in the form
and manner prescribed by the commissioner, the following information, if applicable:

(1) the deleted text begin namedeleted text end new text begin descriptionnew text end and price of the drug and the net increase, expressed as a
percentagedeleted text begin ;deleted text end new text begin , with the following listed separately:
new text end

new text begin (i) the national drug code;
new text end

new text begin (ii) the product name;
new text end

new text begin (iii) the dosage form;
new text end

new text begin (iv) the strength; and
new text end

new text begin (v) the package size;
new text end

(2) the factors that contributed to the price increase;

(3) the name of any generic version of the prescription drug available on the market;

(4) the introductory price of the prescription drug when it was deleted text begin approved for marketing
by the Food and Drug Administration and the net yearly increase, by calendar year, in the
price of the prescription drug during the previous five yearsdeleted text end new text begin introduced for sale in the United
States and the price of the drug on the last day of each of the five calendar years preceding
the price increasenew text end ;

(5) the direct costs incurred new text begin during the previous 12-month period new text end by the manufacturer
that are associated with the prescription drug, listed separately:

(i) to manufacture the prescription drug;

(ii) to market the prescription drug, including advertising costs; and

(iii) to distribute the prescription drug;

(6) the total sales revenue for the prescription drug during the previous 12-month period;

(7) the manufacturer's net profit attributable to the prescription drug during the previous
12-month period;

(8) the total amount of financial assistance the manufacturer has provided through patient
prescription assistance programsnew text begin during the previous 12-month periodnew text end , if applicable;

(9) any agreement between a manufacturer and another entity contingent upon any delay
in offering to market a generic version of the prescription drug;

(10) the patent expiration date of the prescription drug if it is under patent;

(11) the name and location of the company that manufactured the drug; deleted text begin and
deleted text end

(12) if a brand name prescription drug, the deleted text begin tendeleted text end highest deleted text begin pricesdeleted text end new text begin pricenew text end paid for the
prescription drug during the previous calendar year in deleted text begin any country other thandeleted text end new text begin the ten
countries, excludingnew text end the United Statesdeleted text begin .deleted text end new text begin , that charged the highest single price for the
prescription drug; and
new text end

new text begin (13) if the prescription drug was acquired by the manufacturer during the previous
12-month period, all of the following information:
new text end

new text begin (i) price at acquisition;
new text end

new text begin (ii) price in the calendar year prior to acquisition;
new text end

new text begin (iii) name of the company from which the drug was acquired;
new text end

new text begin (iv) date of acquisition; and
new text end

new text begin (v) acquisition price.
new text end

Sec. 10.

Minnesota Statutes 2022, section 62J.84, subdivision 4, is amended to read:

Subd. 4.

New prescription drug price reporting.

(a) Beginning January 1, 2022, no
later than 60 days after a manufacturer introduces a new prescription drug for sale in the
United States that is a new brand name drug with a price that is greater than the tier threshold
established by the Centers for Medicare and Medicaid Services for specialty drugs in the
Medicare Part D program for a 30-day supply new text begin or for a course of treatment lasting fewer than
30 days new text end or a new generic or biosimilar drug with a price that is greater than the tier threshold
established by the Centers for Medicare and Medicaid Services for specialty drugs in the
Medicare Part D program for a 30-day supply new text begin or for a course of treatment lasting fewer than
30 days new text end and is not at least 15 percent lower than the referenced brand name drug when the
generic or biosimilar drug is launched, the manufacturer must submit to the commissioner,
in the form and manner prescribed by the commissioner, the following information, if
applicable:

new text begin (1) the description of the drug, with the following listed separately:
new text end

new text begin (i) the national drug code;
new text end

new text begin (ii) the product name;
new text end

new text begin (iii) the dosage form;
new text end

new text begin (iv) the strength; and
new text end

new text begin (v) the package size;
new text end

deleted text begin (1)deleted text end new text begin (2)new text end the price of the prescription drug;

deleted text begin (2)deleted text end new text begin (3)new text end whether the Food and Drug Administration granted the new prescription drug a
breakthrough therapy designation or a priority review;

deleted text begin (3)deleted text end new text begin (4)new text end the direct costs incurred by the manufacturer that are associated with the
prescription drug, listed separately:

(i) to manufacture the prescription drug;

(ii) to market the prescription drug, including advertising costs; and

(iii) to distribute the prescription drug; and

deleted text begin (4)deleted text end new text begin (5)new text end the patent expiration date of the drug if it is under patent.

(b) The manufacturer may submit documentation necessary to support the information
reported under this subdivision.

Sec. 11.

Minnesota Statutes 2022, section 62J.84, subdivision 6, is amended to read:

Subd. 6.

Public posting of prescription drug price information.

(a) The commissioner
shall post on the department's website, or may contract with a private entity or consortium
that satisfies the standards of section 62U.04, subdivision 6, to meet this requirement, the
following information:

(1) a list of the prescription drugs reported under subdivisions 3, 4, and deleted text begin 5,deleted text end new text begin 11 to 14new text end and
the manufacturers of those prescription drugs; and

(2) information reported to the commissioner under subdivisions 3, 4, and deleted text begin 5deleted text end new text begin 11 to 14new text end .

(b) The information must be published in an easy-to-read format and in a manner that
identifies the information that is disclosed on a per-drug basis and must not be aggregated
in a manner that prevents the identification of the prescription drug.

(c) The commissioner shall not post to the department's website or a private entity
contracting with the commissioner shall not post any information described in this section
if the information is not public data under section 13.02, subdivision 8a; or is trade secret
information under section 13.37, subdivision 1, paragraph (b); or is trade secret information
pursuant to the Defend Trade Secrets Act of 2016, United States Code, title 18, section
1836, as amended. If a deleted text begin manufacturerdeleted text end new text begin reporting entitynew text end believes information should be withheld
from public disclosure pursuant to this paragraph, the deleted text begin manufacturerdeleted text end new text begin reporting entitynew text end must
clearly and specifically identify that information and describe the legal basis in writing
when the deleted text begin manufacturerdeleted text end new text begin reporting entitynew text end submits the information under this section. If the
commissioner disagrees with the deleted text begin manufacturer'sdeleted text end new text begin reporting entity'snew text end request to withhold
information from public disclosure, the commissioner shall provide the deleted text begin manufacturerdeleted text end new text begin
reporting entitynew text end written notice that the information will be publicly posted 30 days after the
date of the notice.

(d) If the commissioner withholds any information from public disclosure pursuant to
this subdivision, the commissioner shall post to the department's website a report describing
the nature of the information and the commissioner's basis for withholding the information
from disclosure.

(e) To the extent the information required to be posted under this subdivision is collected
and made available to the public by another state, by the University of Minnesota, or through
an online drug pricing reference and analytical tool, the commissioner may reference the
availability of this drug price data from another source including, within existing
appropriations, creating the ability of the public to access the data from the source for
purposes of meeting the reporting requirements of this subdivision.

Sec. 12.

Minnesota Statutes 2022, section 62J.84, subdivision 7, is amended to read:

Subd. 7.

Consultation.

(a) The commissioner may consult with a private entity or
consortium that satisfies the standards of section 62U.04, subdivision 6, the University of
Minnesota, or the commissioner of commerce, as appropriate, in issuing the form and format
of the information reported under this section; in posting information pursuant to subdivision
6; and in taking any other action for the purpose of implementing this section.

(b) The commissioner may consult with representatives of the deleted text begin manufacturersdeleted text end new text begin reporting
entitiesnew text end to establish a standard format for reporting information under this section and may
use existing reporting methodologies to establish a standard format to minimize
administrative burdens to the state and deleted text begin manufacturersdeleted text end new text begin reporting entitiesnew text end .

Sec. 13.

Minnesota Statutes 2022, section 62J.84, subdivision 8, is amended to read:

Subd. 8.

Enforcement and penalties.

(a) A deleted text begin manufacturerdeleted text end new text begin reporting entitynew text end may be subject
to a civil penalty, as provided in paragraph (b), for:

new text begin (1) failing to register under subdivision 15;
new text end

deleted text begin (1)deleted text end new text begin (2)new text end failing to submit timely reports or notices as required by this section;

deleted text begin (2)deleted text end new text begin (3)new text end failing to provide information required under this section; or

deleted text begin (3)deleted text end new text begin (4)new text end providing inaccurate or incomplete information under this section.

(b) The commissioner shall adopt a schedule of civil penalties, not to exceed $10,000
per day of violation, based on the severity of each violation.

(d) The commissioner may remit or mitigate civil penalties under this section upon terms
and conditions the commissioner considers proper and consistent with public health and
safety.

(e) Civil penalties collected under this section shall be deposited in the health care access
fund.

Sec. 14.

Minnesota Statutes 2022, section 62J.84, subdivision 9, is amended to read:

Subd. 9.

Legislative report.

(a) No later than May 15, 2022, and by January 15 of each
year thereafter, the commissioner shall report to the chairs and ranking minority members
of the legislative committees with jurisdiction over commerce and health and human services
policy and finance on the implementation of this section, including but not limited to the
effectiveness in addressing the following goals:

(1) promoting transparency in pharmaceutical pricing for the state and other payers;

(2) enhancing the understanding on pharmaceutical spending trends; and

(3) assisting the state and other payers in the management of pharmaceutical costs.

(b) The report must include a summary of the information submitted to the commissioner
under subdivisions 3, 4, and deleted text begin 5deleted text end new text begin 11 to 14new text end .

Sec. 15.

Minnesota Statutes 2022, section 62J.84, is amended by adding a subdivision to
read:

new text begin Subd. 10.new text end

new text begin Notice of prescription drugs of substantial public interest.new text end

new text begin (a) No later than
January 31, 2024, and quarterly thereafter, the commissioner shall produce and post on the
department's website a list of prescription drugs that the commissioner determines to represent
a substantial public interest and for which the commissioner intends to request data under
subdivisions 11 to 14, subject to paragraph (c). The commissioner shall base its inclusion
of prescription drugs on any information the commissioner determines is relevant to providing
greater consumer awareness of the factors contributing to the cost of prescription drugs in
the state, and the commissioner shall consider drug product families that include prescription
drugs:
new text end

new text begin (1) that triggered reporting under subdivision 3 or 4 during the previous calendar quarter;
new text end

new text begin (2) for which average claims paid amounts exceeded 125 percent of the price as of the
claim incurred date during the most recent calendar quarter for which claims paid amounts
are available; or
new text end

new text begin (3) that are identified by members of the public during a public comment process.
new text end

new text begin (b) Not sooner than 30 days after publicly posting the list of prescription drugs under
paragraph (a), the department shall notify, via email, reporting entities registered with the
department of the requirement to report under subdivisions 11 to 14.
new text end

new text begin (c) The commissioner must not designate more than 500 prescription drugs as having a
substantial public interest in any one notice.
new text end

Sec. 16.

Minnesota Statutes 2022, section 62J.84, is amended by adding a subdivision to
read:

new text begin Subd. 11.new text end

new text begin Manufacturer prescription drug substantial public interest reporting.new text end

new text begin (a)
Beginning January 1, 2024, a manufacturer must submit to the commissioner the information
described in paragraph (b) for any prescription drug:
new text end

new text begin (1) included in a notification to report issued to the manufacturer by the department
under subdivision 10;
new text end

new text begin (2) which the manufacturer manufactures or repackages;
new text end

new text begin (3) for which the manufacturer sets the wholesale acquisition cost; and
new text end

new text begin (4) for which the manufacturer has not submitted data under subdivision 3 during the
120-day period prior to the date of the notification to report.
new text end

new text begin (b) For each of the drugs described in paragraph (a), the manufacturer shall submit to
the commissioner no later than 60 days after the date of the notification to report, in the
form and manner prescribed by the commissioner, the following information, if applicable:
new text end

new text begin (1) a description of the drug with the following listed separately:
new text end

new text begin (i) the national drug code;
new text end

new text begin (ii) the product name;
new text end

new text begin (iii) the dosage form;
new text end

new text begin (iv) the strength; and
new text end

new text begin (v) the package size;
new text end

new text begin (2) the price of the drug product on the later of:
new text end

new text begin (i) the day one year prior to the date of the notification to report;
new text end

new text begin (ii) the introduced to market date; or
new text end

new text begin (iii) the acquisition date;
new text end

new text begin (3) the price of the drug product on the date of the notification to report;
new text end

new text begin (4) the introductory price of the prescription drug when it was introduced for sale in the
United States and the price of the drug on the last day of each of the five calendar years
preceding the date of the notification to report;
new text end

new text begin (5) the direct costs incurred during the 12-month period prior to the date of the notification
to report by the manufacturers that are associated with the prescription drug, listed separately:
new text end

new text begin (i) to manufacture the prescription drug;
new text end

new text begin (ii) to market the prescription drug, including advertising costs; and
new text end

new text begin (iii) to distribute the prescription drug;
new text end

new text begin (6) the number of units of the prescription drug sold during the 12-month period prior
to the date of the notification to report;
new text end

new text begin (7) the total sales revenue for the prescription drug during the 12-month period prior to
the date of the notification to report;
new text end

new text begin (8) the total rebate payable amount accrued for the prescription drug during the 12-month
period prior to the date of the notification to report;
new text end

new text begin (9) the manufacturer's net profit attributable to the prescription drug during the 12-month
period prior to the date of the notification to report;
new text end

new text begin (10) the total amount of financial assistance the manufacturer has provided through
patient prescription assistance programs during the 12-month period prior to the date of the
notification to report, if applicable;
new text end

new text begin (11) any agreement between a manufacturer and another entity contingent upon any
delay in offering to market a generic version of the prescription drug;
new text end

new text begin (12) the patent expiration date of the prescription drug if the prescription drug is under
patent;
new text end

new text begin (13) the name and location of the company that manufactured the drug;
new text end

new text begin (14) if the prescription drug is a brand name prescription drug, the ten countries other
than the United States that paid the highest prices for the prescription drug during the
previous calendar year and their prices; and
new text end

new text begin (15) if the prescription drug was acquired by the manufacturer within a 12-month period
prior to the date of the notification to report, all of the following information:
new text end

new text begin (i) the price at acquisition;
new text end

new text begin (ii) the price in the calendar year prior to acquisition;
new text end

new text begin (iii) the name of the company from which the drug was acquired;
new text end

new text begin (iv) the date of acquisition; and
new text end

new text begin (v) the acquisition price.
new text end

new text begin (c) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.
new text end

Sec. 17.

Minnesota Statutes 2022, section 62J.84, is amended by adding a subdivision to
read:

new text begin Subd. 12.new text end

new text begin Pharmacy prescription drug substantial public interest reporting.new text end

new text begin (a)
Beginning January 1, 2024, a pharmacy must submit to the commissioner the information
described in paragraph (b) for any prescription drug included in a notification to report
issued to the pharmacy by the department under subdivision 10.
new text end

new text begin (b) For each of the drugs described in paragraph (a), the pharmacy shall submit to the
commissioner no later than 60 days after the date of the notification to report, in the form
and manner prescribed by the commissioner, the following information, if applicable:
new text end

new text begin (1) a description of the drug with the following listed separately:
new text end

new text begin (i) the national drug code;
new text end

new text begin (ii) the product name;
new text end

new text begin (iii) the dosage form;
new text end

new text begin (iv) the strength; and
new text end

new text begin (v) the package size;
new text end

new text begin (2) the number of units of the drug acquired during the 12-month period prior to the date
of the notification to report;
new text end

new text begin (3) the total spent before rebates by the pharmacy to acquire the drug during the 12-month
period prior to the date of the notification to report;
new text end

new text begin (4) the total rebate receivable amount accrued by the pharmacy for the drug during the
12-month period prior to the date of the notification to report;
new text end

new text begin (5) the number of pricing units of the drug dispensed by the pharmacy during the
12-month period prior to the date of the notification to report;
new text end

new text begin (6) the total payment receivable by the pharmacy for dispensing the drug including
ingredient cost, dispensing fee, and administrative fees during the 12-month period prior
to the date of the notification to report;
new text end

new text begin (7) the total rebate payable amount accrued by the pharmacy for the drug during the
12-month period prior to the date of the notification to report; and
new text end

new text begin (8) the average cash price paid by consumers per pricing unit for prescriptions dispensed
where no claim was submitted to a health care service plan or health insurer during the
12-month period prior to the date of the notification to report.
new text end

new text begin (c) The pharmacy may submit any documentation necessary to support the information
reported under this subdivision.
new text end

new text begin (d) The commissioner may grant extensions, exemptions, or both to compliance with
the requirements of paragraphs (a) and (b) by small or independent pharmacies, if compliance
with paragraphs (a) and (b) would represent a hardship or undue burden to the pharmacy.
The commissioner may establish procedures for small or independent pharmacies to request
extensions or exemptions under this paragraph.
new text end

Sec. 18.

Minnesota Statutes 2022, section 62J.84, is amended by adding a subdivision to
read:

new text begin Subd. 13.new text end

new text begin PBM prescription drug substantial public interest reporting.new text end

new text begin (a) Beginning
January 1, 2024, a PBM must submit to the commissioner the information described in
paragraph (b) for any prescription drug included in a notification to report issued to the
PBM by the department under subdivision 10.
new text end

new text begin (b) For each of the drugs described in paragraph (a), the PBM shall submit to the
commissioner no later than 60 days after the date of the notification to report, in the form
and manner prescribed by the commissioner, the following information, if applicable:
new text end

new text begin (1) a description of the drug with the following listed separately:
new text end

new text begin (i) the national drug code;
new text end

new text begin (ii) the product name;
new text end

new text begin (iii) the dosage form;
new text end

new text begin (iv) the strength; and
new text end

new text begin (v) the package size;
new text end

new text begin (2) the number of pricing units of the drug product filled for which the PBM administered
claims during the 12-month period prior to the date of the notification to report;
new text end

new text begin (3) the total reimbursement amount accrued and payable to pharmacies for pricing units
of the drug product filled for which the PBM administered claims during the 12-month
period prior to the date of the notification to report;
new text end

new text begin (4) the total reimbursement or administrative fee amount, or both, accrued and receivable
from payers for pricing units of the drug product filled for which the PBM administered
claims during the 12-month period prior to the date of the notification to report;
new text end

new text begin (5) the total rebate receivable amount accrued by the PBM for the drug product during
the 12-month period prior to the date of the notification to report; and
new text end

new text begin (6) the total rebate payable amount accrued by the PBM for the drug product during the
12-month period prior to the date of the notification to report.
new text end

new text begin (c) The PBM may submit any documentation necessary to support the information
reported under this subdivision.
new text end

Sec. 19.

Minnesota Statutes 2022, section 62J.84, is amended by adding a subdivision to
read:

new text begin Subd. 14.new text end

new text begin Wholesale drug distributor prescription drug substantial public interest
reporting.new text end

new text begin (a) Beginning January 1, 2024, a wholesale drug distributor must submit to the
commissioner the information described in paragraph (b) for any prescription drug included
in a notification to report issued to the wholesale drug distributor by the department under
subdivision 10.
new text end

new text begin (b) For each of the drugs described in paragraph (a), the wholesale drug distributor shall
submit to the commissioner no later than 60 days after the date of the notification to report,
in the form and manner prescribed by the commissioner, the following information, if
applicable:
new text end

new text begin (1) a description of the drug with the following listed separately:
new text end

new text begin (i) the national drug code;
new text end

new text begin (ii) the product name;
new text end

new text begin (iii) the dosage form;
new text end

new text begin (iv) the strength; and
new text end

new text begin (v) the package size;
new text end

new text begin (2) the number of units of the drug product acquired by the wholesale drug distributor
during the 12-month period prior to the date of the notification to report;
new text end

new text begin (3) the total spent before rebates by the wholesale drug distributor to acquire the drug
product during the 12-month period prior to the date of the notification to report;
new text end

new text begin (4) the total rebate receivable amount accrued by the wholesale drug distributor for the
drug product during the 12-month period prior to the date of the notification to report;
new text end

new text begin (5) the number of units of the drug product sold by the wholesale drug distributor during
the 12-month period prior to the date of the notification to report;
new text end

new text begin (6) gross revenue from sales in the United States generated by the wholesale drug
distributor for this drug product during the 12-month period prior to the date of the
notification to report; and
new text end

new text begin (7) total rebate payable amount accrued by the wholesale drug distributor for the drug
product during the 12-month period prior to the date of the notification to report.
new text end

new text begin (c) The wholesale drug distributor may submit any documentation necessary to support
the information reported under this subdivision.
new text end

Sec. 20.

Minnesota Statutes 2022, section 62J.84, is amended by adding a subdivision to
read:

new text begin Subd. 15.new text end

new text begin Registration requirements.new text end

new text begin Beginning January 1, 2024, a reporting entity
subject to this chapter shall register with the department in a form and manner prescribed
by the commissioner.
new text end

Sec. 21.

Minnesota Statutes 2022, section 62J.84, is amended by adding a subdivision to
read:

new text begin Subd. 16.new text end

new text begin Rulemaking.new text end

new text begin For the purposes of this section, the commissioner may use the
expedited rulemaking process under section 14.389.
new text end

Sec. 22.

Minnesota Statutes 2022, section 62K.10, subdivision 4, is amended to read:

Subd. 4.

Network adequacy.

new text begin (a) new text end Each designated provider network must include a
sufficient number and type of providers, including providers that specialize in mental health
and substance use disorder services, to ensure that covered services are available to all
enrollees without unreasonable delay. In determining network adequacy, the commissioner
of health shall consider availability of services, including the following:

(1) primary care physician services are available and accessible 24 hours per day, seven
days per week, within the network area;

(2) a sufficient number of primary care physicians have hospital admitting privileges at
one or more participating hospitals within the network area so that necessary admissions
are made on a timely basis consistent with generally accepted practice parameters;

(3) specialty physician service is available through the network or contract arrangement;

(4) mental health and substance use disorder treatment providersnew text begin , including but not
limited to psychiatric residential treatment facilities,new text end are available and accessible through
the network or contract arrangement;

(5) to the extent that primary care services are provided through primary care providers
other than physicians, and to the extent permitted under applicable scope of practice in state
law for a given provider, these services shall be available and accessible; and

(6) the network has available, either directly or through arrangements, appropriate and
sufficient personnel, physical resources, and equipment to meet the projected needs of
enrollees for covered health care services.

new text begin (b) The commissioner may establish sufficiency by referencing any reasonable criteria,
which include but are not limited to:
new text end

new text begin (1) ratios of providers to enrollees by specialty;
new text end

new text begin (2) ratios of primary care professionals to enrollees;
new text end

new text begin (3) geographic accessibility of providers;
new text end

new text begin (4) waiting times for an appointment with participating providers;
new text end

new text begin (5) hours of operation;
new text end

new text begin (6) the ability of the network to meet the needs of enrollees that are:
new text end

new text begin (i) low-income persons;
new text end

new text begin (ii) children and adults with serious, chronic, or complex health conditions, physical
disabilities, or mental illness; or
new text end

new text begin (iii) persons with limited English proficiency and persons from underserved communities;
new text end

new text begin (7) other health care service delivery system options, including telemedicine or telehealth,
mobile clinics, centers of excellence, and other ways of delivering care; and
new text end

new text begin (8) the volume of technological and specialty care services available to serve the needs
of enrollees that need technologically advanced or specialty care services.
new text end

new text begin EFFECTIVE DATE; APPLICATION.new text end

new text begin Paragraph (a) is effective July 1, 2023.
Paragraph (b) is effective January 1, 2025, and applies to health plans offered, issued, or
renewed on or after that date. This section supercedes S.F. No. 2744, article 2, section 39,
if enacted in the 2023 legislative session.
new text end

Sec. 23.

Minnesota Statutes 2022, section 62Q.01, is amended by adding a subdivision to
read:

new text begin Subd. 6b.new text end

new text begin No Surprises Act.new text end

new text begin "No Surprises Act" means Division BB of the Consolidated
Appropriations Act, 2021, which amended Title XXVII of the Public Health Service Act,
Public Law 116-260, and any amendments to and any federal guidance or regulations issued
under this act.
new text end

Sec. 24.

Minnesota Statutes 2022, section 62Q.021, is amended by adding a subdivision
to read:

new text begin Subd. 3.new text end

new text begin Compliance with 2021 federal law.new text end

new text begin Each health plan company, health provider,
and health facility shall comply with the No Surprises Act, including any federal regulations
adopted under the act, to the extent that the act imposes requirements that apply in this state
but are not required under the laws of this state. This subdivision does not require compliance
with any provision of the No Surprises Act before the effective date provided for that
provision in the No Surprises Act. The commissioner shall enforce this subdivision.
new text end

Sec. 25.

new text begin [62Q.451] UNRESTRICTED ACCESS TO SERVICES FOR THE
DIAGNOSIS, MONITORING, AND TREATMENT OF RARE DISEASES.
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.
new text end

new text begin (b) "Rare disease or condition" means any disease or condition:
new text end

new text begin (1) that affects fewer than 200,000 persons in the United States and is chronic, serious,
life-altering, or life-threatening;
new text end

new text begin (2) that affects more than 200,000 persons in the United States and a drug for treatment
has been designated as a drug for a rare disease or condition pursuant to United States Code,
title 21, section 360bb;
new text end

new text begin (3) that is labeled as a rare disease or condition on the Genetic and Rare Diseases
Information Center list created by the National Institutes of Health; or
new text end

new text begin (4) for which an enrollee:
new text end

new text begin (i) has received two or more clinical consultations from a primary care provider or
specialty provider that are specific to the presenting complaint;
new text end

new text begin (ii) has documentation in the enrollee's medical record of a developmental delay through
standardized assessment, developmental regression, failure to thrive, or progressive
multisystemic involvement; and
new text end

new text begin (iii) had laboratory or clinical testing that failed to provide a definitive diagnosis or
resulted in conflicting diagnoses.
new text end

new text begin A rare disease or condition does not include an infectious disease that has widely available
and known protocols for diagnosis and treatment and that is commonly treated in a primary
care setting, even if it affects less than 200,000 persons in the United States.
new text end

new text begin Subd. 2.new text end

new text begin Unrestricted access.new text end

new text begin (a) No health plan company may restrict the choice of an
enrollee as to where the enrollee receives services from a licensed health care provider
related to the diagnosis, monitoring, and treatment of a rare disease or condition, including
but not limited to additional restrictions through any prior authorization, preauthorization,
prior approval, precertification process, increased fees, or other methods.
new text end

new text begin (b) Any services provided by, referred for, or ordered by an out-of-network provider for
an enrollee who, before receiving and being notified of a definitive diagnosis, satisfied the
requirements in subdivision 1, paragraph (b), clause (4), are governed by paragraph (c),
even if the subsequent definitive diagnosis does not meet the definition of rare disease or
condition in subdivision 1, paragraph (b), clause (1), (2), or (3). Once the enrollee is
definitively diagnosed with a disease or condition that does not meet the definition of rare
disease or condition in subdivision 1, paragraph (b), clause (1), (2), or (3), and notification
of the diagnosis has been provided to both the health plan and the enrollee, or a parent or
guardian of a minor enrollee, any services provided by, referred for, or ordered by an
out-of-network provider related to the diagnosis are governed by paragraph (c) for up to 60
days, providing time for care to be transferred to a qualified in-network provider and to
schedule needed in-network appointments. After this 60-day period, subsequent services
provided by, referred for, or ordered by an out-of-network provider related to the diagnosis
are no longer governed by paragraph (c).
new text end

new text begin (c) Cost-sharing requirements and benefit or services limitations for the diagnosis and
treatment of a rare disease or condition must not place a greater financial burden on the
enrollee or be more restrictive than those requirements for in-network medical treatment.
new text end

new text begin (d) A health plan company must provide enrollees with written information on the content
and application of this section and must train customer service representatives on the content
and application of this section.
new text end

new text begin Subd. 3.new text end

new text begin Coverage; prior authorization.new text end

new text begin (a) Nothing in this section requires a health
plan company to provide coverage for a medication, procedure or treatment, or laboratory
or clinical testing, that is not covered under the enrollee's health plan.
new text end

new text begin (b) Coverage for a service must not be denied solely on the basis that it was provided
by, referred for, or ordered by an out-of-network provider.
new text end

new text begin (d) Subject to the requirements of this section and chapter 62W, a health plan may require
use of a specialty pharmacy, as defined in section 62W.02, subdivision 20.
new text end

new text begin Subd. 4.new text end

new text begin Payments to out-of-network providers for services provided in this state.new text end

new text begin (a)
If a health plan company has an established contractual payment under a health plan in the
commercial insurance market with an out-of-network provider for a service provided in
Minnesota related to the diagnosis, monitoring, and treatment of a rare disease or condition,
across any of the health plan's networks, then the provider shall accept the established
contractual payment for that service as payment in full.
new text end

new text begin (b) If a health plan company does not have an established contractual payment under a
health plan in the commercial insurance market with an out-of-network provider for a service
provided in Minnesota related to the diagnosis, monitoring, and treatment of a rare disease
or condition, across any of the health plan's networks, then the provider shall accept:
new text end

new text begin (1) the provider's established rate for uninsured patients for that service as payment in
full; or
new text end

new text begin (2) if the provider does not have an established rate for uninsured patients for that service,
then the average commercial insurance rate the health plan company has paid for that service
in this state over the past 12 months as payment in full.
new text end

new text begin (d) If the payment amount is determined under paragraph (b), clause (2), and the health
plan company has not paid for that service in this state within the past 12 months, then the
health plan company shall pay the lesser of the following:
new text end

new text begin (1) the average rate in the commercial insurance market the health plan company paid
for that service across all states over the past 12 months; or
new text end

new text begin (2) the provider's standard charge.
new text end

new text begin (e) This subdivision does not apply to managed care organizations or county-based
purchasing plans when the plan provides coverage to public health care program enrollees
under chapters 256B or 256L.
new text end

new text begin Subd. 5.new text end

new text begin Payments to out-of-network providers when services are provided outside
of the state.new text end

new text begin (a) If a health plan company has an established contractual payment under a
health plan in the commercial insurance market with an out-of-network provider for a service
provided in another state related to the diagnosis, monitoring, and treatment of a rare disease
or condition, across any of the health plan's networks in the state where the service is
provided, then the health plan company shall pay the established contractual payment for
that service.
new text end

new text begin (b) If a health plan company does not have an established contractual payment under a
health plan in the commercial insurance market with an out-of-network provider for a service
provided in another state related to the diagnosis, monitoring, and treatment of a rare disease
or condition, across any of the health plan's networks in the state where the service is
provided, then the health plan company shall pay:
new text end

new text begin (1) the provider's established rate for uninsured patients for that service; or
new text end

new text begin (2) if the provider does not have an established rate for uninsured patients for that service,
then the average commercial insurance rate the health plan company has paid for that service
in the state where the service is provided over the past 12 months.
new text end

new text begin (c) If the payment amount is determined under paragraph (b), clause (2), and the health
plan company has not paid for that service in the state where the service is provided within
the past 12 months, then the health plan company shall pay the lesser of the following:
new text end

new text begin (1) the average commercial insurance rate the health plan company has paid for that
service across all states over the last 12 months; or
new text end

new text begin (2) the provider's standard charge.
new text end

new text begin (d) This subdivision does not apply to managed care organizations or county-based
purchasing plans when the plan provides coverage to public health care program enrollees
under chapter 256B or 256L.
new text end

new text begin Subd. 6.new text end

new text begin Exclusion.new text end

new text begin This section does not apply to medications obtained from a retail
pharmacy as defined in section 62W.02, subdivision 18.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2024, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 26.

new text begin [62Q.473] BIOMARKER TESTING.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

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

new text begin (b) "Biomarker" means a characteristic that is objectively measured and evaluated as an
indicator of normal biological processes, pathogenic processes, or pharmacologic responses
to a specific therapeutic intervention, including but not limited to known gene-drug
interactions for medications being considered for use or already being administered.
Biomarkers include but are not limited to gene mutations, characteristics of genes, or protein
expression.
new text end

new text begin (c) "Biomarker testing" means the analysis of an individual's tissue, blood, or other
biospecimen for the presence of a biomarker. Biomarker testing includes but is not limited
to single-analyst tests; multiplex panel tests; protein expression; and whole exome, whole
genome, and whole transcriptome sequencing.
new text end

new text begin (d) "Clinical utility" means a test provides information that is used to formulate a
treatment or monitoring strategy that informs a patient's outcome and impacts the clinical
decision. The most appropriate test may include information that is actionable and some
information that cannot be immediately used to formulate a clinical decision.
new text end

new text begin (e) "Consensus statement" means a statement that: (1) describes optimal clinical care
outcomes, based on the best available evidence, for a specific clinical circumstance; and
(2) is developed by an independent, multidisciplinary panel of experts that: (i) uses a rigorous
and validated development process that includes a transparent methodology and reporting
structure; and (ii) strictly adheres to the panel's conflict of interest policy.
new text end

new text begin (f) "Nationally recognized clinical practice guideline" means an evidence-based clinical
practice guideline that: (1) establishes a standard of care informed by (i) a systematic review
of evidence, and (ii) an assessment of the risks and benefits of alternative care options; and
(2) is developed by an independent organization or medical professional society that: (i)
uses a transparent methodology and reporting structure; and (ii) adheres to a conflict of
interest policy. Nationally recognized clinical practice guideline includes recommendations
to optimize patient care.
new text end

new text begin Subd. 2.new text end

new text begin Biomarker testing; coverage required.new text end

new text begin (a) A health plan must provide coverage
for biomarker testing to diagnose, treat, manage, and monitor illness or disease if the test
provides clinical utility. For purposes of this section, a test's clinical utility may be
demonstrated by medical and scientific evidence, including but not limited to:
new text end

new text begin (1) nationally recognized clinical practice guidelines as defined in this section;
new text end

new text begin (2) consensus statements as defined in this section;
new text end

new text begin (3) labeled indications for a United States Food and Drug Administration (FDA) approved
or FDA-cleared test, indicated tests for an FDA-approved drug, or adherence to warnings
and precautions on FDA-approved drug labels; or
new text end

new text begin (4) Centers for Medicare and Medicaid Services national coverage determinations or
Medicare Administrative Contractor local coverage determinations.
new text end

new text begin (b) Coverage under this section must be provided in a manner that limits disruption of
care, including the need for multiple biopsies or biospecimen samples.
new text end

new text begin (c) Nothing in this section prohibits a health plan company from requiring a prior
authorization or imposing other utilization controls when approving coverage for biomarker
testing.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2025, and applies to health
plans offered, issued, or renewed on or after that date.
new text end

Sec. 27.

new text begin [62Q.522] COVERAGE OF CONTRACEPTIVE METHODS AND
SERVICES.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

new text begin (a) The definitions in this subdivision apply to this section.
new text end

new text begin (b) "Closely held for-profit entity" means an entity that:
new text end

new text begin (1) is not a nonprofit entity;
new text end

new text begin (2) has more than 50 percent of the value of its ownership interest owned directly or
indirectly by five or fewer owners; and
new text end

new text begin (3) has no publicly traded ownership interest.
new text end

new text begin For purposes of this paragraph:
new text end

new text begin (i) ownership interests owned by a corporation, partnership, limited liability company,
estate, trust, or similar entity are considered owned by that entity's shareholders, partners,
members, or beneficiaries in proportion to their interest held in the corporation, partnership,
limited liability company, estate, trust, or similar entity;
new text end

new text begin (ii) ownership interests owned by a nonprofit entity are considered owned by a single
owner;
new text end

new text begin (iii) ownership interests owned by all individuals in a family are considered held by a
single owner. For purposes of this item, "family" means brothers and sisters, including
half-brothers and half-sisters, a spouse, ancestors, and lineal descendants; and
new text end

new text begin (iv) if an individual or entity holds an option, warrant, or similar right to purchase an
ownership interest, the individual or entity is considered to be the owner of those ownership
interests.
new text end

new text begin (c) "Contraceptive method" means a drug, device, or other product approved by the Food
and Drug Administration to prevent unintended pregnancy.
new text end

new text begin (d) "Contraceptive service" means consultation, examination, procedures, and medical
services related to the prevention of unintended pregnancy, excluding vasectomies. This
includes but is not limited to voluntary sterilization procedures, patient education, counseling
on contraceptives, and follow-up services related to contraceptive methods or services,
management of side effects, counseling for continued adherence, and device insertion or
removal.
new text end

new text begin (e) "Eligible organization" means an organization that opposes providing coverage for
some or all contraceptive methods or services on account of religious objections and that
is:
new text end

new text begin (1) organized as a nonprofit entity and holds itself out to be religious; or
new text end

new text begin (2) organized and operates as a closely held for-profit entity, and the organization's
owners or highest governing body has adopted, under the organization's applicable rules of
governance and consistent with state law, a resolution or similar action establishing that the
organization objects to covering some or all contraceptive methods or services on account
of the owners' sincerely held religious beliefs.
new text end

new text begin (f) "Exempt organization" means an organization that is organized and operates as a
nonprofit entity and meets the requirements of section 6033(a)(3)(A)(i) or (iii) of the Internal
Revenue Code of 1986, as amended.
new text end

new text begin (g) "Medical necessity" includes but is not limited to considerations such as severity of
side effects, difference in permanence and reversibility of a contraceptive method or service,
and ability to adhere to the appropriate use of the contraceptive method or service, as
determined by the attending provider.
new text end

new text begin (h) "Therapeutic equivalent version" means a drug, device, or product that can be expected
to have the same clinical effect and safety profile when administered to a patient under the
conditions specified in the labeling, and that:
new text end

new text begin (1) is approved as safe and effective;
new text end

new text begin (2) is a pharmaceutical equivalent: (i) containing identical amounts of the same active
drug ingredient in the same dosage form and route of administration; and (ii) meeting
compendial or other applicable standards of strength, quality, purity, and identity;
new text end

new text begin (3) is bioequivalent in that:
new text end

new text begin (i) the drug, device, or product does not present a known or potential bioequivalence
problem and meets an acceptable in vitro standard; or
new text end

new text begin (ii) if the drug, device, or product does present a known or potential bioequivalence
problem, it is shown to meet an appropriate bioequivalence standard;
new text end

new text begin (4) is adequately labeled; and
new text end

new text begin (5) is manufactured in compliance with current manufacturing practice regulations.
new text end

new text begin Subd. 2.new text end

new text begin Required coverage; cost sharing prohibited.new text end

new text begin (a) A health plan must provide
coverage for contraceptive methods and services.
new text end

new text begin (b) A health plan company must not impose cost-sharing requirements, including co-pays,
deductibles, or coinsurance, for contraceptive methods or services.
new text end

new text begin (c) A health plan company must not impose any referral requirements, restrictions, or
delays for contraceptive methods or services.
new text end

new text begin (d) A health plan must include at least one of each type of Food and Drug Administration
approved contraceptive method in its formulary. If more than one therapeutic equivalent
version of a contraceptive method is approved, a health plan must include at least one
therapeutic equivalent version in its formulary, but is not required to include all therapeutic
equivalent versions.
new text end

new text begin (e) For each health plan, a health plan company must list the contraceptive methods and
services that are covered without cost-sharing in a manner that is easily accessible to
enrollees, health care providers, and representatives of health care providers. The list for
each health plan must be promptly updated to reflect changes to the coverage.
new text end

new text begin (f) If an enrollee's attending provider recommends a particular contraceptive method or
service based on a determination of medical necessity for that enrollee, the health plan must
cover that contraceptive method or service without cost-sharing. The health plan company
issuing the health plan must defer to the attending provider's determination that the particular
contraceptive method or service is medically necessary for the enrollee.
new text end

new text begin Subd. 3.new text end

new text begin Exemption.new text end

new text begin (a) An exempt organization is not required to cover contraceptives
or contraceptive services if the exempt organization has religious objections to the coverage.
An exempt organization that chooses to not provide coverage for some or all contraceptives
and contraceptive services must notify employees as part of the hiring process and to all
employees at least 30 days before:
new text end

new text begin (1) an employee enrolls in the health plan; or
new text end

new text begin (2) the effective date of the health plan, whichever occurs first.
new text end

new text begin (b) If the exempt organization provides coverage for some contraceptive methods or
services, the notice required under paragraph (a) must provide a list of the contraceptive
methods or services the organization refuses to cover.
new text end

new text begin Subd. 4.new text end

new text begin Accommodation for eligible organizations.new text end

new text begin (a) A health plan established or
maintained by an eligible organization complies with the requirements of subdivision 2 to
provide coverage of contraceptive methods and services, with respect to the contraceptive
methods or services identified in the notice under this paragraph, if the eligible organization
provides notice to any health plan company the eligible organization contracts with that it
is an eligible organization and that the eligible organization has a religious objection to
coverage for all or a subset of contraceptive methods or services.
new text end

new text begin (b) The notice from an eligible organization to a health plan company under paragraph
(a) must include: (1) the name of the eligible organization; (2) a statement that it objects to
coverage for some or all of contraceptive methods or services, including a list of the
contraceptive methods or services the eligible organization objects to, if applicable; and (3)
the health plan name. The notice must be executed by a person authorized to provide notice
on behalf of the eligible organization.
new text end

new text begin (c) An eligible organization must provide a copy of the notice under paragraph (a) to
prospective employees as part of the hiring process and to all employees at least 30 days
before:
new text end

new text begin (1) an employee enrolls in the health plan; or
new text end

new text begin (2) the effective date of the health plan, whichever occurs first.
new text end

new text begin (d) A health plan company that receives a copy of the notice under paragraph (a) with
respect to a health plan established or maintained by an eligible organization must, for all
future enrollments in the health plan:
new text end

new text begin (1) expressly exclude coverage for those contraceptive methods or services identified
in the notice under paragraph (a) from the health plan; and
new text end

new text begin (2) provide separate payments for any contraceptive methods or services required to be
covered under subdivision 2 for enrollees as long as the enrollee remains enrolled in the
health plan.
new text end

new text begin (e) The health plan company must not impose any cost-sharing requirements, including
co-pays, deductibles, or coinsurance, or directly or indirectly impose any premium, fee, or
other charge for contraceptive services or methods on the eligible organization, health plan,
or enrollee.
new text end

new text begin (f) On January 1, 2024, and every year thereafter a health plan company must notify the
commissioner, in a manner determined by the commissioner, of the number of eligible
organizations granted an accommodation under this subdivision.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2024, and applies to coverage
offered, sold, issued, or renewed on or after that date.
new text end

Sec. 28.

new text begin [62Q.523] COVERAGE FOR PRESCRIPTION CONTRACEPTIVES;
SUPPLY REQUIREMENTS.
new text end

new text begin Subdivision 1.new text end

new text begin Scope of coverage.new text end

new text begin Except as otherwise provided in section 62Q.522,
subdivisions 3 and 4, all health plans that provide prescription coverage must comply with
the requirements of this section.
new text end

new text begin Subd. 2.new text end

new text begin Definition.new text end

new text begin For purposes of this section, "prescription contraceptive" means
any drug or device that requires a prescription and is approved by the Food and Drug
Administration to prevent pregnancy. Prescription contraceptive does not include an
emergency contraceptive drug that prevents pregnancy when administered after sexual
contact.
new text end

new text begin Subd. 3.new text end

new text begin Required coverage.new text end

new text begin Health plan coverage for a prescription contraceptive must
provide a 12-month supply for any prescription contraceptive if a 12-month supply is
prescribed by the prescribing health care provider. The prescribing health care provider
must determine the appropriate duration to prescribe the prescription contraceptives for up
to 12 months.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2024, and applies to coverage
offered, sold, issued, or renewed on or after that date.
new text end

Sec. 29.

Minnesota Statutes 2022, section 62Q.55, subdivision 5, is amended to read:

Subd. 5.

Coverage restrictions or limitations.

If emergency services are provided by
a nonparticipating provider, with or without prior authorization, the health plan company
shall not impose coverage restrictions or limitations that are more restrictive than apply to
emergency services received from a participating provider. Cost-sharing requirements that
apply to emergency services received out-of-network must be the same as the cost-sharing
requirements that apply to services received in-networknew text begin and shall count toward the in-network
deductible. All coverage and charges for emergency services must comply with the No
Surprises Actnew text end .

Sec. 30.

Minnesota Statutes 2022, section 62Q.556, is amended to read:

62Q.556 deleted text begin UNAUTHORIZED PROVIDER SERVICESdeleted text end new text begin CONSUMER
PROTECTIONS AGAINST BALANCE BILLINGnew text end .

Subdivision 1.

deleted text begin Unauthorized provider servicesdeleted text end new text begin Nonparticipating provider balance
billing prohibitionnew text end .

(a) Except as provided in paragraph deleted text begin (c), unauthorized provider services
occurdeleted text end new text begin (b), balance billing is prohibitednew text end when an enrollee receives servicesnew text begin fromnew text end :

(1) deleted text begin fromdeleted text end a nonparticipating provider at a participating hospital or ambulatory surgical
center, deleted text begin when the services are rendered:deleted text end new text begin as described by the No Surprises Act, including any
federal regulations adopted under that act;
new text end

deleted text begin (i) due to the unavailability of a participating provider;
deleted text end

deleted text begin (ii) by a nonparticipating provider without the enrollee's knowledge; or
deleted text end

deleted text begin (iii) due to the need for unforeseen services arising at the time the services are being
rendered; or
deleted text end

(2) deleted text begin fromdeleted text end a participating provider that sends a specimen taken from the enrollee in the
participating provider's practice setting to a nonparticipating laboratory, pathologist, or other
medical testing facilitydeleted text begin .deleted text end new text begin ; or
new text end

new text begin (3) a nonparticipating provider or facility providing emergency services as defined in
section 62Q.55, subdivision 3, and other services as described in the requirements of the
No Surprises Act.
new text end

deleted text begin (b) Unauthorized provider services do not include emergency services as defined in
section 62Q.55, subdivision 3.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end The services described in paragraph (a), deleted text begin clause (2)deleted text end new text begin clauses (1), (2), and (3), as
defined in the No Surprises Act, and any federal regulations adopted under that actnew text end , are deleted text begin not
unauthorized provider servicesdeleted text end new text begin subject to balance billingnew text end if the enrollee deleted text begin gives advance writtendeleted text end new text begin
provides informednew text end consent deleted text begin todeleted text end new text begin prior to receiving services fromnew text end thenew text begin nonparticipatingnew text end provider
acknowledging that the use of a provider, or the services to be rendered, may result in costs
not covered by the health plan.new text begin The informed consent must comply with all requirements
of the No Surprises Act, including any federal regulations adopted under that act.
new text end

Subd. 2.

deleted text begin Prohibitiondeleted text end new text begin Cost-sharing requirements and independent dispute
resolutionnew text end .

(a) An enrollee's financial responsibility for the deleted text begin unauthorizeddeleted text end new text begin nonparticipatingnew text end
provider servicesnew text begin described in subdivision 1, paragraph (a),new text end shall be the same cost-sharing
requirements, including co-payments, deductibles, coinsurance, coverage restrictions, and
coverage limitations, as those applicable to services received by the enrollee from a
participating provider. A health plan company must apply any enrollee cost sharing
requirements, including co-payments, deductibles, and coinsurance, for deleted text begin unauthorizeddeleted text end new text begin
nonparticipatingnew text end provider services to the enrollee's annual out-of-pocket limit to the same
extent payments to a participating provider would be applied.

(b) A health plan company must attempt to negotiate the reimbursement, less any
applicable enrollee cost sharing under paragraph (a), for the deleted text begin unauthorizeddeleted text end new text begin nonparticipatingnew text end
provider services with the nonparticipating provider. If deleted text begin a health plan company's and
nonparticipating provider's attemptsdeleted text end new text begin the attemptnew text end to negotiate reimbursement for the deleted text begin health
caredeleted text end new text begin nonparticipating providernew text end services deleted text begin dodeleted text end new text begin doesnew text end not result in a resolution, deleted text begin the health plan
company or provider may elect to refer the matter for binding arbitration, chosen in
accordance with paragraph (c). A nondisclosure agreement must be executed by both parties
prior to engaging an arbitrator in accordance with this section. The cost of arbitration must
be shared equally between the parties.deleted text end new text begin either party may initiate the federal independent
dispute resolution process pursuant to the No Surprises Act, including any federal regulations
adopted under that act.
new text end

deleted text begin (c) The commissioner of health, in consultation with the commissioner of the Bureau
of Mediation Services, must develop a list of professionals qualified in arbitration, for the
purpose of resolving disputes between a health plan company and nonparticipating provider
arising from the payment for unauthorized provider services. The commissioner of health
shall publish the list on the Department of Health website, and update the list as appropriate.
deleted text end

deleted text begin (d) The arbitrator must consider relevant information, including the health plan company's
payments to other nonparticipating providers for the same services, the circumstances and
complexity of the particular case, and the usual and customary rate for the service based on
information available in a database in a national, independent, not-for-profit corporation,
and similar fees received by the provider for the same services from other health plans in
which the provider is nonparticipating, in reaching a decision.
deleted text end

new text begin Subd. 3.new text end

new text begin Annual data reporting.new text end

new text begin (a) Beginning April 1, 2024, a health plan company
must report annually to the commissioner of health:
new text end

new text begin (1) the total number of claims and total billed and paid amounts for nonparticipating
provider services, by service and provider type, submitted to the health plan in the prior
calendar year; and
new text end

new text begin (2) the total number of enrollee complaints received regarding the rights and protections
established by the No Surprises Act in the prior calendar year.
new text end

new text begin (b) The commissioners of commerce and health shall develop the form and manner for
health plan companies to comply with paragraph (a).
new text end

new text begin Subd. 4.new text end

new text begin Enforcement.new text end

new text begin (a) Any provider or facility, including a health care provider or
facility pursuant to section 62A.63, subdivision 2, or 62J.03, subdivision 8, that is subject
to the relevant provisions of the No Surprises Act is subject to the requirements of this
section and section 62J.811.
new text end

new text begin (b) The commissioner of commerce or health shall enforce this section.
new text end

new text begin (c) If a health-related licensing board has cause to believe that a provider has violated
this section, it may further investigate and enforce the provisions of this section pursuant
to chapter 214.
new text end

Sec. 31.

Minnesota Statutes 2022, section 62Q.56, subdivision 2, is amended to read:

Subd. 2.

Change in health plans.

(a) If an enrollee is subject to a change in health plans,
the enrollee's new health plan company must provide, upon request, authorization to receive
services that are otherwise covered under the terms of the new health plan through the
enrollee's current provider:

(1) for up to 120 days if the enrollee is engaged in a current course of treatment for one
or more of the following conditions:

(i) an acute condition;

(ii) a life-threatening mental or physical illness;

(iii) pregnancy deleted text begin beyond the first trimester of pregnancydeleted text end ;

(iv) a physical or mental disability defined as an inability to engage in one or more major
life activities, provided that the disability has lasted or can be expected to last for at least
one year, or can be expected to result in death; or

(v) a disabling or chronic condition that is in an acute phase; or

(2) for the rest of the enrollee's life if a physician certifies that the enrollee has an expected
lifetime of 180 days or less.

For all requests for authorization under this paragraph, the health plan company must grant
the request for authorization unless the enrollee does not meet the criteria provided in this
paragraph.

(b) The health plan company shall prepare a written plan that provides a process for
coverage determinations regarding continuity of care of up to 120 days for new enrollees
who request continuity of care with their former provider, if the new enrollee:

(1) is receiving culturally appropriate services and the health plan company does not
have a provider in its preferred provider network with special expertise in the delivery of
those culturally appropriate services within the time and distance requirements of section
62D.124, subdivision 1; or

(2) does not speak English and the health plan company does not have a provider in its
preferred provider network who can communicate with the enrollee, either directly or through
an interpreter, within the time and distance requirements of section 62D.124, subdivision
1.

The written plan must explain the criteria that will be used to determine whether a need for
continuity of care exists and how it will be provided.

(c) This subdivision applies only to group coverage and continuation and conversion
coverage, and applies only to changes in health plans made by the employer.

Sec. 32.

Minnesota Statutes 2022, section 62Q.73, subdivision 1, is amended to read:

Subdivision 1.

Definition.

For purposes of this section, "adverse determination" means:

(1) for individual health plans, a complaint decision relating to a health care service or
claim that is partially or wholly adverse to the complainant;

(2) an individual health plan that is grandfathered plan coverage may instead apply the
definition of adverse determination for group coverage in clause (3);

(3) for group health plans, a complaint decision relating to a health care service or claim
that has been appealed in accordance with section 62Q.70 and the appeal decision is partially
or wholly adverse to the complainant;

(4) any adverse determination, as defined in section 62M.02, subdivision 1a, that has
been appealed in accordance with section 62M.06 and the appeal did not reverse the adverse
determination;

(5) a decision relating to a health care service made by a health plan company licensed
under chapter 60A that denies the service on the basis that the service was not medically
necessary; deleted text begin or
deleted text end

(6) the enrollee has met the requirements of subdivision 6, paragraph (e)deleted text begin .deleted text end new text begin ; or
new text end

new text begin (7) a decision relating to a health plan's coverage of nonparticipating provider services
as described in and subject to section 62Q.556, subdivision 1, paragraph (a).
new text end

An adverse determination does not include complaints relating to fraudulent marketing
practices or agent misrepresentation.

Sec. 33.

Minnesota Statutes 2022, section 62Q.73, subdivision 7, is amended to read:

Subd. 7.

Standards of review.

(a) For an external review of any issue in an adverse
determination that does not require a medical necessity determination, the external review
must be based on whether the adverse determination was in compliance with the enrollee's
health benefit plannew text begin or section 62Q.556, subdivision 1, paragraph (a)new text end .

(b) For an external review of any issue in an adverse determination by a health plan
company licensed under chapter 62D that requires a medical necessity determination, the
external review must determine whether the adverse determination was consistent with the
definition of medically necessary care in Minnesota Rules, part 4685.0100, subpart 9b.

(c) For an external review of any issue in an adverse determination by a health plan
company, other than a health plan company licensed under chapter 62D, that requires a
medical necessity determination, the external review must determine whether the adverse
determination was consistent with the definition of medically necessary care in section
62Q.53, subdivision 2.

(d) For an external review of an adverse determination involving experimental or
investigational treatment, the external review entity must base its decision on all documents
submitted by the health plan company and enrollee, including:

(1) medical records;

(2) the recommendation of the attending physician, advanced practice registered nurse,
physician assistant, or health care professional;

(3) consulting reports from health care professionals;

(4) the terms of coverage;

(5) federal Food and Drug Administration approval; and

(6) medical or scientific evidence or evidence-based standards.

Sec. 34.

Minnesota Statutes 2022, section 62U.01, is amended by adding a subdivision to
read:

new text begin Subd. 5a.new text end

new text begin Dental organization.new text end

new text begin "Dental organization" has the meaning given in section
62Q.76, subdivision 7.
new text end

Sec. 35.

Minnesota Statutes 2022, section 62U.04, subdivision 4, is amended to read:

Subd. 4.

Encounter data.

(a) All health plan companiesnew text begin , dental organizations,new text end and
third-party administrators shall submit encounter data on a monthly basis to a private entity
designated by the commissioner of health. The data shall be submitted in a form and manner
specified by the commissioner subject to the following requirements:

(1) the data must be de-identified data as described under the Code of Federal Regulations,
title 45, section 164.514;

(2) the data for each encounter must include an identifier for the patient's health care
home if the patient has selected a health care homenew text begin , data on contractual value-based payments, new text end
anddeleted text begin , for claims incurred on or after January 1, 2019,deleted text end data deemed necessary by the
commissioner to uniquely identify claims in the individual health insurance market; deleted text begin and
deleted text end

(3) new text begin the data must include enrollee race and ethnicity, to the extent available, for claims
incurred on or after January 1, 2023; and
new text end

new text begin (4) new text end except for the deleted text begin identifierdeleted text end new text begin datanew text end described in deleted text begin clausedeleted text end new text begin clausesnew text end (2)new text begin and (3)new text end , the data must
not include information that is not included in a health care claimnew text begin , dental care claim,new text end or
equivalent encounter information transaction that is required under section 62J.536.

(b) The commissioner or the commissioner's designee shall only use the data submitted
under paragraph (a) to carry out the commissioner's responsibilities in this section, including
supplying the data to providers so they can verify their results of the peer grouping process
consistent with the recommendations developed pursuant to subdivision 3c, paragraph (d),
and adopted by the commissioner and, if necessary, submit comments to the commissioner
or initiate an appeal.

(c) Data on providers collected under this subdivision are private data on individuals or
nonpublic data, as defined in section 13.02. deleted text begin Notwithstanding the definition of summary data
in section 13.02, subdivision 19, summary data prepared under this subdivision may be
derived from nonpublic data.deleted text end new text begin Notwithstanding the data classifications in this paragraph,
data on providers collected under this subdivision may be released or published as authorized
in subdivision 11.new text end The commissioner or the commissioner's designee shall establish
procedures and safeguards to protect the integrity and confidentiality of any data that it
maintains.

(d) The commissioner or the commissioner's designee shall not publish analyses or
reports that identify, or could potentially identify, individual patients.

(e) The commissioner shall compile summary information on the data submitted under
this subdivision. The commissioner shall work with its vendors to assess the data submitted
in terms of compliance with the data submission requirements and the completeness of the
data submitted by comparing the data with summary information compiled by the
commissioner and with established and emerging data quality standards to ensure data
quality.

Sec. 36.

Minnesota Statutes 2022, section 62U.04, subdivision 5, is amended to read:

Subd. 5.

Pricing data.

(a) All health plan companiesnew text begin , dental organizations,new text end and third-party
administrators shall submit, on a monthly basis, data on their contracted prices with health
care providers new text begin and dental care providers new text end to a private entity designated by the commissioner
of health for the purposes of performing the analyses required under this subdivision.new text begin Data
on contracted prices submitted under this paragraph must include data on supplemental
contractual value-based payments paid to health care providers.new text end The data shall be submitted
in the form and manner specified by the commissioner of health.

(b) The commissioner or the commissioner's designee shall only use the data submitted
under this subdivision to carry out the commissioner's responsibilities under this section,
including supplying the data to providers so they can verify their results of the peer grouping
process consistent with the recommendations developed pursuant to subdivision 3c, paragraph
(d), and adopted by the commissioner and, if necessary, submit comments to the
commissioner or initiate an appeal.

(c) Data collected under this subdivision are new text begin private data on individuals ornew text end nonpublic
data as defined in section 13.02. Notwithstanding the definition of summary data in section
13.02, subdivision 19, summary data prepared under this section may be derived from
nonpublic data. new text begin Notwithstanding the data classifications in this paragraph, data on providers
collected under this subdivision may be released or published as authorized in subdivision
11. new text end The commissioner shall establish procedures and safeguards to protect the integrity and
confidentiality of any data that it maintains.

Sec. 37.

Minnesota Statutes 2022, section 62U.04, subdivision 5a, is amended to read:

Subd. 5a.

Self-insurers.

new text begin (a) new text end The commissioner shall not require a self-insurer governed
by the federal Employee Retirement Income Security Act of 1974 (ERISA) to comply with
this section.

new text begin (b) A third-party administrator must annually notify the self-insurers whose health plans
are administered by the third-party administrator that the self-insurer may elect to have the
third-party administrator submit encounter data, data on contracted prices, and data on
nonclaims-based payments under subdivisions 4, 5, and 5b, from the self-insurer's health
plan for the upcoming plan year. This notice must be provided in a form and manner specified
by the commissioner. After receiving responses from self-insurers, a third-party administrator
must, in a form and manner specified by the commissioner, report to the commissioner:
new text end

new text begin (1) the number of self-insured clients that elected to have the third-party administrator
submit encounter data, data on contracted prices, and data on nonclaims-based payments
from the self-insurer's health plan for the upcoming plan year, along with the number of
covered lives, claims volume, and aggregated claim value;
new text end

new text begin (2) the number of self-insured clients that declined to have the third-party administrator
submit encounter data, data on contracted prices, and data on nonclaims-based payments
from the self-insurer's health plan for the upcoming plan year, along with the number of
covered lives, claims volume, and aggregated claim value; and
new text end

new text begin (3) data deemed necessary by the commissioner to assure the quality of the submitted
data.
new text end

new text begin (c) Data collected under this subdivision are private data on individuals or nonpublic
data as defined in section 13.02. Notwithstanding the definition of summary data in section
13.02, subdivision 19, summary data prepared under this subdivision may be derived from
nonpublic data. The commissioner shall establish procedures and safeguards to protect the
integrity and confidentiality of any data maintained by the commissioner.
new text end

Sec. 38.

Minnesota Statutes 2022, section 62U.04, is amended by adding a subdivision to
read:

new text begin Subd. 5b.new text end

new text begin Nonclaims-based payments.new text end

new text begin (a) Beginning January 1, 2025, all health plan
companies and third-party administrators shall submit to a private entity designated by the
commissioner of health all nonclaims-based payments made to health care providers. The
data shall be submitted in a form, manner, and frequency specified by the commissioner.
Nonclaims-based payments are payments to health care providers designed to pay for value
of health care services over volume of health care services and include alternative payment
models or incentives, payments for infrastructure expenditures or investments, and payments
for workforce expenditures or investments. Nonclaims-based payments submitted under
this subdivision must, to the extent possible, be attributed to a health care provider in the
same manner in which claims-based data are attributed to a health care provider and, where
appropriate, must be combined with data collected under subdivisions 4 to 5a in analyses
of health care spending.
new text end

new text begin (b) Data collected under this subdivision are private data on individuals or nonpublic
data as defined in section 13.02. Notwithstanding the definition of summary data in section
13.02, subdivision 19, summary data prepared under this subdivision may be derived from
nonpublic data. The commissioner shall establish procedures and safeguards to protect the
integrity and confidentiality of any data maintained by the commissioner.
new text end

new text begin (c) The commissioner shall consult with health plan companies, hospitals, health care
providers, and the commissioner of human services in developing the data reported under
this subdivision and standardized reporting forms.
new text end

Sec. 39.

Minnesota Statutes 2022, section 62U.04, subdivision 11, is amended to read:

Subd. 11.

Restricted uses of the all-payer claims data.

(a) Notwithstanding subdivision
4, paragraph (b), and subdivision 5, paragraph (b), the commissioner or the commissioner's
designee shall only use the data submitted under subdivisions 4 deleted text begin anddeleted text end new text begin ,new text end 5new text begin , 5a, and 5bnew text end for the
deleted text begin followingdeleted text end purposesnew text begin authorized in this subdivision and in subdivision 13new text end :

(1) to evaluate the performance of the health care home program as authorized under
section 62U.03, subdivision 7;

(2) to study, in collaboration with the reducing avoidable readmissions effectively
(RARE) campaign, hospital readmission trends and rates;

(3) to analyze variations in health care costs, quality, utilization, and illness burden based
on geographical areas or populations;

(4) to evaluate the state innovation model (SIM) testing grant received by the Departments
of Health and Human Services, including the analysis of health care cost, quality, and
utilization baseline and trend information for targeted populations and communities; and

(5) to compile one or more public use files of summary data or tables that must:

(i) be available to the public for no or minimal cost by March 1, 2016, and available by
web-based electronic data download by June 30, 2019;

(ii) not identify individual patientsdeleted text begin , payers, or providersdeleted text end new text begin but that may identify the
rendering or billing hospital, clinic, or medical practice so long as no individual health
professionals are identified and the commissioner finds the data to be accurate, valid, and
suitable for publication for such usenew text end ;

(iii) be updated by the commissioner, at least annually, with the most current data
available;new text begin and
new text end

(iv) contain clear and conspicuous explanations of the characteristics of the data, such
as the dates of the data contained in the files, the absence of costs of care for uninsured
patients or nonresidents, and other disclaimers that provide appropriate contextdeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (v) not lead to the collection of additional data elements beyond what is authorized under
this section as of June 30, 2015.
deleted text end

(b) The commissioner may publish the results of the authorized uses identified in
paragraph (a) deleted text begin so long as the data released publicly do not contain information or descriptions
in which the identity of individual hospitals, clinics, or other providers may be discerneddeleted text end .new text begin
The data published under this paragraph may identify hospitals, clinics, and medical practices
so long as no individual health professionals are identified and the commissioner finds the
data to be accurate, valid, and suitable for publication for such use.
new text end

deleted text begin (c) Nothing in this subdivision shall be construed to prohibit the commissioner from
using the data collected under subdivision 4 to complete the state-based risk adjustment
system assessment due to the legislature on October 1, 2015.
deleted text end

deleted text begin (d) The commissioner or the commissioner's designee may use the data submitted under
subdivisions 4 and 5 for the purpose described in paragraph (a), clause (3), until July 1,
2023.
deleted text end

deleted text begin (e) The commissioner shall consult with the all-payer claims database work group
established under subdivision 12 regarding the technical considerations necessary to create
the public use files of summary data described in paragraph (a), clause (5).
deleted text end

Sec. 40.

Minnesota Statutes 2022, section 62U.04, is amended by adding a subdivision to
read:

new text begin Subd. 13.new text end

new text begin Expanded access to and use of the all-payer claims data.new text end

new text begin (a) The
commissioner or the commissioner's designee shall make the data submitted under
subdivisions 4, 5, 5a, and 5b, including data classified as private or nonpublic, available to
individuals and organizations engaged in research on, or efforts to effect transformation in,
health care outcomes, access, quality, disparities, or spending, provided the use of the data
serves a public benefit. Data made available under this subdivision may not be used to:
new text end

new text begin (1) create an unfair market advantage for any participant in the health care market in
Minnesota, including health plan companies, payers, and providers;
new text end

new text begin (2) reidentify or attempt to reidentify an individual in the data; or
new text end

new text begin (3) publicly report contract details between a health plan company and provider and
derived from the data.
new text end

new text begin (b) To implement paragraph (a), the commissioner shall:
new text end

new text begin (1) establish detailed requirements for data access; a process for data users to apply to
access and use the data; legally enforceable data use agreements to which data users must
consent; a clear and robust oversight process for data access and use, including a data
management plan, that ensures compliance with state and federal data privacy laws;
agreements for state agencies and the University of Minnesota to ensure proper and efficient
use and security of data; and technical assistance for users of the data and for stakeholders;
new text end

new text begin (2) develop a fee schedule to support the cost of expanded access to and use of the data,
provided the fees charged under the schedule do not create a barrier to access or use for
those most affected by disparities; and
new text end

new text begin (3) create a research advisory group to advise the commissioner on applications for data
use under this subdivision, including an examination of the rigor of the research approach,
the technical capabilities of the proposed user, and the ability of the proposed user to
successfully safeguard the data.
new text end

Sec. 41. new text begin REPORT ON TRANSPARENCY OF HEALTH CARE PAYMENTS.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

new text begin (a) The terms defined in this subdivision apply to this section.
new text end

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

new text begin (c) "Nonclaims-based payments" means payments to health care providers designed to
support and reward value of health care services over volume of health care services and
includes alternative payment models or incentives, payments for infrastructure expenditures
or investments, and payments for workforce expenditures or investments.
new text end

new text begin (d) "Nonpublic data" has the meaning given in Minnesota Statutes, section 13.02,
subdivision 9.
new text end

new text begin (e) "Primary care services" means integrated, accessible health care services provided
by clinicians who are accountable for addressing a large majority of personal health care
needs, developing a sustained partnership with patients, and practicing in the context of
family and community. Primary care services include but are not limited to preventive
services, office visits, administration of vaccines, annual physicals, pre-operative physicals,
assessments, care coordination, development of treatment plans, management of chronic
conditions, and diagnostic tests.
new text end

new text begin Subd. 2.new text end

new text begin Report.new text end

new text begin (a) To provide the legislature with information needed to meet the
evolving health care needs of Minnesotans, the commissioner shall report to the legislature
by February 15, 2024, on the volume and distribution of health care spending across payment
models used by health plan companies and third-party administrators, with a particular focus
on value-based care models and primary care spending.
new text end

new text begin (b) The report must include specific health plan and third-party administrator estimates
of health care spending for claims-based payments and nonclaims-based payments for the
most recent available year, reported separately for Minnesotans enrolled in state health care
programs, Medicare Advantage, and commercial health insurance. The report must also
include recommendations on changes needed to gather better data from health plan companies
and third-party administrators on the use of value-based payments that pay for value of
health care services provided over volume of services provided, promote the health of all
Minnesotans, reduce health disparities, and support the provision of primary care services
and preventive services.
new text end

new text begin (c) In preparing the report, the commissioner shall:
new text end

new text begin (1) describe the form, manner, and timeline for submission of data by health plan
companies and third-party administrators to produce estimates as specified in paragraph
(b);
new text end

new text begin (2) collect summary data that permits the computation of:
new text end

new text begin (i) the percentage of total payments that are nonclaims-based payments; and
new text end

new text begin (ii) the percentage of payments in item (i) that are for primary care services;
new text end

new text begin (3) where data was not directly derived, specify the methods used to estimate data
elements;
new text end

new text begin (4) notwithstanding Minnesota Statutes, section 62U.04, subdivision 11, conduct analyses
of the magnitude of primary care payments using data collected by the commissioner under
Minnesota Statutes, section 62U.04; and
new text end

new text begin (5) conduct interviews with health plan companies and third-party administrators to
better understand the types of nonclaims-based payments and models in use, the purposes
or goals of each, the criteria for health care providers to qualify for these payments, and the
timing and structure of health plan companies or third-party administrators making these
payments to health care provider organizations.
new text end

new text begin (d) Health plan companies and third-party administrators must comply with data requests
from the commissioner under this section within 60 days after receiving the request.
new text end

new text begin (e) Data collected under this section is nonpublic data. Notwithstanding the definition
of summary data in Minnesota Statutes, section 13.02, subdivision 19, summary data prepared
under this section may be derived from nonpublic data. The commissioner shall establish
procedures and safeguards to protect the integrity and confidentiality of any data maintained
by the commissioner.
new text end

Sec. 42. new text begin STATEWIDE HEALTH CARE PROVIDER DIRECTORY.
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.
new text end

new text begin (b) "Health care provider" means a practicing provider that accepts reimbursement from
a group purchaser.
new text end

new text begin (c) "Health care provider directory" means an electronic catalog and index that supports
the management of health care provider information, both individual and organizational, in
a directory structure for public use to find available providers and networks and support
state agency responsibilities.
new text end

new text begin (d) "Group purchaser" has the meaning given in Minnesota Statutes, section 62J.03,
subdivision 6.
new text end

new text begin Subd. 2.new text end

new text begin Health care provider directory.new text end

new text begin The commissioner shall assess the feasibility
and stakeholder commitment to develop, manage, and maintain a statewide electronic
directory of health care providers. The assessment must take into consideration consumer
information needs, state agency applications, stakeholder needs, technical requirements,
alignment with national standards, governance, operations, legal and policy considerations,
and existing directories. The commissioner shall conduct this assessment in consultation
with stakeholders, including but not limited to consumers, group purchasers, health care
providers, community health boards, and state agencies.
new text end

Sec. 43. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2022, section 62J.84, subdivision 5,new text end new text begin is repealed.
new text end

ARTICLE 3

DEPARTMENT OF HEALTH POLICY

Section 1.

Minnesota Statutes 2022, section 62J.17, subdivision 5a, is amended to read:

Subd. 5a.

Retrospective review.

(a) The commissioner shall retrospectively review
each major spending commitment and deleted text begin notify the provider of the results of the review. The
commissioner shalldeleted text end determine whether the major spending commitment was appropriate.
In making the determination, the commissioner may consider the following criteria: the
major spending commitment's impact on the cost, access, and quality of health care; the
clinical effectiveness and cost-effectiveness of the major spending commitment; and the
alternatives available to the provider.new text begin If the major expenditure is determined to not be
appropriate, the commissioner shall notify the provider.
new text end

(b) The commissioner may not prevent or prohibit a major spending commitment subject
to retrospective review. However, if the provider fails the retrospective review, any major
spending commitments by that provider for the five-year period following the commissioner's
decision are subject to prospective review under subdivision 6a.

Sec. 2.

Minnesota Statutes 2022, section 62Q.675, is amended to read:

62Q.675 HEARING AIDSdeleted text begin ; PERSONS 18 OR YOUNGERdeleted text end .

A health plan must cover hearing aids for new text begin all new text end individuals deleted text begin 18 years of age or youngerdeleted text end for
hearing loss that is not correctable by other covered procedures. Coverage required under
this section is limited to one hearing aid in each ear every three years. No special deductible,
coinsurance, co-payment, or other limitation on the coverage under this section that is not
generally applicable to other coverages under the plan may be imposed.

Sec. 3.

Minnesota Statutes 2022, section 144.1481, subdivision 1, is amended to read:

Subdivision 1.

Establishment; membership.

The commissioner of health shall establish
a deleted text begin 16-memberdeleted text end Rural Health Advisory Committee. The committee shall consist of the following
new text begin 22new text end members, all of whom must reside outside the seven-county metropolitan area, as defined
in section 473.121, subdivision 2:

(1) two members from the house of representatives of the state of Minnesota, one from
the majority party and one from the minority party;

(2) two members from the senate of the state of Minnesota, one from the majority party
and one from the minority party;

(3) a volunteer member of an ambulance service based outside the seven-county
metropolitan area;

(4) a representative of a hospital located outside the seven-county metropolitan area;

(5) a representative of a nursing home located outside the seven-county metropolitan
area;

(6) a medical doctor or doctor of osteopathic medicine licensed under chapter 147;

(7) a dentist licensed under chapter 150A;

new text begin (8) an allied dental personnel as defined in Minnesota Rules, part 3100.0100, subpart
5;
new text end

deleted text begin (8)deleted text end new text begin (9)new text end deleted text begin a midlevel practitionerdeleted text end new text begin an advanced practice professionalnew text end ;

deleted text begin (9)deleted text end new text begin (10)new text end a registered nurse or licensed practical nurse;

deleted text begin (10)deleted text end new text begin (11)new text end a licensed health care professional from an occupation not otherwise represented
on the committee;

deleted text begin (11)deleted text end new text begin (12)new text end a representative of an institution of higher education located outside the
seven-county metropolitan area that provides training for rural health care providers; deleted text begin and
deleted text end

new text begin (13) a member of a Tribal Nation;
new text end

new text begin (14) a representative of a local public health agency or community health board;
new text end

new text begin (15) a health professional or advocate with experience working with people with mental
illness;
new text end

new text begin (16) a representative of a community organization that works with individuals
experiencing health disparities;
new text end

new text begin (17) an individual with expertise in economic development, or an employer working
outside the seven-county metropolitan area;
new text end

deleted text begin (12) threedeleted text end new text begin (18) twonew text end consumers, at least one of whom must be deleted text begin an advocate for persons
who are mentally ill or developmentally disableddeleted text end new text begin from a community experiencing health
disparities; and
new text end

new text begin (19) one consumer who is an advocate for persons who are developmentally disablednew text end .

The commissioner will make recommendations for committee membership. Committee
members will be appointed by the governor. In making appointments, the governor shall
ensure that appointments provide geographic balance among those areas of the state outside
the seven-county metropolitan area. The chair of the committee shall be elected by the
members. The advisory committee is governed by section 15.059, except that the members
do not receive per diem compensation.

Sec. 4.

Minnesota Statutes 2022, section 144.2151, is amended to read:

144.2151 new text begin FETAL DEATH new text end RECORDnew text begin AND CERTIFICATEnew text end OF BIRTH
RESULTING IN STILLBIRTH.

Subdivision 1.

deleted text begin Filingdeleted text end new text begin Registrationnew text end .

A new text begin fetal death new text end record deleted text begin of birth for each birth resulting
in a stillbirth in this state, on or after August 1, 2005,deleted text end new text begin must be establishednew text end for deleted text begin which adeleted text end new text begin eachnew text end
fetal death deleted text begin report is requireddeleted text end new text begin reported and registerednew text end under section 144.222, subdivision 1deleted text begin ,
shall be filed with the state registrar within five days after the birth if the parent or parents
of the stillbirth request to have a record of birth resulting in stillbirth prepareddeleted text end .

Subd. 2.

Information to parents.

The party responsible for filing a fetal death report
under section 144.222, subdivision 1, shall advise the parent or parents of a stillbirth:

deleted text begin (1) that they may request preparation of a record of birth resulting in stillbirth;
deleted text end

deleted text begin (2) that preparation of the record is optional; and
deleted text end

deleted text begin (3) how to obtain a certified copy of the record if one is requested and prepared.
deleted text end

new text begin (1) that the parent or parents may choose to provide a full name or provide only a last
name for the record;
new text end

new text begin (2) that the parent or parents may request a certificate of birth resulting in stillbirth after
the fetal death record is established;
new text end

new text begin (3) that the parent who gave birth may request an informational copy of the fetal death
record; and
new text end

new text begin (4) that the parent or parents named on the fetal death record and the party responsible
for reporting the fetal death may correct or amend the record to protect the integrity and
accuracy of vital records.
new text end

Subd. 3.

deleted text begin Preparationdeleted text end new text begin Responsibilities of the state registrarnew text end .

deleted text begin (a) Within five days after
delivery of a stillbirth, the parent or parents of the stillbirth may prepare and file the record
with the state registrar if the parent or parents of the stillbirth, after being advised as provided
in subdivision 2, request to have a record of birth resulting in stillbirth prepared.
deleted text end

deleted text begin (b) If the parent or parents of the stillbirth do not choose to provide a full name for the
stillbirth, the parent or parents may choose to file only a last name.
deleted text end

deleted text begin (c) Either parent of the stillbirth or, if neither parent is available, another person with
knowledge of the facts of the stillbirth shall attest to the accuracy of the personal data entered
on the record in time to permit the filing of the record within five days after delivery.
deleted text end

new text begin The state registrar shall:
new text end

new text begin (1) prescribe the process to:
new text end

new text begin (i) register a fetal death;
new text end

new text begin (ii) request the certificate of birth resulting in stillbirth; and
new text end

new text begin (iii) request the informational copy of a fetal death record;
new text end

new text begin (2) prescribe a standardized format for the certificate of birth resulting in stillbirth, which
shall integrate security features and be as similar as possible to a birth certificate;
new text end

new text begin (3) issue a certificate of birth resulting in stillbirth or a statement of no vital record found
to the parent or parents named on the fetal death record upon the parent's proper completion
of an attestation provided by the commissioner and payment of the required fee;
new text end

new text begin (4) correct or amend the fetal death record upon a request from the parent who gave
birth, parents, or the person who registered the fetal death or filed the report; and
new text end

new text begin (5) refuse to amend or correct the fetal death record when an applicant does not submit
the minimum documentation required to amend the record or when the state registrar has
cause to question the validity or completeness of the applicant's statements or any
documentary evidence and the deficiencies are not corrected. The state registrar shall advise
the applicant of the reason for this action and shall further advise the applicant of the right
of appeal to a court with competent jurisdiction over the Department of Health.
new text end

Subd. 4.

deleted text begin Retroactive applicationdeleted text end new text begin Delayed registrationnew text end .

deleted text begin Notwithstanding subdivisions
1 to 3,deleted text end If a deleted text begin birth thatdeleted text end new text begin fetal deathnew text end occurred in this state at any time deleted text begin resulted in a stillbirthdeleted text end for
which a fetal death report was required under section 144.222, subdivision 1, but a deleted text begin record
of birth resulting in stillbirth was not prepared under subdivision 3, a parent of the stillbirth
may submit to the state registrar, on or after August 1, 2005, a written request for preparation
of a record of birth resulting in stillbirth and evidence of the facts of the stillbirth in the
form and manner specified by the state registrar. The state registrar shall prepare and file
the record of birth resulting in stillbirth within 30 days after receiving satisfactory evidence
of the facts of the stillbirth.deleted text end new text begin fetal death was not registered and a record was not established,
a person responsible for registering the fetal death, the medical examiner or coroner with
jurisdiction, or a parent may submit to the state registrar a written request to register the
fetal death and submit the evidence to support the request.
new text end

deleted text begin Subd. 5.deleted text end

deleted text begin Responsibilities of state registrar.deleted text end

deleted text begin The state registrar shall:
deleted text end

deleted text begin (1) prescribe the form of and information to be included on a record of birth resulting
in stillbirth, which shall be as similar as possible to the form of and information included
on a record of birth;
deleted text end

deleted text begin (2) prescribe the form of and information to be provided by the parent of a stillbirth
requesting a record of birth resulting in stillbirth under subdivisions 3 and 4 and make this
form available on the Department of Health's website;
deleted text end

deleted text begin (3) issue a certified copy of a record of birth resulting in stillbirth to a parent of the
stillbirth that is the subject of the record if:
deleted text end

deleted text begin (i) a record of birth resulting in stillbirth has been prepared and filed under subdivision
3 or 4; and
deleted text end

deleted text begin (ii) the parent requesting a certified copy of the record submits the request in writing;
and
deleted text end

deleted text begin (4) create and implement a process for entering, preparing, and handling stillbirth records
identical or as close as possible to the processes for birth and fetal death records when
feasible, but no later than the date on which the next reprogramming of the Department of
Health's database for vital records is completed.
deleted text end

Sec. 5.

Minnesota Statutes 2022, section 144.222, is amended to read:

144.222 new text begin FETAL DEATH new text end REPORTS deleted text begin OF FETAL OR INFANT DEATHdeleted text end new text begin AND
REGISTRATIONnew text end .

Subdivision 1.

Fetal death report required.

A fetal death deleted text begin reportdeleted text end must be deleted text begin fileddeleted text end new text begin registered
or reportednew text end within five days of the death of a fetus for whom 20 or more weeks of gestation
have elapsed, except for abortions defined under section 145.4241. A fetal death deleted text begin report must
be prepareddeleted text end new text begin must be registered or reportednew text end in a format prescribed by the state registrar and
filed in accordance with Minnesota Rules, parts 4601.0100 to 4601.2600 by:

(1) a person in charge of an institution or that person's authorized designee if a fetus is
delivered in the institution or en route to the institution;

(2) a physician, certified nurse midwife, or other licensed medical personnel in attendance
at or immediately after the delivery if a fetus is delivered outside an institution; or

(3) a parent or other person in charge of the disposition of the remains if a fetal death
occurred without medical attendance at or immediately after the delivery.

deleted text begin Subd. 2.deleted text end

deleted text begin Sudden infant deathdeleted text end deleted text begin .deleted text end

deleted text begin Each infant death which is diagnosed as sudden infant
death syndrome shall be reported within five days to the state registrar.
deleted text end

Sec. 6.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 2a.new text end

new text begin Connector.new text end

new text begin "Connector" means gooseneck, pigtail, and other service line
connectors. A connector is typically a short section of piping not exceeding two feet that
can be bent and used for connections between rigid service piping.
new text end

Sec. 7.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 3a.new text end

new text begin Galvanized requiring replacement.new text end

new text begin "Galvanized requiring replacement"
means a galvanized service line that is or was at any time connected to a lead service line
or lead status unknown service line, or is currently or was previously affixed to a lead
connector. The majority of galvanized service lines fall under this category.
new text end

Sec. 8.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 3b.new text end

new text begin Galvanized service line.new text end

new text begin "Galvanized service line" means a service line made
of iron or piping that has been dipped in zinc to prevent corrosion and rusting.
new text end

Sec. 9.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision to
read:

new text begin Subd. 3c.new text end

new text begin Lead connector.new text end

new text begin "Lead connector" means a connector made of lead.
new text end

Sec. 10.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision
to read:

new text begin Subd. 3d.new text end

new text begin Lead service line.new text end

new text begin "Lead service line" means a portion of pipe that is made
of lead, which connects the water main to the building inlet. A lead service line may be
owned by the water system, by the property owner, or both.
new text end

Sec. 11.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision
to read:

new text begin Subd. 3e.new text end

new text begin Lead status unknown service line or unknown service line.new text end

new text begin "Lead status
unknown service line" or "unknown service line" means a service line that has not been
demonstrated to meet or does not meet the definition of lead free in section 1417 of the Safe
Drinking Water Act.
new text end

Sec. 12.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision
to read:

new text begin Subd. 3f.new text end

new text begin Nonlead service line.new text end

new text begin "Nonlead service line" means a service line determined
through an evidence-based record, method, or technique not to be a lead service line or
galvanized service line requiring replacement. Most nonlead service lines are made of copper
or plastic.
new text end

Sec. 13.

Minnesota Statutes 2022, section 144.382, is amended by adding a subdivision
to read:

new text begin Subd. 4a.new text end

new text begin Service line.new text end

new text begin "Service line" means a portion of pipe that connects the water
main to the building inlet. A service line may be owned by the water system, by the property
owner, or both. A service line may be made of many materials, such as lead, copper,
galvanized steel, or plastic.
new text end

Sec. 14.

new text begin [144.3853] CLASSIFICATION OF SERVICE LINES.
new text end

new text begin Subdivision 1.new text end

new text begin Classification of lead status of service line.new text end

new text begin (a) A water system may
classify the actual material of a service line, such as copper or plastic, as an alternative to
classifying the service line as a nonlead service line, for the purpose of the lead service line
inventory.
new text end

new text begin (b) It is not necessary to physically verify the material composition, such as copper or
plastic, of a service line for its lead status to be identified. For example, if records demonstrate
the service line was installed after a municipal, state, or federal ban on the installation of
lead service lines, the service line may be classified as a nonlead service line.
new text end

new text begin Subd. 2.new text end

new text begin Lead connector.new text end

new text begin For the purposes of the lead service line inventory and lead
service line replacement plan, if a service line has a lead connector, the service line shall
be classified as a lead service line or a galvanized service line requiring replacement.
new text end

new text begin Subd. 3.new text end

new text begin Galvanized service line.new text end

new text begin A galvanized service line may only be classified as
a nonlead service line if there is documentation verifying it was never connected to a lead
service line or lead connector. Rarely will a galvanized service line be considered a nonlead
service line.
new text end

Sec. 15.

Minnesota Statutes 2022, section 144.55, subdivision 3, is amended to read:

Subd. 3.

Standards for licensure.

(a) Notwithstanding the provisions of section 144.56,
for the purpose of hospital licensure, the commissioner of health shall use as minimum
standards the hospital certification regulations promulgated pursuant to title XVIII of the
Social Security Act, United States Code, title 42, section 1395, et seq. The commissioner
may use as minimum standards changes in the federal hospital certification regulations
promulgated after May 7, 1981, if the commissioner finds that such changes are reasonably
necessary to protect public health and safety. deleted text begin The commissioner shall also promulgate in
rules additional minimum standards for new construction.
deleted text end

new text begin (b) Hospitals must meet the applicable provisions of the 2022 edition of the Facility
Guidelines Institute Guidelines for Design and Construction of Hospitals. This minimum
design standard must be met for all new licenses, new construction, change of use, or change
of occupancy for which plan review packages are received on or after January 1, 2024. For
the purposes of this subdivision, "Facility Guidelines Institute Guidelines for Design and
Construction of Hospitals" does not include any appendices to the guidelines.
new text end

new text begin (c) The commissioner shall review each new edition of the guidelines to determine if
they will be updated. If the commissioner decides to update the edition of the guidelines
specified in paragraph (b) for purposes of this subdivision, the commissioner must notify
the chairs and ranking minority members of the legislative committees with jurisdiction
over health care and public safety of the planned update by January 15 of the year in which
the new edition will become effective. Following notice from the commissioner, the new
edition shall become effective for hospitals beginning August 1 of that year, unless otherwise
provided in law. The commissioner shall, by publication in the State Register, specify a
date by which hospitals must comply with the updated edition. The date by which hospitals
must comply shall not be sooner than 12 months after publication of the commissioner's
notice in the State Register and applies only to plan review submissions received on or after
that date.
new text end

new text begin (d) Hospitals shall be in compliance with all applicable state and local governing laws,
regulations, standards, ordinances, and codes for fire safety, building, and zoning
requirements. The commissioner shall develop guidance to outline how the commissioner
will resolve conflicts between the guidelines and other applicable state and local governing
laws, regulations, standards, ordinances, and codes for fire safety, building, and zoning.
Guidance must be made publicly available at the time a new edition of the guidelines
becomes effective and shall be periodically updated.
new text end

deleted text begin (b)deleted text end new text begin (e)new text end Each hospital and outpatient surgical center shall establish policies and procedures
to prevent the transmission of human immunodeficiency virus and hepatitis B virus to
patients and within the health care setting. The policies and procedures shall be developed
in conformance with the most recent recommendations issued by the United States
Department of Health and Human Services, Public Health Service, Centers for Disease
Control. The commissioner of health shall evaluate a hospital's compliance with the policies
and procedures according to subdivision 4.

deleted text begin (c)deleted text end new text begin (f)new text end An outpatient surgical center must establish and maintain a comprehensive
tuberculosis infection control program according to the most current tuberculosis infection
control guidelines issued by the United States Centers for Disease Control and Prevention
(CDC), Division of Tuberculosis Elimination, as published in CDC's Morbidity and Mortality
Weekly Report (MMWR). This program must include a tuberculosis infection control plan
that covers all paid and unpaid employees, contractors, students, and volunteers. The
Department of Health shall provide technical assistance regarding implementation of the
guidelines.

deleted text begin (d)deleted text end new text begin (g)new text end Written compliance with this subdivision must be maintained by the outpatient
surgical center.

new text begin EFFECTIVE DATE.new text end

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

Sec. 16.

Minnesota Statutes 2022, section 144.6535, subdivision 1, is amended to read:

Subdivision 1.

Request for variance or waiver.

A hospital may request that the
commissioner grant a variance or waiver from the provisions of deleted text begin Minnesota Rules, chapter
4640 or 4645deleted text end new text begin section 144.55, subdivision 3, paragraph (b)new text end . A request for a variance or waiver
must be submitted to the commissioner in writing. Each request must contain:

(1) the specific deleted text begin rule or rulesdeleted text end new text begin requirementnew text end for which the variance or waiver is requested;

(2) the reasons for the request;

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

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

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

new text begin EFFECTIVE DATE.new text end

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

Sec. 17.

Minnesota Statutes 2022, section 144.6535, subdivision 2, is amended to read:

Subd. 2.

Criteria for evaluation.

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

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

(2) whether the alternative measures to be taken, if any, are equivalent to or superior to
those prescribed in deleted text begin Minnesota Rules, chapter 4640 or 4645deleted text end new text begin section 144.55, subdivision 3,
paragraph (b)new text end ; and

(3) whether compliance with the deleted text begin rule or rulesdeleted text end new text begin requirementsnew text end would impose an undue
burden upon the applicant.

new text begin EFFECTIVE DATE.new text end

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

Sec. 18.

Minnesota Statutes 2022, section 144.6535, subdivision 4, is amended to read:

Subd. 4.

Effect of alternative measures or conditions.

(a) Alternative measures or
conditions attached to a variance or waiver have the same force and effect as the deleted text begin rulesdeleted text end new text begin
requirementnew text end under deleted text begin Minnesota Rules, chapter 4640 or 4645deleted text end new text begin section 144.55, subdivision 3,
paragraph (b)new text end , and are subject to the issuance of correction orders and penalty assessments
in accordance with section 144.55.

(b) Fines for a violation of this section shall be in the same amount as that specified for
the particular deleted text begin ruledeleted text end new text begin requirementnew text end for which the variance or waiver was requested.

new text begin EFFECTIVE DATE.new text end

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

Sec. 19.

Minnesota Statutes 2022, section 144.69, is amended to read:

144.69 CLASSIFICATION OF DATA ON INDIVIDUALS.

new text begin Subdivision 1.new text end

new text begin Data collected by the cancer reporting system.new text end

Notwithstanding any
law to the contrary, including section 13.05, subdivision 9, data collected on individuals by
the cancer deleted text begin surveillancedeleted text end new text begin reportingnew text end system, including the names and personal identifiers of
persons required in section 144.68 to report, shall be private and may only be used for the
purposes set forth in this section and sections 144.671, 144.672, and 144.68. Any disclosure
other than is provided for in this section and sections 144.671, 144.672, and 144.68, is
declared to be a misdemeanor and punishable as such. Except as provided by rule, and as
part of an epidemiologic investigation, an officer or employee of the commissioner of health
may interview patients named in any such report, or relatives of any such patient, only after
deleted text begin the consent ofdeleted text end new text begin notifyingnew text end the attending physician, advanced practice registered nurse, physician
assistant, or surgeon deleted text begin is obtaineddeleted text end .new text begin Research protections for patients must be consistent with
section 13.04, subdivision 2, and Code of Federal Regulations, title 45, part 46.
new text end

new text begin Subd. 2.new text end

new text begin Transfers of information to state cancer registries and federal government
agencies.new text end

new text begin (a) Information containing personal identifiers of a non-Minnesota resident
collected by the cancer reporting system may be provided to the statewide cancer registry
of the nonresident's home state solely for the purposes consistent with this section and
sections 144.671, 144.672, and 144.68, provided that the other state agrees to maintain the
classification of the information as provided under subdivision 1.
new text end

new text begin (b) Information, excluding direct identifiers such as name, Social Security number,
telephone number, and street address, collected by the cancer reporting system may be
provided to the Centers for Disease Control and Prevention's National Program of Cancer
Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results
Program registry.
new text end

Sec. 20.

Minnesota Statutes 2022, section 144.9501, subdivision 17, is amended to read:

Subd. 17.

Lead hazard reduction.

new text begin (a) new text end "Lead hazard reduction" means abatementnew text begin , swab
team services,new text end or interim controls undertaken to make a residence, child care facility, school,
playground, or other location where lead hazards are identified lead-safe by complying with
the lead standards and methods adopted under section 144.9508.

new text begin (b) Lead hazard reduction does not include renovation activity that is primarily intended
to remodel, repair, or restore a given structure or dwelling rather than abate or control
lead-based paint hazards.
new text end

new text begin (c) Lead hazard reduction does not include activities that disturb painted surfaces that
total:
new text end

new text begin (1) less than 20 square feet (two square meters) on exterior surfaces; or
new text end

new text begin (2) less than two square feet (0.2 square meters) in an interior room.
new text end

Sec. 21.

Minnesota Statutes 2022, section 144.9501, subdivision 26a, is amended to read:

Subd. 26a.

Regulated lead work.

deleted text begin (a)deleted text end "Regulated lead work" means:

(1) abatement;

(2) interim controls;

(3) a clearance inspection;

(4) a lead hazard screen;

(5) a lead inspection;

(6) a lead risk assessment;

(7) lead project designer services;

(8) lead sampling technician services;

(9) swab team services;

(10) renovation activities; deleted text begin or
deleted text end

new text begin (11) lead hazard reduction; or
new text end

deleted text begin (11)deleted text end new text begin (12)new text end activities performed to comply with lead orders issued by deleted text begin a community health
boarddeleted text end new text begin an assessing agencynew text end .

deleted text begin (b) Regulated lead work does not include abatement, interim controls, swab team services,
or renovation activities that disturb painted surfaces that total no more than:
deleted text end

deleted text begin (1) 20 square feet (two square meters) on exterior surfaces; or
deleted text end

deleted text begin (2) six square feet (0.6 square meters) in an interior room.
deleted text end

Sec. 22.

Minnesota Statutes 2022, section 144.9501, subdivision 26b, is amended to read:

Subd. 26b.

Renovation.

new text begin (a) new text end "Renovation" means the modification of any pre-1978
affected property new text begin for compensation new text end that results in the disturbance of known or presumed
lead-containing painted surfaces defined under section 144.9508, unless that activity is
performed as lead hazard reduction. A renovation performed for the purpose of converting
a building or part of a building into an affected property is a renovation under this
subdivision.

new text begin (b) Renovation does not include minor repair and maintenance activities described in
this paragraph. All activities that disturb painted surfaces and are performed within 30 days
of other activities that disturb painted surfaces in the same room must be considered a single
project when applying the criteria below. Unless the activity involves window replacement
or demolition of a painted surface, building component, or portion of a structure, for purposes
of this paragraph, "minor repair and maintenance" means activities that disturb painted
surfaces totaling:
new text end

new text begin (1) less than 20 square feet (two square meters) on exterior surfaces; or
new text end

new text begin (2) less than six square feet (0.6 square meters) in an interior room.
new text end

new text begin (c) Renovation does not include total demolition of a freestanding structure. For purposes
of this paragraph, "total demolition" means demolition and disposal of all interior and
exterior painted surfaces, including windows. Unpainted foundation building components
remaining after total demolition may be reused.
new text end

Sec. 23.

Minnesota Statutes 2022, section 144.9501, is amended by adding a subdivision
to read:

new text begin Subd. 33.new text end

new text begin Compensation.new text end

new text begin "Compensation" means money or other mutually agreed upon
form of payment given or received for regulated lead work, including rental payments,
rental income, or salaries derived from rental payments.
new text end

Sec. 24.

Minnesota Statutes 2022, section 144.9501, is amended by adding a subdivision
to read:

new text begin Subd. 34.new text end

new text begin Individual.new text end

new text begin "Individual" means a natural person.
new text end

Sec. 25.

Minnesota Statutes 2022, section 144.9505, subdivision 1, is amended to read:

Subdivision 1.

Licensing, certification, and permitting.

(a) Fees collected under this
section shall be deposited into the state treasury and credited to the state government special
revenue fund.

(b) Persons shall not advertise or otherwise present themselves as lead supervisors, lead
workers, lead inspectors, lead risk assessors, lead sampling technicians, lead project designers,
renovation firms, or lead firms unless they have licenses or certificates issued by the
commissioner under this section.

(c) The fees required in this section for inspectors, risk assessors, and certified lead firms
are waived for state or local government employees performing services for or as an assessing
agency.

(d) deleted text begin An individual who is the owner of property on which regulated lead work is to be
performed or an adult individual who is related to the property owner, as defined under
section 245A.02, subdivision 13, is exempt from the requirements to obtain a license and
pay a fee according to this section.deleted text end new text begin Individual residential property owners or an adult
individual who is related to the property owner who performs regulated lead work on the
residence are exempt from the licensure and firm certification requirements of this section.
Notwithstanding the provisions of paragraphs (a) to (c), this exemption does not apply when
the regulated lead work is a renovation performed for compensation, when a child with an
elevated blood level has been identified in the residence or the building in which the residence
is located, or when the residence is occupied by one or more individuals who are not related
to the property owner, as defined under section 245A.02, subdivision 13.
new text end

deleted text begin (e) A person that employs individuals to perform regulated lead work outside of the
person's property must obtain certification as a certified lead firm. An individual who
performs lead hazard reduction, lead hazard screens, lead inspections, lead risk assessments,
clearance inspections, lead project designer services, lead sampling technician services,
swab team services, and activities performed to comply with lead orders must be employed
by a certified lead firm, unless the individual is a sole proprietor and does not employ any
other individuals, the individual is employed by a person that does not perform regulated
lead work outside of the person's property, or the individual is employed by an assessing
agency.
deleted text end

Sec. 26.

Minnesota Statutes 2022, section 144.9505, subdivision 1g, is amended to read:

Subd. 1g.

Certified lead firm.

A person whonew text begin performs ornew text end employs individuals to perform
regulated lead work, with the exception of renovation, deleted text begin outside of the person's propertydeleted text end must
obtain certification as a lead firm. The certificate must be in writing, contain an expiration
date, be signed by the commissioner, and give the name and address of the person to whom
it is issued. A lead firm certificate is valid for one year. The certification fee is $100, is
nonrefundable, and must be submitted with each application. The lead firm certificate or a
copy of the certificate must be readily available at the worksite for review by the contracting
entity, the commissioner, and other public health officials charged with the health, safety,
and welfare of the state's citizens.

Sec. 27.

Minnesota Statutes 2022, section 144.9505, subdivision 1h, is amended to read:

Subd. 1h.

Certified renovation firm.

A person who new text begin performs or new text end employs individuals
to perform renovation deleted text begin activities outside of the person's propertydeleted text end new text begin for compensationnew text end must
obtain certification as a renovation firm. The certificate must be in writing, contain an
expiration date, be signed by the commissioner, and give the name and address of the person
to whom it is issued. A renovation firm certificate is valid for two years. The certification
fee is $100, is nonrefundable, and must be submitted with each application. The renovation
firm certificate or a copy of the certificate must be readily available at the worksite for
review by the contracting entity, the commissioner, and other public health officials charged
with the health, safety, and welfare of the state's citizens.

Sec. 28.

Minnesota Statutes 2022, section 144.9508, subdivision 2, is amended to read:

Subd. 2.

Regulated lead work standards and methods.

(a) The commissioner shall
adopt rules establishing regulated lead work standards and methods in accordance with the
provisions of this section, for lead in paint, dust, drinking water, and soil in a manner that
protects public health and the environment for all residences, including residences also used
for a commercial purpose, child care facilities, playgrounds, and schools.

(b) In the rules required by this section, the commissioner shall require lead hazard
reduction of intact paint only if the commissioner finds that the intact paint is on a chewable
or lead-dust producing surface that is a known source of actual lead exposure to a specific
individual. The commissioner shall prohibit methods that disperse lead dust into the air that
could accumulate to a level that would exceed the lead dust standard specified under this
section. The commissioner shall work cooperatively with the commissioner of administration
to determine which lead hazard reduction methods adopted under this section may be used
for lead-safe practices including prohibited practices, preparation, disposal, and cleanup.
The commissioner shall work cooperatively with the commissioner of the Pollution Control
Agency to develop disposal procedures. In adopting rules under this section, the
commissioner shall require the best available technology for regulated lead work methods,
paint stabilization, and repainting.

(c) The commissioner of health shall adopt regulated lead work standards and methods
for lead in bare soil in a manner to protect public health and the environment. The
commissioner shall adopt a maximum standard of 100 parts of lead per million in bare soil.
The commissioner shall set a soil replacement standard not to exceed 25 parts of lead per
million. Soil lead hazard reduction methods shall focus on erosion control and covering of
bare soil.

(d) The commissioner shall adopt regulated lead work standards and methods for lead
in dust in a manner to protect the public health and environment. Dust standards shall use
a weight of lead per area measure and include dust on the floor, on the window sills, and
on window wells. Lead hazard reduction methods for dust shall focus on dust removal and
other practices which minimize the formation of lead dust from paint, soil, or other sources.

(e) The commissioner shall adopt lead hazard reduction standards and methods for lead
in drinking water both at the tap and public water supply system or private well in a manner
to protect the public health and the environment. The commissioner may adopt the rules
for controlling lead in drinking water as contained in Code of Federal Regulations, title 40,
part 141. Drinking water lead hazard reduction methods may include an educational approach
of minimizing lead exposure from lead in drinking water.

(f) The commissioner of the Pollution Control Agency shall adopt rules to ensure that
removal of exterior lead-based coatings from residences and steel structures by abrasive
blasting methods is conducted in a manner that protects health and the environment.

(g) All regulated lead work standards shall provide reasonable margins of safety that
are consistent with more than a summary review of scientific evidence and an emphasis on
overprotection rather than underprotection when the scientific evidence is ambiguous.

(h) No unit of local government shall have an ordinance or regulation governing regulated
lead work standards or methods for lead in paint, dust, drinking water, or soil that require
a different regulated lead work standard or method than the standards or methods established
under this section.

(i) Notwithstanding paragraph (h), the commissioner may approve the use by a unit of
local government of an innovative lead hazard reduction method which is consistent in
approach with methods established under this section.

(j) The commissioner shall adopt rules for issuing lead orders required under section
144.9504, rules for notification of abatement or interim control activities requirements, and
other rules necessary to implement sections 144.9501 to 144.9512.

(k) The commissioner shall adopt rules consistent with section 402(c)(3) of the Toxic
Substances Control Act new text begin and all regulations adopted thereunder new text end to ensure that renovation in
a pre-1978 affected property deleted text begin where a child or pregnant female residesdeleted text end is conducted in a
manner that protects health and the environment. Notwithstanding sections 14.125 and
14.128, the authority to adopt these rules does not expire.

(l) The commissioner shall adopt rules consistent with sections 406(a) and 406(b) of the
Toxic Substances Control Act. Notwithstanding sections 14.125 and 14.128, the authority
to adopt these rules does not expire.

Sec. 29.

Minnesota Statutes 2022, section 144A.06, subdivision 2, is amended to read:

Subd. 2.

New license required; change of ownership.

(a) The commissioner of health
by rule shall prescribe procedures for licensure under this section.

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

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

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

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

(i) a different personnew text begin or multiple different personsnew text end ; or

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

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

Sec. 30.

Minnesota Statutes 2022, section 144A.071, subdivision 2, is amended to read:

Subd. 2.

Moratorium.

new text begin (a) new text end The commissioner of health, in coordination with the
commissioner of human services, shall deny each request for new licensed or certified
nursing home or certified boarding care beds except as provided in subdivision 3 or 4a, or
section 144A.073. "Certified bed" means a nursing home bed or a boarding care bed certified
by the commissioner of health for the purposes of the medical assistance program, under
United States Code, title 42, sections 1396 et seq. Certified beds in facilities which do not
allow medical assistance intake shall be deemed to be decertified for purposes of this section
only.

new text begin (b) new text end The commissioner of human services, in coordination with the commissioner of
health, shall deny any request to issue a license under section 252.28 and chapter 245A to
a nursing home or boarding care home, if that license would result in an increase in the
medical assistance reimbursement amount.

new text begin (c) new text end In addition, the commissioner of health must not approve any construction project
whose cost exceeds $1,000,000, unless:

deleted text begin (a)deleted text end new text begin (1)new text end any construction costs exceeding $1,000,000 are not added to the facility's
appraised value and are not included in the facility's payment rate for reimbursement under
the medical assistance program; or

deleted text begin (b)deleted text end new text begin (2)new text end the project:

deleted text begin (1)deleted text end new text begin (i)new text end has been approved through the process described in section 144A.073;

deleted text begin (2)deleted text end new text begin (ii)new text end meets an exception in subdivision 3 or 4a;

deleted text begin (3)deleted text end new text begin (iii)new text end is necessary to correct violations of state or federal law issued by the
commissioner of health;

deleted text begin (4)deleted text end new text begin (iv)new text end is necessary to repair or replace a portion of the facility that was damaged by
fire, lightning, ground shifts, or other such hazards, including environmental hazards,
provided that the provisions of subdivision 4a, clause (a), are met; or

deleted text begin (5)deleted text end new text begin (v)new text end is being proposed by a licensed nursing facility that is not certified to participate
in the medical assistance program and will not result in new licensed or certified beds.

new text begin (d) new text end Prior to the final plan approval of any construction project, the commissioners of
health and human services shall be provided with an itemized cost estimate for the project
construction costs. If a construction project is anticipated to be completed in phases, the
total estimated cost of all phases of the project shall be submitted to the commissioners and
shall be considered as one construction project. Once the construction project is completed
and prior to the final clearance by the commissioners, the total project construction costs
for the construction project shall be submitted to the commissioners. If the final project
construction cost exceeds the dollar threshold in this subdivision, the commissioner of
human services shall not recognize any of the project construction costs or the related
financing costs in excess of this threshold in establishing the facility's property-related
payment rate.

new text begin (e) new text end The dollar thresholds for construction projects are as follows: for construction projects
other than those authorized in deleted text begin clauses (1) to (6)deleted text end new text begin paragraph (c), clause (2), items (i) to (v)new text end ,
the dollar threshold is $1,000,000. For projects authorized after July 1, 1993, under deleted text begin clause
(1)deleted text end new text begin paragraph (c), clause (2), item (i)new text end , the dollar threshold is the cost estimate submitted
with a proposal for an exception under section 144A.073, plus inflation as calculated
according to section 256B.431, subdivision 3f, paragraph (a). For projects authorized under
deleted text begin clauses (2) to (4)deleted text end new text begin paragraph (c), clause (2), items (ii) to (iv)new text end , the dollar threshold is the
itemized estimate project construction costs submitted to the commissioner of health at the
time of final plan approval, plus inflation as calculated according to section 256B.431,
subdivision 3f, paragraph (a).

new text begin (f) new text end The commissioner of health shall adopt rules to implement this section or to amend
the emergency rules for granting exceptions to the moratorium on nursing homes under
section 144A.073.

new text begin (g) All construction projects approved through section 144A.073, subdivision 3, after
March 1, 2020, are subject to the fair rental value property rate as described in section
256R.26.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective retroactively from March 1, 2020.
new text end

Sec. 31.

Minnesota Statutes 2022, section 144A.073, subdivision 3b, is amended to read:

Subd. 3b.

Amendments to approved projects.

(a) Nursing facilities that have received
approval deleted text begin on or after July 1, 1993,deleted text end for exceptions to the moratorium on nursing homes through
the process described in this section may request amendments to the designs of the projects
by writing the commissioner within 15 months of receiving approval. Applicants shall
submit supporting materials that demonstrate how the amended projects meet the criteria
described in paragraph (b).

(b) The commissioner shall approve requests for amendments for projects approved deleted text begin on
or after July 1, 1993,deleted text end according to the following criteria:

(1) the amended project designs must provide solutions to all of the problems addressed
by the original application that are at least as effective as the original solutions;

(2) the amended project designs may not reduce the space in each resident's living area
or in the total amount of common space devoted to resident and family uses by more than
five percent;

(3) the costs deleted text begin recognized for reimbursementdeleted text end of amended project designs shall be deleted text begin the
threshold amount of the original proposal as identified according to section 144A.071,
subdivision 2deleted text end new text begin the cost estimate associated with the project as originally approvednew text end , except
under conditions described in clause (4); and

(4) total costs deleted text begin up to ten percent greater than the cost identified in clause (3) may be
recognized for reimbursement ifdeleted text end new text begin of the amendment are no greater than ten percent of the
cost estimate associated with the project as initially approved ifnew text end the proposer can document
that one of the following circumstances is true:

(i) changes are needed due to a natural disaster;

(ii) conditions that affect the safety or durability of the project that could not have
reasonably been known prior to approval are discovered;

(iii) state or federal law require changes in project design; or

(iv) documentable circumstances occur that are beyond the control of the owner and
require changes in the design.

(c) Approval of a request for an amendment does not alter the expiration of approval of
the project according to subdivision 3.

new text begin (d) Reimbursement for amendments to approved projects is independent of the actual
construction costs and based on the allowable appraised value of the completed project. An
approved project may not be amended to reduce the scope of an approved project.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective retroactively from March 1, 2020.
new text end

Sec. 32.

Minnesota Statutes 2022, section 144A.474, subdivision 3, is amended to read:

Subd. 3.

Survey process.

The survey process for core surveys shall include the following
as applicable to the particular licensee and setting surveyed:

(1) presurvey review of pertinent documents and notification to the ombudsman for
long-term care;

(2) an entrance conference with available staff;

(3) communication with managerial officials or the registered nurse in charge, if available,
and ongoing communication with key staff throughout the survey regarding information
needed by the surveyor, clarifications regarding home care requirements, and applicable
standards of practice;

(4) presentation of written contact information to the provider about the survey staff
conducting the survey, the supervisor, and the process for requesting a reconsideration of
the survey results;

(5) a brief tour of deleted text begin a sample ofdeleted text end the deleted text begin housing with services establishmentsdeleted text end new text begin establishmentnew text end
in which the provider is providing home care services;

(6) a sample selection of home care clients;

(7) information-gathering through client and staff observations, client and staff interviews,
and reviews of records, policies, procedures, practices, and other agency information;

(8) interviews of clients' family members, if available, with clients' consent when the
client can legally give consent;

(9) except for complaint surveys conducted by the Office of Health Facilities Complaints,
an deleted text begin on-sitedeleted text end exit conferencedeleted text begin ,deleted text end with preliminary findings deleted text begin shared anddeleted text end discussed with the providernew text begin
within one business day after completion of survey activitiesnew text end , deleted text begin documentation that an exit
conference occurred,deleted text end and new text begin with new text end written information provided on the process for requesting
a reconsideration of the survey results; and

(10) postsurvey analysis of findings and formulation of survey results, including
correction orders when applicable.

new text begin EFFECTIVE DATE.new text end

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

Sec. 33.

Minnesota Statutes 2022, section 144A.474, subdivision 9, is amended to read:

Subd. 9.

Follow-up surveys.

For providers that have Level 3 or Level 4 violations under
subdivision 11, deleted text begin or any violations determined to be widespread,deleted text end the department shall conduct
a follow-up survey within 90 calendar days of the survey. When conducting a follow-up
survey, the surveyor will focus on whether the previous violations have been corrected and
may also address any new violations that are observed while evaluating the corrections that
have been made.

new text begin EFFECTIVE DATE.new text end

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

Sec. 34.

Minnesota Statutes 2022, section 144A.474, subdivision 12, is amended to read:

Subd. 12.

Reconsideration.

(a) The commissioner shall make available to home care
providers a correction order reconsideration process. This process may be used to challenge
the correction order issued, including the level and scope described in subdivision 11, and
any fine assessed. During the correction order reconsideration request, the issuance for the
correction orders under reconsideration are not stayed, but the department shall post
information on the website with the correction order that the licensee has requested a
reconsideration and that the review is pending.

(b) A licensed home care provider may request from the commissioner, in writing, a
correction order reconsideration regarding any correction order issued to the provider. The
written request for reconsideration must be received by the commissioner within 15 deleted text begin calendardeleted text end new text begin
businessnew text end days of the correction order receipt date. The correction order reconsideration shall
not be reviewed by any surveyor, investigator, or supervisor that participated in the writing
or reviewing of the correction order being disputed. The correction order reconsiderations
may be conducted in person, by telephone, by another electronic form, or in writing, as
determined by the commissioner. The commissioner shall respond in writing to the request
from a home care provider for a correction order reconsideration within 60 days of the date
the provider requests a reconsideration. The commissioner's response shall identify the
commissioner's decision regarding each citation challenged by the home care provider.

(1) supported in full, the correction order is supported in full, with no deletion of findings
to the citation;

(2) supported in substance, the correction order is supported, but one or more findings
are deleted or modified without any change in the citation;

(3) correction order cited an incorrect home care licensing requirement, the correction
order is amended by changing the correction order to the appropriate statutory reference;

(4) correction order was issued under an incorrect citation, the correction order is amended
to be issued under the more appropriate correction order citation;

(5) the correction order is rescinded;

(6) fine is amended, it is determined that the fine assigned to the correction order was
applied incorrectly; or

(7) the level or scope of the citation is modified based on the reconsideration.

(d) If the correction order findings are changed by the commissioner, the commissioner
shall update the correction order website.

(e) This subdivision does not apply to temporary licensees.

Sec. 35.

Minnesota Statutes 2022, section 144A.4791, subdivision 10, is amended to read:

Subd. 10.

Termination of service plan.

(a) If a home care provider terminates a service
plan with a client, and the client continues to need home care services, the home care provider
shall provide the client and the client's representative, if any, with a written notice of
termination which includes the following information:

(1) the effective date of termination;

(2) the reason for termination;

new text begin (3) for clients age 18 or older, a statement that the client may contact the Office of
Ombudsman for Long-Term Care to request an advocate to assist regarding the termination
and contact information for the office, including the office's central telephone number;
new text end

deleted text begin (3)deleted text end new text begin (4)new text end a list of known licensed home care providers in the client's immediate geographic
area;

deleted text begin (4)deleted text end new text begin (5)new text end a statement that the home care provider will participate in a coordinated transfer
of care of the client to another home care provider, health care provider, or caregiver, as
required by the home care bill of rights, section 144A.44, subdivision 1, clause (17);

deleted text begin (5)deleted text end new text begin (6)new text end the name and contact information of a person employed by the home care provider
with whom the client may discuss the notice of termination; and

deleted text begin (6)deleted text end new text begin (7)new text end if applicable, a statement that the notice of termination of home care services
does not constitute notice of termination of deleted text begin the housing with services contract with a housing
with services establishmentdeleted text end new text begin any housing contractnew text end .

(b) When the home care provider voluntarily discontinues services to all clients, the
home care provider must notify the commissioner, lead agencies, and ombudsman for
long-term care about its clients and comply with the requirements in this subdivision.

Sec. 36.

Minnesota Statutes 2022, section 148.512, subdivision 10a, is amended to read:

Subd. 10a.

Hearing aid.

"Hearing aid" means deleted text begin an instrumentdeleted text end new text begin a prescribed aidnew text end , or any of
its parts, worn in the ear canal and designed to or represented as being able to aid deleted text begin or enhancedeleted text end
human hearing. "Hearing aid" includes the aid's parts, attachments, or accessories, including,
but not limited to, ear molds and behind the ear (BTE) devices with or without an ear mold.
Batteries and cords are not parts, attachments, or accessories of a hearing aid. Surgically
implanted hearing aids, and assistive listening devices not worn within the ear canal, are
not hearing aids.

Sec. 37.

Minnesota Statutes 2022, section 148.512, subdivision 10b, is amended to read:

Subd. 10b.

Hearing aid dispensing.

"Hearing aid dispensing" means making ear mold
impressions, prescribingdeleted text begin , or recommendingdeleted text end a hearing aid, assisting the consumer in
new text begin prescription new text end aid selectiondeleted text begin , selling hearing aids at retaildeleted text end , or testing human hearing in connection
with these activities regardless of whether the person conducting these activities has a
monetary interest in the dispensing of new text begin prescription new text end hearing aids to the consumer.new text begin Hearing
aid dispensing does not include selling over-the-counter hearing aids.
new text end

Sec. 38.

Minnesota Statutes 2022, section 148.512, is amended by adding a subdivision
to read:

new text begin Subd. 10c.new text end

new text begin Over-the-counter hearing aid or OTC hearing aid.new text end

new text begin "Over-the-counter
hearing aid" or "OTC hearing aid" has the meaning given to that term in Code of Federal
Regulations, title 21, section 800.30(b).
new text end

Sec. 39.

Minnesota Statutes 2022, section 148.512, is amended by adding a subdivision
to read:

new text begin Subd. 13a.new text end

new text begin Prescription hearing aid.new text end

new text begin "Prescription hearing aid" means a hearing aid
requiring a prescription from a certified hearing aid dispenser or licensed audiologist that
is not an OTC hearing aid.
new text end

Sec. 40.

Minnesota Statutes 2022, section 148.513, is amended by adding a subdivision
to read:

new text begin Subd. 4.new text end

new text begin Over-the-counter hearing aids.new text end

new text begin Nothing in sections 148.511 to 148.5198 shall
preclude licensed audiologists from dispensing or selling over-the-counter hearing aids.
new text end

Sec. 41.

Minnesota Statutes 2022, section 148.515, subdivision 6, is amended to read:

Subd. 6.

Dispensing audiologist examination requirements.

(a) Audiologists are
exempt from the written examination requirement in section 153A.14, subdivision 2h,
paragraph (a), clause (1).

(b) After July 31, 2005, all applicants for audiologist licensure under sections 148.512
to 148.5198 must achieve a passing score on the practical tests of proficiency described in
section 153A.14, subdivision 2h, paragraph (a), clause (2), within the time period described
in section 153A.14, subdivision 2h, paragraph (c).

(c) In order to dispense new text begin prescription new text end hearing aids as a sole proprietor, member of a
partnership, or for a limited liability company, corporation, or any other entity organized
for profit, a licensee who obtained audiologist licensure under sections 148.512 to 148.5198,
before August 1, 2005, and who is not certified to dispense new text begin prescription new text end hearing aids under
chapter 153A, must achieve a passing score on the practical tests of proficiency described
in section 153A.14, subdivision 2h, paragraph (a), clause (2), within the time period described
in section 153A.14, subdivision 2h, paragraph (c). All other audiologist licensees who
obtained licensure before August 1, 2005, are exempt from the practical tests.

(d) An applicant for an audiology license who obtains a temporary license under section
148.5175 may dispense new text begin prescription new text end hearing aids only under supervision of a licensed
audiologist who dispenses new text begin prescription new text end hearing aids.

Sec. 42.

Minnesota Statutes 2022, section 148.5175, is amended to read:

148.5175 TEMPORARY LICENSURE.

(a) The commissioner shall issue temporary licensure as a speech-language pathologist,
an audiologist, or both, to an applicant who:

(1) submits a signed and dated affidavit stating that the applicant is not the subject of a
disciplinary action or past disciplinary action in this or another jurisdiction and is not
disqualified on the basis of section 148.5195, subdivision 3; and

(2) either:

(i) provides a copy of a current credential as a speech-language pathologist, an audiologist,
or both, held in the District of Columbia or a state or territory of the United States; or

(ii) provides a copy of a current certificate of clinical competence issued by the American
Speech-Language-Hearing Association or board certification in audiology by the American
Board of Audiology.

(b) A temporary license issued to a person under this subdivision expires 90 days after
it is issued or on the date the commissioner grants or denies licensure, whichever occurs
first.

(c) Upon application, a temporary license shall be renewed twice to a person who is able
to demonstrate good cause for failure to meet the requirements for licensure within the
initial temporary licensure period and who is not the subject of a disciplinary action or
disqualified on the basis of section 148.5195, subdivision 3. Good cause includes but is not
limited to inability to take and complete the required practical exam for dispensing
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end .

(d) Upon application, a temporary license shall be issued to a person who meets the
requirements of section 148.515, subdivisions 2a and 4, but has not completed the
requirement in section 148.515, subdivision 6.

Sec. 43.

Minnesota Statutes 2022, section 148.5195, subdivision 3, is amended to read:

Subd. 3.

Grounds for disciplinary action by commissioner.

The commissioner may
take any of the disciplinary actions listed in subdivision 4 on proof that the individual has:

(1) intentionally submitted false or misleading information to the commissioner or the
advisory council;

(2) failed, within 30 days, to provide information in response to a written request by the
commissioner or advisory council;

(3) performed services of a speech-language pathologist or audiologist in an incompetent
or negligent manner;

(4) violated sections 148.511 to 148.5198;

(5) failed to perform services with reasonable judgment, skill, or safety due to the use
of alcohol or drugs, or other physical or mental impairment;

(6) violated any state or federal law, rule, or regulation, and the violation is a felony or
misdemeanor, an essential element of which is dishonesty, or which relates directly or
indirectly to the practice of speech-language pathology or audiology. Conviction for violating
any state or federal law which relates to speech-language pathology or audiology is
necessarily considered to constitute a violation, except as provided in chapter 364;

(7) aided or abetted another person in violating any provision of sections 148.511 to
148.5198;

(8) been or is being disciplined by another jurisdiction, if any of the grounds for the
discipline is the same or substantially equivalent to those under sections 148.511 to 148.5198;

(9) not cooperated with the commissioner or advisory council in an investigation
conducted according to subdivision 1;

(10) advertised in a manner that is false or misleading;

(11) engaged in conduct likely to deceive, defraud, or harm the public; or demonstrated
a willful or careless disregard for the health, welfare, or safety of a client;

(12) failed to disclose to the consumer any fee splitting or any promise to pay a portion
of a fee to any other professional other than a fee for services rendered by the other
professional to the client;

(13) engaged in abusive or fraudulent billing practices, including violations of federal
Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical
assistance laws;

(14) obtained money, property, or services from a consumer through the use of undue
influence, high pressure sales tactics, harassment, duress, deception, or fraud;

(15) performed services for a client who had no possibility of benefiting from the services;

(16) failed to refer a client for medical evaluation or to other health care professionals
when appropriate or when a client indicated symptoms associated with diseases that could
be medically or surgically treated;

(17) had the certification required by chapter 153A denied, suspended, or revoked
according to chapter 153A;

(18) used the term doctor of audiology, doctor of speech-language pathology, AuD, or
SLPD without having obtained the degree from an institution accredited by the North Central
Association of Colleges and Secondary Schools, the Council on Academic Accreditation
in Audiology and Speech-Language Pathology, the United States Department of Education,
or an equivalent;

(19) failed to comply with the requirements of section 148.5192 regarding supervision
of speech-language pathology assistants; or

(20) if the individual is an audiologist or certified new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispenser:

(i) prescribed deleted text begin or otherwise recommendeddeleted text end to a consumer or potential consumer the use
of a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end , unless the prescription from a physician deleted text begin or
recommendation fromdeleted text end new text begin ,new text end an audiologistnew text begin ,new text end or new text begin a new text end certified dispenser is in writing, is based on an
audiogram that is delivered to the consumer or potential consumer when the prescription
deleted text begin or recommendationdeleted text end is made, and bears the following information in all capital letters of
12-point or larger boldface type: "THIS PRESCRIPTION deleted text begin OR RECOMMENDATIONdeleted text end
MAY BE FILLED BY, AND new text begin PRESCRIPTION new text end HEARING deleted text begin INSTRUMENTSdeleted text end new text begin AIDSnew text end MAY
BE PURCHASED FROM, THE LICENSED AUDIOLOGIST OR CERTIFIED DISPENSER
OF YOUR CHOICE";

(ii) failed to give a copy of the audiogram, upon which the prescription deleted text begin or
recommendationdeleted text end is based, to the consumer when the consumer requests a copy;

(iii) failed to provide the consumer rights brochure required by section 148.5197,
subdivision 3;

(iv) failed to comply with restrictions on sales of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end
in sections 148.5197, subdivision 3, and 148.5198;

(v) failed to return a consumer's new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end used as a trade-in
or for a discount in the price of a newnew text begin prescriptionnew text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end when requested
by the consumer upon cancellation of the purchase agreement;

(vi) failed to follow Food and Drug Administration or Federal Trade Commission
regulations relating to dispensingnew text begin prescriptionnew text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ;

(vii) failed to dispense a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end in a competent manner or
without appropriate training;

(viii) delegated new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing authority to a person not
authorized to dispense a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end under this chapter or chapter
153A;

(ix) failed to comply with the requirements of an employer or supervisor of a new text begin prescription
new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser trainee;

(x) violated a state or federal court order or judgment, including a conciliation court
judgment, relating to the activities of the individual's new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensing; or

(xi) failed to include on the audiogram the practitioner's printed name, credential type,
credential number, signature, and date.

Sec. 44.

Minnesota Statutes 2022, section 148.5196, subdivision 1, is amended to read:

Subdivision 1.

Membership.

The commissioner shall appoint 12 persons to a
Speech-Language Pathologist and Audiologist Advisory Council. The 12 persons must
include:

(1) three public members, as defined in section 214.02. Two of the public members shall
be either persons receiving services of a speech-language pathologist or audiologist, or
family members of or caregivers to such persons, and at least one of the public members
shall be either a hearing deleted text begin instrumentdeleted text end new text begin aidnew text end user or an advocate of one;

(2) three speech-language pathologists licensed under sections 148.511 to 148.5198,
one of whom is currently and has been, for the five years immediately preceding the
appointment, engaged in the practice of speech-language pathology in Minnesota and each
of whom is employed in a different employment setting including, but not limited to, private
practice, hospitals, rehabilitation settings, educational settings, and government agencies;

(3) one speech-language pathologist licensed under sections 148.511 to 148.5198, who
is currently and has been, for the five years immediately preceding the appointment,
employed by a Minnesota public school district or a Minnesota public school district
consortium that is authorized by Minnesota Statutes and who is licensed in speech-language
pathology by the Professional Educator Licensing and Standards Board;

(4) three audiologists licensed under sections 148.511 to 148.5198, two of whom are
currently and have been, for the five years immediately preceding the appointment, engaged
in the practice of audiology and the dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end in
Minnesota and each of whom is employed in a different employment setting including, but
not limited to, private practice, hospitals, rehabilitation settings, educational settings, industry,
and government agencies;

(5) one nonaudiologist new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser recommended by
a professional association representing new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers; and

(6) one physician licensed under chapter 147 and certified by the American Board of
Otolaryngology, Head and Neck Surgery.

Sec. 45.

Minnesota Statutes 2022, section 148.5197, is amended to read:

148.5197 HEARING AID DISPENSING.

Subdivision 1.

Content of contracts.

Oral statements made by an audiologist or certified
dispenser regarding the provision of warranties, refunds, and service on the new text begin prescription
new text end hearing aid or aids dispensed must be written on, and become part of, the contract of sale,
specify the item or items covered, and indicate the person or business entity obligated to
provide the warranty, refund, or service.

Subd. 2.

Required use of license number.

The audiologist's license number or certified
dispenser's certificate number must appear on all contracts, bills of sale, and receipts used
in the sale of new text begin prescription new text end hearing aids.

Subd. 3.

Consumer rights information.

An audiologist or certified dispenser shall, at
the time of the deleted text begin recommendation ordeleted text end prescription, give a consumer rights brochure, prepared
by the commissioner and containing information about legal requirements pertaining to
dispensing of new text begin prescription new text end hearing aids, to each potential consumer of a new text begin prescription new text end hearing
aid. The brochure must contain information about the consumer information center described
in section 153A.18. A contract for a new text begin prescription new text end hearing aid must note the receipt of the
brochure by the consumer, along with the consumer's signature or initials.

Subd. 4.

Liability for contracts.

Owners of entities in the business of dispensing
new text begin prescription new text end hearing aids, employers of audiologists or persons who dispense new text begin prescription
new text end hearing aids, supervisors of trainees or audiology students, and hearing aid dispensers
conducting the transaction at issue are liable for satisfying all terms of contracts, written or
oral, made by their agents, employees, assignees, affiliates, or trainees, including terms
relating to products, repairs, warranties, service, and refunds. The commissioner may enforce
the terms of new text begin prescription new text end hearing aid contracts against the principal, employer, supervisor,
or dispenser who conducted the transaction and may impose any remedy provided for in
this chapter.

Sec. 46.

Minnesota Statutes 2022, section 148.5198, is amended to read:

148.5198 RESTRICTION ON SALE OF new text begin PRESCRIPTION new text end HEARING AIDS.

Subdivision 1.

45-calendar-day guarantee and buyer right to cancel.

(a) An audiologist
or certified dispenser dispensing a new text begin prescription new text end hearing aid in this state must comply with
paragraphs (b) and (c).

(b) The audiologist or certified dispenser must provide the buyer with a 45-calendar-day
written money-back guarantee. The guarantee must permit the buyer to cancel the purchase
for any reason within 45 calendar days after receiving the new text begin prescription new text end hearing aid by giving
or mailing written notice of cancellation to the audiologist or certified dispenser. If the buyer
mails the notice of cancellation, the 45-calendar-day period is counted using the postmark
date, to the date of receipt by the audiologist or certified dispenser. If the new text begin prescription new text end hearing
aid must be repaired, remade, or adjusted during the 45-calendar-day money-back guarantee
period, the running of the 45-calendar-day period is suspended one day for each 24-hour
period that the new text begin prescription new text end hearing aid is not in the buyer's possession. A repaired, remade,
or adjusted new text begin prescription new text end hearing aid must be claimed by the buyer within three business
days after notification of availability, after which time the running of the 45-calendar-day
period resumes. The guarantee must entitle the buyer, upon cancellation, to receive a refund
of payment within 30 days of return of the new text begin prescription new text end hearing aid to the audiologist or
certified dispenser. The audiologist or certified dispenser may retain as a cancellation fee
no more than $250 of the buyer's total purchase price of the new text begin prescription new text end hearing aid.

(c) The audiologist or certified dispenser shall provide the buyer with a contract written
in plain English, that contains uniform language and provisions that meet the requirements
under the Plain Language Contract Act, sections 325G.29 to 325G.36. The contract must
include, but is not limited to, the following: in immediate proximity to the space reserved
for the signature of the buyer, or on the first page if there is no space reserved for the
signature of the buyer, a clear and conspicuous disclosure of the following specific statement
in all capital letters of no less than 12-point boldface type: "MINNESOTA STATE LAW
GIVES THE BUYER THE RIGHT TO CANCEL THIS PURCHASE FOR ANY REASON
AT ANY TIME PRIOR TO MIDNIGHT OF THE 45TH CALENDAR DAY AFTER
RECEIPT OF THE new text begin PRESCRIPTION new text end HEARING AID(S). THIS CANCELLATION MUST
BE IN WRITING AND MUST BE GIVEN OR MAILED TO THE AUDIOLOGIST OR
CERTIFIED DISPENSER. IF THE BUYER DECIDES TO RETURN THE new text begin PRESCRIPTION
new text end HEARING AID(S) WITHIN THIS 45-CALENDAR-DAY PERIOD, THE BUYER WILL
RECEIVE A REFUND OF THE TOTAL PURCHASE PRICE OF THE AID(S) FROM
WHICH THE AUDIOLOGIST OR CERTIFIED DISPENSER MAY RETAIN AS A
CANCELLATION FEE NO MORE THAN $250."

Subd. 2.

Itemized repair bill.

Any audiologist, certified dispenser, or company who
agrees to repair a new text begin prescription new text end hearing aid must provide the owner of the new text begin prescription new text end hearing
aid, or the owner's representative, with a bill that describes the repair and services rendered.
The bill must also include the repairing audiologist's, certified dispenser's, or company's
name, address, and telephone number.

This subdivision does not apply to an audiologist, certified dispenser, or company that
repairs a new text begin prescription new text end hearing aid pursuant to an express warranty covering the entire
new text begin prescription new text end hearing aid and the warranty covers the entire cost, both parts and labor, of the
repair.

Subd. 3.

Repair warranty.

Any guarantee of new text begin prescription new text end hearing aid repairs must be
in writing and delivered to the owner of the new text begin prescription new text end hearing aid, or the owner's
representative, stating the repairing audiologist's, certified dispenser's, or company's name,
address, telephone number, length of guarantee, model, and serial number of the new text begin prescription
new text end hearing aid and all other terms and conditions of the guarantee.

Subd. 4.

Misdemeanor.

A person found to have violated this section is guilty of a
misdemeanor.

Subd. 5.

Additional.

In addition to the penalty provided in subdivision 4, a person found
to have violated this section is subject to the penalties and remedies provided in section
325F.69, subdivision 1.

Subd. 6.

Estimates.

Upon the request of the owner of a new text begin prescription new text end hearing aid or the
owner's representative for a written estimate and prior to the commencement of repairs, a
repairing audiologist, certified dispenser, or company shall provide the customer with a
written estimate of the price of repairs. If a repairing audiologist, certified dispenser, or
company provides a written estimate of the price of repairs, it must not charge more than
the total price stated in the estimate for the repairs. If the repairing audiologist, certified
dispenser, or company after commencing repairs determines that additional work is necessary
to accomplish repairs that are the subject of a written estimate and if the repairing audiologist,
certified dispenser, or company did not unreasonably fail to disclose the possible need for
the additional work when the estimate was made, the repairing audiologist, certified
dispenser, or company may charge more than the estimate for the repairs if the repairing
audiologist, certified dispenser, or company immediately provides the owner or owner's
representative a revised written estimate pursuant to this section and receives authorization
to continue with the repairs. If continuation of the repairs is not authorized, the repairing
audiologist, certified dispenser, or company shall return the new text begin prescription new text end hearing aid as close
as possible to its former condition and shall release the new text begin prescription new text end hearing aid to the owner
or owner's representative upon payment of charges for repairs actually performed and not
in excess of the original estimate.

Sec. 47.

Minnesota Statutes 2022, section 151.37, subdivision 12, is amended to read:

Subd. 12.

Administration of opiate antagonists for drug overdose.

(a) A licensed
physician, a licensed advanced practice registered nurse authorized to prescribe drugs
pursuant to section 148.235, or a licensed physician assistant may authorize the following
individuals to administer opiate antagonists, as defined in section 604A.04, subdivision 1:

(1) an emergency medical responder registered pursuant to section 144E.27;

(2) a peace officer as defined in section 626.84, subdivision 1, paragraphs (c) and (d);

(3) correctional employees of a state or local political subdivision;

(4) staff of community-based health disease prevention or social service programs;

(5) a volunteer firefighter; and

(6) a deleted text begin licensed schooldeleted text end nurse or deleted text begin certified public health nursedeleted text end new text begin any other personnelnew text end employed
by, or under contract with, a deleted text begin school board under section 121A.21deleted text end new text begin charter, public, or private
schoolnew text end .

(b) For the purposes of this subdivision, opiate antagonists may be administered by one
of these individuals only if:

(1) the licensed physician, licensed physician assistant, or licensed advanced practice
registered nurse has issued a standing order to, or entered into a protocol with, the individual;
and

(2) the individual has training in the recognition of signs of opiate overdose and the use
of opiate antagonists as part of the emergency response to opiate overdose.

new text begin (d) Notwithstanding section 148.235, subdivisions 8 and 9, a licensed practical nurse is
authorized to possess and administer according to this subdivision an opiate antagonist in
a school setting.
new text end

Sec. 48.

Minnesota Statutes 2022, section 152.28, subdivision 1, is amended to read:

Subdivision 1.

Health care practitioner duties.

(a) Prior to a patient's enrollment in
the registry program, a health care practitioner shall:

(1) determine, in the health care practitioner's medical judgment, whether a patient suffers
from a qualifying medical condition, and, if so determined, provide the patient with a
certification of that diagnosis;

(2) advise patients, registered designated caregivers, and parents, legal guardians, or
spouses who are acting as caregivers of the existence of any nonprofit patient support groups
or organizations;

(3) provide explanatory information from the commissioner to patients with qualifying
medical conditions, including disclosure to all patients about the experimental nature of
therapeutic use of medical cannabis; the possible risks, benefits, and side effects of the
proposed treatment; the application and other materials from the commissioner; and provide
patients with the Tennessen warning as required by section 13.04, subdivision 2; and

(4) agree to continue treatment of the patient's qualifying medical condition and report
medical findings to the commissioner.

(b) Upon notification from the commissioner of the patient's enrollment in the registry
program, the health care practitioner shall:

(1) participate in the patient registry reporting system under the guidance and supervision
of the commissioner;

(2) report health records of the patient throughout the ongoing treatment of the patient
to the commissioner in a manner determined by the commissioner and in accordance with
subdivision 2;

(3) determine, on a yearly basis, if the patient continues to suffer from a qualifying
medical condition and, if so, issue the patient a new certification of that diagnosis; and

(4) otherwise comply with all requirements developed by the commissioner.

(c) A health care practitioner may deleted text begin conduct a patient assessment to issue a recertification
as required under paragraph (b), clause (3), viadeleted text end new text begin utilize new text end telehealth, as defined in section
62A.673, subdivision 2new text begin , for certifications and recertificationsnew text end .

(d) Nothing in this section requires a health care practitioner to participate in the registry
program.

Sec. 49.

Minnesota Statutes 2022, section 152.29, subdivision 3a, is amended to read:

Subd. 3a.

Transportation of medical cannabis; new text begin transport new text end staffing.

(a) A medical
cannabis manufacturer may staff a transport motor vehicle with only one employee if the
medical cannabis manufacturer is transporting medical cannabis to either a certified
laboratory for the purpose of testing or a facility for the purpose of disposal. If the medical
cannabis manufacturer is transporting medical cannabis for any other purpose or destination,
the transport motor vehicle must be staffed with a minimum of two employees as required
by rules adopted by the commissioner.

(b) Notwithstanding paragraph (a), a medical cannabis manufacturer that is only
transporting hemp for any purpose may staff the transport motor vehicle with only one
employee.

new text begin (c) A medical cannabis manufacturer may contract with a third party for armored car
services for deliveries of medical cannabis from its production facility to distribution
facilities. A medical cannabis manufacturer that contracts for armored car services remains
responsible for the transportation manifest and inventory tracking requirements in rules
adopted by the commissioner.
new text end

new text begin (d) Department of Health staff may transport medical cannabis for the purposes of
delivering medical cannabis and other samples to a laboratory for testing under rules adopted
by the commissioner and in cases of special investigations when the commissioner has
determined there is a potential threat to public health. The transport motor vehicle must be
staffed with a minimum of two Department of Health employees. The employees must carry
with them their Department of Health identification card and a transport manifest.
new text end

Sec. 50.

Minnesota Statutes 2022, section 153A.13, subdivision 3, is amended to read:

Subd. 3.

Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end .

"Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end " means an instrumentdeleted text begin , or
any of its parts, worn in the ear canal and designed to or represented as being able to aid or
enhance human hearing. "Hearing instrument" includes the instrument's parts, attachments,
or accessories, including, but not limited to, ear molds and behind the ear (BTE) devices
with or without an ear mold. Batteries and cords are not parts, attachments, or accessories
of a hearing instrument. Surgically implanted hearing instruments, and assistive listening
devices not worn within the ear canal, are not hearing instruments.deleted text end new text begin as defined in section
148.512, subdivision 10a.
new text end

Sec. 51.

Minnesota Statutes 2022, section 153A.13, subdivision 4, is amended to read:

Subd. 4.

Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing.

"Hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing"
deleted text begin means making ear mold impressions, prescribing, or recommending a hearing instrument,
assisting the consumer in instrument selection, selling hearing instruments at retail, or testing
human hearing in connection with these activities regardless of whether the person conducting
these activities has a monetary interest in the sale of hearing instruments to the consumer.deleted text end new text begin
has the meaning given in section 148.512, subdivision 10b.
new text end

Sec. 52.

Minnesota Statutes 2022, section 153A.13, subdivision 5, is amended to read:

Subd. 5.

Dispenser of hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end .

"Dispenser of hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end " means a natural person who engages in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensingnew text begin ,new text end
whether or not certified by the commissioner of health or licensed by an existing
health-related board, except that a person described as follows is not a dispenser of
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end :

(1) a student participating in supervised field work that is necessary to meet requirements
of an accredited educational program if the student is designated by a title which clearly
indicates the student's status as a student trainee; or

(2) a person who helps a dispenser of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end in an
administrative or clerical manner and does not engage in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin
aidnew text end dispensing.

A person who offers to dispense a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end , or a person who
advertises, holds out to the public, or otherwise represents that the person is authorized to
dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aids,new text end must be certified by the commissioner except
when the person is an audiologist as defined in section 148.512.

Sec. 53.

Minnesota Statutes 2022, section 153A.13, subdivision 6, is amended to read:

Subd. 6.

Advisory council.

"Advisory council" means the Minnesota Hearing deleted text begin Instrumentdeleted text end new text begin
Aidnew text end Dispenser Advisory Council, or a committee of deleted text begin itdeleted text end new text begin the councilnew text end , established under section
153A.20.

Sec. 54.

Minnesota Statutes 2022, section 153A.13, subdivision 7, is amended to read:

Subd. 7.

ANSI.

"ANSI" means deleted text begin ANSI S3.6-1989,deleted text end American National Standard
Specification for Audiometers deleted text begin from the American National Standards Institute. This
document is available through the Minitex interlibrary loan systemdeleted text end new text begin as defined in the United
States Food and Drug Administration, Code of Federal Regulations, title 21, section
874.1050new text end .

Sec. 55.

Minnesota Statutes 2022, section 153A.13, subdivision 9, is amended to read:

Subd. 9.

Supervision.

"Supervision" means monitoring activities of, and accepting
responsibility for, the new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing activities of a trainee.

Sec. 56.

Minnesota Statutes 2022, section 153A.13, subdivision 10, is amended to read:

Subd. 10.

Direct supervision or directly supervised.

"Direct supervision" or "directly
supervised" means the on-site and contemporaneous location of a supervisor and trainee,
when the supervisor observes the trainee engaging in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensing with a consumer.

Sec. 57.

Minnesota Statutes 2022, section 153A.13, subdivision 11, is amended to read:

Subd. 11.

Indirect supervision or indirectly supervised.

"Indirect supervision" or
"indirectly supervised" means the remote and independent performance of new text begin prescription
new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing by a trainee when authorized under section 153A.14,
subdivision 4a, paragraph (b).

Sec. 58.

Minnesota Statutes 2022, section 153A.13, is amended by adding a subdivision
to read:

new text begin Subd. 12.new text end

new text begin Over-the-counter hearing aid or OTC hearing aid.new text end

new text begin "Over-the-counter
hearing aid" or "OTC hearing aid" has the meaning given in section 148.512, subdivision
10c.
new text end

Sec. 59.

Minnesota Statutes 2022, section 153A.13, is amended by adding a subdivision
to read:

new text begin Subd. 13.new text end

new text begin Prescription hearing aid.new text end

new text begin "Prescription hearing aid" has the meaning given
in section 148.512, subdivision 13a.
new text end

Sec. 60.

Minnesota Statutes 2022, section 153A.14, subdivision 1, is amended to read:

Subdivision 1.

Application for certificate.

An applicant must:

(1) be 21 years of age or older;

(2) apply to the commissioner for a certificate to dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end on application forms provided by the commissioner;

(3) at a minimum, provide the applicant's name, Social Security number, business address
and phone number, employer, and information about the applicant's education, training,
and experience in testing human hearing and fitting new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ;

(4) include with the application a statement that the statements in the application are
true and correct to the best of the applicant's knowledge and belief;

(5) include with the application a written and signed authorization that authorizes the
commissioner to make inquiries to appropriate regulatory agencies in this or any other state
where the applicant has sold new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ;

(6) submit certification to the commissioner that the applicant's audiometric equipment
has been calibrated to meet current ANSI standards within 12 months of the date of the
application;

(7) submit evidence of continuing education credits, if required;

(8) submit all fees as required under section 153A.17; and

(9) consent to a fingerprint-based criminal history records check required under section
144.0572, pay all required fees, and cooperate with all requests for information. An applicant
must complete a new criminal background check if more than one year has elapsed since
the applicant last applied for a license.

Sec. 61.

Minnesota Statutes 2022, section 153A.14, subdivision 2, is amended to read:

Subd. 2.

Issuance of certificate.

(a) The commissioner shall issue a certificate to each
dispenser of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end who applies under subdivision 1 if the
commissioner determines that the applicant is in compliance with this chapter, has passed
an examination administered by the commissioner, has met the continuing education
requirements, if required, and has paid the fee set by the commissioner. The commissioner
may reject or deny an application for a certificate if there is evidence of a violation or failure
to comply with this chapter.

(b) The commissioner shall not issue a certificate to an applicant who refuses to consent
to a criminal history background check as required by section 144.0572 within 90 days after
submission of an application or fails to submit fingerprints to the Department of Human
Services. Any fees paid by the applicant to the Department of Health shall be forfeited if
the applicant refuses to consent to the background study.

Sec. 62.

Minnesota Statutes 2022, section 153A.14, subdivision 2h, is amended to read:

Subd. 2h.

Certification by examination.

An applicant must achieve a passing score,
as determined by the commissioner, on an examination according to paragraphs (a) to (c).

(a) The examination must include, but is not limited to:

(1) A written examination approved by the commissioner covering the following areas
as they pertain to new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end selling:

(i) basic physics of sound;

(ii) the anatomy and physiology of the ear;

(iii) the function of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end ; and

(iv) the principles of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end selection.

(2) Practical tests of proficiency in the following techniques as they pertain to new text begin prescription
new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end selling:

(i) pure tone audiometry, including air conduction testing and bone conduction testing;

(ii) live voice or recorded voice speech audiometry including speech recognition
(discrimination) testing, most comfortable loudness level, and uncomfortable loudness
measurements of tolerance thresholds;

(iii) masking when indicated;

(iv) recording and evaluation of audiograms and speech audiometry to determine proper
selection and fitting of a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end ;

(v) taking ear mold impressions;

(vi) using an otoscope for the visual observation of the entire ear canal; and

(vii) state and federal laws, rules, and regulations.

(b) The practical examination shall be administered by the commissioner at least twice
a year.

(c) An applicant must achieve a passing score on all portions of the examination within
a two-year period. An applicant who does not achieve a passing score on all portions of the
examination within a two-year period must retake the entire examination and achieve a
passing score on each portion of the examination. An applicant who does not apply for
certification within one year of successful completion of the examination must retake the
examination and achieve a passing score on each portion of the examination. An applicant
may not take any part of the practical examination more than three times in a two-year
period.

Sec. 63.

Minnesota Statutes 2022, section 153A.14, subdivision 2i, is amended to read:

Subd. 2i.

Continuing education requirement.

On forms provided by the commissioner,
each certified dispenser must submit with the application for renewal of certification evidence
of completion of ten course hours of continuing education earned within the 12-month
period of November 1 to October 31, between the effective and expiration dates of
certification. Continuing education courses must be directly related tonew text begin prescriptionnew text end hearing
deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing and approved by the International Hearing Society, the American
Speech-Language-Hearing Association, or the American Academy of Audiology. Evidence
of completion of the ten course hours of continuing education must be submitted by
December 1 of each year. This requirement does not apply to dispensers certified for less
than one year.

Sec. 64.

Minnesota Statutes 2022, section 153A.14, subdivision 2j, is amended to read:

Subd. 2j.

Required use of certification number.

The certification holder must use the
certification number on all contracts, bills of sale, and receipts used in the sale of new text begin prescription
new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end .

Sec. 65.

Minnesota Statutes 2022, section 153A.14, subdivision 4, is amended to read:

Subd. 4.

Dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end without
certificate.

Except as provided in subdivisions 4a and 4c, and in sections 148.512 to
148.5198, it is unlawful for any person not holding a valid certificate to dispense a
new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end as defined in section 153A.13, subdivision 3. A person
who dispenses a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end without the certificate required by this
section is guilty of a gross misdemeanor.

Sec. 66.

Minnesota Statutes 2022, section 153A.14, subdivision 4a, is amended to read:

Subd. 4a.

Trainees.

(a) A person who is not certified under this section may dispense
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end as a trainee for a period not to exceed 12 months if
the person:

(1) submits an application on forms provided by the commissioner;

(2) is under the supervision of a certified dispenser meeting the requirements of this
subdivision;

(3) meets all requirements for certification except passage of the examination required
by this section; and

(4) uses the title "dispenser trainee" in contacts with the patients, clients, or consumers.

(b) A certified new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser may not supervise more
than two trainees at the same time and may not directly supervise more than one trainee at
a time. The certified dispenser is responsible for all actions or omissions of a trainee in
connection with the dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end . A certified dispenser
may not supervise a trainee if there are any commissioner, court, or other orders, currently
in effect or issued within the last five years, that were issued with respect to an action or
omission of a certified dispenser or a trainee under the certified dispenser's supervision.

Until taking and passing the practical examination testing the techniques described in
subdivision 2h, paragraph (a), clause (2), trainees must be directly supervised in all areas
described in subdivision 4b, and the activities tested by the practical examination. Thereafter,
trainees may dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end under indirect supervision until
expiration of the trainee period. Under indirect supervision, the trainee must complete two
monitored activities a week. Monitored activities may be executed by correspondence,
telephone, or other telephonic devices, and include, but are not limited to, evaluation of
audiograms, written reports, and contracts. The time spent in supervision must be recorded
and the record retained by the supervisor.

Sec. 67.

Minnesota Statutes 2022, section 153A.14, subdivision 4b, is amended to read:

Subd. 4b.

new text begin Prescription new text end hearing testing protocol.

A dispenser when conducting a hearing
test for the purpose of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing must:

(1) comply with the United States Food and Drug Administration warning regarding
potential medical conditions required by Code of Federal Regulations, title 21, section
deleted text begin 801.420deleted text end new text begin 801.422new text end ;

(2) complete a case history of the client's hearing;

(3) inspect the client's ears with an otoscope; and

(4) conduct the following tests on both ears of the client and document the results, and
if for any reason one of the following tests cannot be performed pursuant to the United
States Food and Drug Administration guidelines, an audiologist shall evaluate the hearing
and the need for a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end :

(i) air conduction at 250, 500, 1,000, 2,000, 4,000, and 8,000 Hertz. When a difference
of 20 dB or more occurs between adjacent octave frequencies the interoctave frequency
must be tested;

(ii) bone conduction at 500, 1,000, 2,000, and 4,000 Hertz for any frequency where the
air conduction threshold is greater than 15 dB HL;

(iii) monaural word recognition (discrimination), with a minimum of 25 words presented
for each ear; and

(iv) loudness discomfort level, monaural, for setting a new text begin prescription new text end hearing deleted text begin instrument'sdeleted text end new text begin
aid'snew text end maximum power output; and

(5) include masking in all tests whenever necessary to ensure accurate results.

Sec. 68.

Minnesota Statutes 2022, section 153A.14, subdivision 4c, is amended to read:

Subd. 4c.

Reciprocity.

(a) A person who has dispensed new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end in another jurisdiction may dispensenew text begin prescriptionnew text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end as a trainee
under indirect supervision if the person:

(1) satisfies the provisions of subdivision 4a, paragraph (a);

(2) submits a signed and dated affidavit stating that the applicant is not the subject of a
disciplinary action or past disciplinary action in this or another jurisdiction and is not
disqualified on the basis of section 153A.15, subdivision 1; and

(3) provides a copy of a current credential as a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispenser held in the District of Columbia or a state or territory of the United States.

(b) A person becoming a trainee under this subdivision who fails to take and pass the
practical examination described in subdivision 2h, paragraph (a), clause (2), when next
offered must cease dispensing new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end unless under direct
supervision.

Sec. 69.

Minnesota Statutes 2022, section 153A.14, subdivision 4e, is amended to read:

Subd. 4e.

new text begin Prescription new text end hearing aids; enforcement.

Costs incurred by the Minnesota
Department of Health for conducting investigations of unlicensed new text begin prescription new text end hearing aid
deleted text begin dispensersdeleted text end new text begin dispensingnew text end shall be apportioned between all licensed or credentialed professions
that dispense new text begin prescription new text end hearing aids.

Sec. 70.

Minnesota Statutes 2022, section 153A.14, subdivision 6, is amended to read:

Subd. 6.

new text begin Prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end to comply with federal and state
requirements.

The commissioner shall ensure that new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end
are dispensed in compliance with state requirements and the requirements of the United
States Food and Drug Administration. Failure to comply with state or federal regulations
may be grounds for enforcement actions under section 153A.15, subdivision 2.

Sec. 71.

Minnesota Statutes 2022, section 153A.14, subdivision 9, is amended to read:

Subd. 9.

Consumer rights.

A new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser shall comply
with the requirements of sections 148.5195, subdivision 3, clause (20); 148.5197; and
148.5198.

Sec. 72.

Minnesota Statutes 2022, section 153A.14, subdivision 11, is amended to read:

Subd. 11.

Requirement to maintain current information.

A dispenser must notify the
commissioner in writing within 30 days of the occurrence of any of the following:

(1) a change of name, address, home or business telephone number, or business name;

(2) the occurrence of conduct prohibited by section 153A.15;

(3) a settlement, conciliation court judgment, or award based on negligence, intentional
acts, or contractual violations committed in the dispensing of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin
aidsnew text end by the dispenser; and

(4) the cessation of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing activities as an
individual or a business.

Sec. 73.

Minnesota Statutes 2022, section 153A.14, is amended by adding a subdivision
to read:

new text begin Subd. 12.new text end

new text begin Over-the-counter hearing aids.new text end

new text begin Nothing in this chapter shall preclude certified
hearing aid dispensers from dispensing or selling over-the-counter hearing aids.
new text end

Sec. 74.

Minnesota Statutes 2022, section 153A.15, subdivision 1, is amended to read:

Subdivision 1.

Prohibited acts.

The commissioner may take enforcement action as
provided under subdivision 2 against a dispenser of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end
for the following acts and conduct:

(1) dispensing a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end to a minor person 18 years or younger
unless evaluated by an audiologist for hearing evaluation and new text begin prescription new text end hearing aid
evaluation;

(2) being disciplined through a revocation, suspension, restriction, or limitation by
another state for conduct subject to action under this chapter;

(3) presenting advertising that is false or misleading;

(4) providing the commissioner with false or misleading statements of credentials,
training, or experience;

(5) engaging in conduct likely to deceive, defraud, or harm the public; or demonstrating
a willful or careless disregard for the health, welfare, or safety of a consumer;

(6) splitting fees or promising to pay a portion of a fee to any other professional other
than a fee for services rendered by the other professional to the client;

(7) engaging in abusive or fraudulent billing practices, including violations of federal
Medicare and Medicaid laws, Food and Drug Administration regulations, or state medical
assistance laws;

(8) obtaining money, property, or services from a consumer through the use of undue
influence, high pressure sales tactics, harassment, duress, deception, or fraud;

(9) performing the services of a certified hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser in an
incompetent or negligent manner;

(10) failing to comply with the requirements of this chapter as an employer, supervisor,
or trainee;

(11) failing to provide information in a timely manner in response to a request by the
commissioner, commissioner's designee, or the advisory council;

(12) being convicted within the past five years of violating any laws of the United States,
or any state or territory of the United States, and the violation is a felony, gross misdemeanor,
or misdemeanor, an essential element of which relates to new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin
aidnew text end dispensing, except as provided in chapter 364;

(13) failing to cooperate with the commissioner, the commissioner's designee, or the
advisory council in any investigation;

(14) failing to perform new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing with reasonable
judgment, skill, or safety due to the use of alcohol or drugs, or other physical or mental
impairment;

(15) failing to fully disclose actions taken against the applicant or the applicant's legal
authorization to dispense new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end in this or another state;

(16) violating a state or federal court order or judgment, including a conciliation court
judgment, relating to the activities of the applicant in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensing;

(17) having been or being disciplined by the commissioner of the Department of Health,
or other authority, in this or another jurisdiction, if any of the grounds for the discipline are
the same or substantially equivalent to those in sections 153A.13 to 153A.18;

(18) misrepresenting the purpose of hearing tests, or in any way communicating that the
hearing test or hearing test protocol required by section 153A.14, subdivision 4b, is a medical
evaluation, a diagnostic hearing evaluation conducted by an audiologist, or is other than a
test to select a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end , except that the new text begin prescription new text end hearing
deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser can determine the need for or recommend the consumer obtain a
medical evaluation consistent with requirements of the United States Food and Drug
Administration;

(19) violating any of the provisions of sections 148.5195, subdivision 3, clause (20);
148.5197; 148.5198; and 153A.13 to 153A.18; and

(20) aiding or abetting another person in violating any of the provisions of sections
148.5195, subdivision 3, clause (20); 148.5197; 148.5198; and 153A.13 to 153A.18.

Sec. 75.

Minnesota Statutes 2022, section 153A.15, subdivision 2, is amended to read:

Subd. 2.

Enforcement actions.

When the commissioner finds that a dispenser of
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end has violated one or more provisions of this chapter,
the commissioner may do one or more of the following:

(1) deny or reject the application for a certificate;

(2) revoke the certificate;

(3) suspend the certificate;

(4) impose, for each violation, a civil penalty that deprives the dispenser of any economic
advantage gained by the violation and that reimburses the Department of Health for costs
of the investigation and proceeding resulting in disciplinary action, including the amount
paid for services of the Office of Administrative Hearings, the amount paid for services of
the Office of the Attorney General, attorney fees, court reporters, witnesses, reproduction
of records, advisory council members' per diem compensation, department staff time, and
expenses incurred by advisory council members and department staff;

(5) censure or reprimand the dispenser;

(6) revoke or suspend the right to supervise trainees;

(7) revoke or suspend the right to be a trainee;

(8) impose a civil penalty not to exceed $10,000 for each separate violation; or

(9) any other action reasonably justified by the individual case.

Sec. 76.

Minnesota Statutes 2022, section 153A.15, subdivision 4, is amended to read:

Subd. 4.

Penalties.

Except as provided in section 153A.14, subdivision 4, a person
violating this chapter is guilty of a misdemeanor. The commissioner may impose an automatic
civil penalty equal to one-fourth the renewal fee on each new text begin prescription new text end hearing deleted text begin instrument
sellerdeleted text end new text begin aid dispensernew text end who fails to renew the certificate required in section 153A.14 by the
renewal deadline.

Sec. 77.

Minnesota Statutes 2022, section 153A.17, is amended to read:

153A.17 EXPENSES; FEES.

(a) The expenses for administering the certification requirements, including the complaint
handling system for new text begin prescription new text end hearing aid dispensers in sections 153A.14 and 153A.15,
and the Consumer Information Center under section 153A.18, must be paid from initial
application and examination fees, renewal fees, penalties, and fines. The commissioner shall
only use fees collected under this section for the purposes of administering this chapter.
The legislature must not transfer money generated by these fees from the state government
special revenue fund to the general fund. deleted text begin Surcharges collected by the commissioner of health
deleted text end deleted text begin under section deleted text end deleted text begin 16E.22deleted text end deleted text begin are not subject to this paragraph.
deleted text end

(b) The fees are as follows:

(1) the initial certification application fee is $772.50;

(2) the annual renewal certification application fee is $750;

(3) the initial examination fee for the practical portion is $1,200, and $600 for each time
it is taken, thereafter; for individuals meeting the requirements of section 148.515, subdivision
2, the fee for the practical portion of the new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing
examination is $600 each time it is taken;

(4) the trainee application fee is $230;

(5) the penalty fee for late submission of a renewal application is $260; and

(6) the fee for verification of certification to other jurisdictions or entities is $25.

(c) The commissioner may prorate the certification fee for new applicants based on the
number of quarters remaining in the annual certification period.

(d) All fees are nonrefundable. All fees, penalties, and fines received must be deposited
in the state government special revenue fund.

(e) Hearing instrument dispensers who were certified before January 1, 2018, shall pay
a onetime surcharge of $22.50 to renew their certification when it expires after October 31,
2020. The surcharge shall cover the commissioner's costs associated with criminal
background checks.

Sec. 78.

Minnesota Statutes 2022, section 153A.175, is amended to read:

153A.175 PENALTY FEES.

(a) The penalty fee for holding oneself out as a hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser without
a current certificate after the credential has expired and before it is renewed is one-half the
amount of the certificate renewal fee for any part of the first day, plus one-half the certificate
renewal fee for any part of any subsequent days up to 30 days.

(b) The penalty fee for applicants who hold themselves out as hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
dispensers after expiration of the trainee period and before being issued a certificate is
one-half the amount of the certificate application fee for any part of the first day, plus
one-half the certificate application fee for any part of any subsequent days up to 30 days.
This paragraph does not apply to applicants not qualifying for a certificate who hold
themselves out as hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers.

(c) The penalty fee for practicing new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing and
failing to submit a continuing education report by the due date with the correct number or
type of hours in the correct time period is $200 plus $200 for each missing clock hour.
"Missing" means not obtained between the effective and expiration dates of the certificate,
the one-month period following the certificate expiration date, or the 30 days following
notice of a penalty fee for failing to report all continuing education hours. The certificate
holder must obtain the missing number of continuing education hours by the next reporting
due date.

(d) Civil penalties and discipline incurred by certificate holders prior to August 1, 2005,
for conduct described in paragraph (a), (b), or (c) shall be recorded as nondisciplinary penalty
fees. Payment of a penalty fee does not preclude any disciplinary action reasonably justified
by the individual case.

Sec. 79.

Minnesota Statutes 2022, section 153A.18, is amended to read:

153A.18 CONSUMER INFORMATION CENTER.

The commissioner shall establish a Consumer Information Center to assist actual and
potential purchasers of new text begin prescription new text end hearing aids by providing them with information
regarding new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end sales. The Consumer Information Center shall
disseminate information about consumers' legal rights related to new text begin prescription new text end hearing
deleted text begin instrumentdeleted text end new text begin aidnew text end sales, provide information relating to complaints about dispensers of
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end , and provide information about outreach and advocacy
services for consumers of new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end . In establishing the center
and developing the information, the commissioner shall consult with representatives of
new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers, audiologists, physicians, and consumers.

Sec. 80.

Minnesota Statutes 2022, section 153A.20, is amended to read:

153A.20 HEARING deleted text begin INSTRUMENTdeleted text end new text begin AIDnew text end DISPENSER ADVISORY COUNCIL.

Subdivision 1.

Membership.

(a) The commissioner shall appoint seven persons to a
Hearing deleted text begin Instrumentdeleted text end new text begin Aidnew text end Dispenser Advisory Council.

(b) The seven persons must include:

(1) three public members, as defined in section 214.02. At least one of the public members
shall be a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end user and one of the public members shall be
either a new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end user or an advocate of one;

(2) three hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensers certified under sections 153A.14 to 153A.20,
each of whom is currently, and has been for the five years immediately preceding their
appointment, engaged in new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing in Minnesota and
who represent the occupation of new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispensing and who
are not audiologists; and

(3) one audiologist licensed as an audiologist under chapter 148 who dispenses
new text begin prescription new text end hearing deleted text begin instrumentsdeleted text end new text begin aidsnew text end , recommended by a professional association
representing audiologists and speech-language pathologists.

(c) The factors the commissioner may consider when appointing advisory council
members include, but are not limited to, professional affiliation, geographical location, and
type of practice.

(d) No two members of the advisory council shall be employees of, or have binding
contracts requiring sales exclusively for, the same new text begin prescription new text end hearing deleted text begin instrumentdeleted text end new text begin aidnew text end
manufacturer or the same employer.

Subd. 2.

Organization.

The advisory council shall be organized and administered
according to section 15.059. The council may form committees to carry out its duties.

Subd. 3.

Duties.

At the commissioner's request, the advisory council shall:

(1) advise the commissioner regarding hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser certification
standards;

(2) provide for distribution of information regarding hearing deleted text begin instrumentdeleted text end new text begin aidnew text end dispenser
certification standards;

(3) review investigation summaries of competency violations and make recommendations
to the commissioner as to whether the allegations of incompetency are substantiated; and

(4) perform other duties as directed by the commissioner.

Sec. 81.

Minnesota Statutes 2022, section 256B.434, subdivision 4f, is amended to read:

Subd. 4f.

Construction project rate adjustments effective October 1, 2006.

(a)
Effective October 1, 2006, facilities reimbursed under this section may receive a property
rate adjustment for construction projects exceeding the threshold in section 256B.431,
subdivision 16, and below the threshold in section 144A.071, subdivision 2, deleted text begin clause (a)deleted text end new text begin
paragraph (c), clause (1)new text end . For these projects, capital assets purchased shall be counted as
construction project costs for a rate adjustment request made by a facility if they are: (1)
purchased within 24 months of the completion of the construction project; (2) purchased
after the completion date of any prior construction project; and (3) are not purchased prior
to July 14, 2005. Except as otherwise provided in this subdivision, the definitions, rate
calculation methods, and principles in sections 144A.071 and 256B.431 and Minnesota
Rules, parts 9549.0010 to 9549.0080, shall be used to calculate rate adjustments for allowable
construction projects under this subdivision and section 144A.073. Facilities completing
construction projects between October 1, 2005, and October 1, 2006, are eligible to have a
property rate adjustment effective October 1, 2006. Facilities completing projects after
October 1, 2006, are eligible for a property rate adjustment effective on the first day of the
month following the completion date. Facilities completing projects after January 1, 2018,
are eligible for a property rate adjustment effective on the first day of the month of January
or July, whichever occurs immediately following the completion date.

(b) Notwithstanding subdivision 18, as of July 14, 2005, facilities with rates set under
section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, that commenced a
construction project on or after October 1, 2004, and do not have a contract under subdivision
3 by September 30, 2006, are eligible to request a rate adjustment under section 256B.431,
subdivision 10, through September 30, 2006. If the request results in the commissioner
determining a rate adjustment is allowable, the rate adjustment is effective on the first of
the month following project completion. These facilities shall be allowed to accumulate
construction project costs for the period October 1, 2004, to September 30, 2006.

(c) Facilities shall be allowed construction project rate adjustments no sooner than 12
months after completing a previous construction project. Facilities must request the rate
adjustment according to section 256B.431, subdivision 10.

(d) Capacity days shall be computed according to Minnesota Rules, part 9549.0060,
subpart 11. For rate calculations under this section, the number of licensed beds in the
nursing facility shall be the number existing after the construction project is completed and
the number of days in the nursing facility's reporting period shall be 365.

(e) The value of assets to be recognized for a total replacement project as defined in
section 256B.431, subdivision 17d, shall be computed as described in clause (1). The value
of assets to be recognized for all other projects shall be computed as described in clause
(2).

(1) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under subdivision 3a, paragraph (c), shall be used to compute the
maximum amount of assets allowable in a facility's property rate calculation. If a facility's
current request for a rate adjustment results from the completion of a construction project
that was previously approved under section 144A.073, the assets to be used in the rate
calculation cannot exceed the lesser of the amount determined under sections 144A.071,
subdivision 2, and 144A.073, subdivision 3b, or the actual allowable costs of the construction
project. A current request that is not the result of a project under section 144A.073 cannot
exceed the limit under section 144A.071, subdivision 2, paragraph deleted text begin (a)deleted text end new text begin (c), clause (1)new text end .
Applicable credits must be deducted from the cost of the construction project.

(2)(i) Replacement-cost-new limits under section 256B.431, subdivision 17e, and the
number of beds allowed under section 256B.431, subdivision 3a, paragraph (c), shall be
used to compute the maximum amount of assets allowable in a facility's property rate
calculation.

(ii) The value of a facility's assets to be compared to the amount in item (i) begins with
the total appraised value from the last rate notice a facility received when its rates were set
under section 256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080. This value
shall be indexed by the factor in section 256B.431, subdivision 3f, paragraph (a), for each
rate year the facility received an inflation factor on its property-related rate when its rates
were set under this section. The value of assets listed as previous capital additions, capital
additions, and special projects on the facility's base year rate notice and the value of assets
related to a construction project for which the facility received a rate adjustment when its
rates were determined under this section shall be added to the indexed appraised value.

(iii) The maximum amount of assets to be recognized in computing a facility's rate
adjustment after a project is completed is the lesser of the aggregate replacement-cost-new
limit computed in (i) minus the assets recognized in (ii) or the actual allowable costs of the
construction project.

(iv) If a facility's current request for a rate adjustment results from the completion of a
construction project that was previously approved under section 144A.073, the assets to be
added to the rate calculation cannot exceed the lesser of the amount determined under
sections 144A.071, subdivision 2, and 144A.073, subdivision 3b, or the actual allowable
costs of the construction project. A current request that is not the result of a project under
section 144A.073 cannot exceed the limit stated in section 144A.071, subdivision 2,
paragraph deleted text begin (a)deleted text end new text begin (c), clause (1)new text end . Assets disposed of as a result of a construction project and
applicable credits must be deducted from the cost of the construction project.

(f) For construction projects approved under section 144A.073, allowable debt may
never exceed the lesser of the cost of the assets purchased, the threshold limit in section
144A.071, subdivision 2, or the replacement-cost-new limit less previously existing capital
debt.

(g) For construction projects that were not approved under section 144A.073, allowable
debt is limited to the lesser of the threshold in section 144A.071, subdivision 2, for such
construction projects or the applicable limit in paragraph (e), clause (1) or (2), less previously
existing capital debt. Amounts of debt taken out that exceed the costs of a construction
project shall not be allowed regardless of the use of the funds.

For all construction projects being recognized, interest expense and average debt shall
be computed based on the first 12 months following project completion. "Previously existing
capital debt" means capital debt recognized on the last rate determined under section
256B.431 and Minnesota Rules, parts 9549.0010 to 9549.0080, and the amount of debt
recognized for a construction project for which the facility received a rate adjustment when
its rates were determined under this section.

For a total replacement project as defined in section 256B.431, subdivision 17d, the
value of previously existing capital debt shall be zero.

(h) In addition to the interest expense allowed from the application of paragraph (f), the
amounts allowed under section 256B.431, subdivision 17a, paragraph (a), clauses (2) and
(3), will be added to interest expense.

(i) The equity portion of the construction project shall be computed as the allowable
assets in paragraph (e), less the average debt in paragraph (f). The equity portion must be
multiplied by 5.66 percent and the allowable interest expense in paragraph (f) must be added.
This sum must be divided by 95 percent of capacity days to compute the construction project
rate adjustment.

(j) For projects that are not a total replacement of a nursing facility, the amount in
paragraph (i) is adjusted for nonreimbursable areas and then added to the current property
payment rate of the facility.

(k) For projects that are a total replacement of a nursing facility, the amount in paragraph
(i) becomes the new property payment rate after being adjusted for nonreimbursable areas.
Any amounts existing in a facility's rate before the effective date of the construction project
for equity incentives under section 256B.431, subdivision 16; capital repairs and replacements
under section 256B.431, subdivision 15; or refinancing incentives under section 256B.431,
subdivision 19, shall be removed from the facility's rates.

(l) No additional equipment allowance is allowed under Minnesota Rules, part 9549.0060,
subpart 10, as the result of construction projects under this section. Allowable equipment
shall be included in the construction project costs.

(m) Capital assets purchased after the completion date of a construction project shall be
counted as construction project costs for any future rate adjustment request made by a facility
under section 144A.071, subdivision 2, deleted text begin clause (a)deleted text end new text begin paragraph (c), clause (1)new text end , if they are
purchased within 24 months of the completion of the future construction project.

(n) In subsequent rate years, the property payment rate for a facility that results from
the application of this subdivision shall be the amount inflated in subdivision 4.

(o) Construction projects are eligible for an equity incentive under section 256B.431,
subdivision 16. When computing the equity incentive for a construction project under this
subdivision, only the allowable costs and allowable debt related to the construction project
shall be used. The equity incentive shall not be a part of the property payment rate and not
inflated under subdivision 4. Effective October 1, 2006, all equity incentives for nursing
facilities reimbursed under this section shall be allowed for a duration determined under
section 256B.431, subdivision 16, paragraph (c).

Sec. 82. new text begin EFFECTIVE DATE CHANGE.
new text end

new text begin The effective date for 2023 H.F. 100, article 6, section 24, if enacted during the 2023
regular legislative session, is July 1, 2023. This section prevails over any contrary effective
date for H.F. 100, article 6, section 24, enacted during the 2023 regular legislative session,
regardless of order of enactment.
new text end

Sec. 83. new text begin REPEALER.
new text end

new text begin (a) new text end new text begin Minnesota Statutes 2022, section 144.9505, subdivision 3,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 153A.14, subdivision 5,new text end new text begin is repealed.
new text end

new text begin (c) new text end new text begin Minnesota Rules, parts 4640.1500; 4640.1600; 4640.1700; 4640.1800; 4640.1900;
4640.2000; 4640.2100; 4640.2200; 4640.2300; 4640.2400; 4640.2500; 4640.2600;
4640.2700; 4640.2800; 4640.2900; 4640.3000; 4640.3100; 4640.3200; 4640.3300;
4640.3400; 4640.3500; 4640.3600; 4640.3700; 4640.3800; 4640.3900; 4640.4000;
4640.4100; 4640.4200; 4640.4300; 4640.6100; 4640.6200; 4640.6300; 4640.6400;
4645.0300; 4645.0400; 4645.0500; 4645.0600; 4645.0700; 4645.0800; 4645.0900;
4645.1000; 4645.1100; 4645.1200; 4645.1300; 4645.1400; 4645.1500; 4645.1600;
4645.1700; 4645.1800; 4645.1900; 4645.2000; 4645.2100; 4645.2200; 4645.2300;
4645.2400; 4645.2500; 4645.2600; 4645.2700; 4645.2800; 4645.2900; 4645.3000;
4645.3100; 4645.3200; 4645.3300; 4645.3400; 4645.3500; 4645.3600; 4645.3700;
4645.3800; 4645.3805; 4645.3900; 4645.4000; 4645.4100; 4645.4200; 4645.4300;
4645.4400; 4645.4500; 4645.4600; 4645.4700; 4645.4800; 4645.4900; 4645.5100; and
4645.5200,new text end new text begin are repealed effective January 1, 2024.
new text end

ARTICLE 4

DEPARTMENT OF HEALTH

Section 1.

Minnesota Statutes 2022, section 12A.08, subdivision 3, is amended to read:

Subd. 3.

Implementation.

To implement the requirements of this section, the
commissioner may cooperate with private health care providers and facilitiesnew text begin , Tribal nations,new text end
and community health boards as defined in section 145A.02deleted text begin ,deleted text end new text begin ;new text end provide grants to assist
community health boardsdeleted text begin ,deleted text end new text begin and Tribal nations;new text end use volunteer services of individuals qualified
to provide public health servicesdeleted text begin ,deleted text end new text begin ;new text end and enter into cooperative or mutual aid agreements to
provide public health services.

Sec. 2.

Minnesota Statutes 2022, section 13.10, subdivision 5, is amended to read:

Subd. 5.

Adoption records.

Notwithstanding any provision of this new text begin or any other new text end chapter,
adoption records shall be treated as provided in sections 259.53, 259.61, 259.79, and 259.83
to deleted text begin 259.89deleted text end new text begin 259.88new text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 3.

Minnesota Statutes 2022, section 13.465, subdivision 8, is amended to read:

Subd. 8.

Adoption records.

Various adoption records are classified under section 259.53,
subdivision 1. Access to the original birth record of a person who has been adopted is
governed by section deleted text begin 259.89deleted text end new text begin 144.2252new text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 4.

Minnesota Statutes 2022, section 16A.151, subdivision 2, is amended to read:

Subd. 2.

Exceptions.

(a) If a state official litigates or settles a matter on behalf of specific
injured persons or entities, this section does not prohibit distribution of money to the specific
injured persons or entities on whose behalf the litigation or settlement efforts were initiated.
If money recovered on behalf of injured persons or entities cannot reasonably be distributed
to those persons or entities because they cannot readily be located or identified or because
the cost of distributing the money would outweigh the benefit to the persons or entities, the
money must be paid into the general fund.

(b) Money recovered on behalf of a fund in the state treasury other than the general fund
may be deposited in that fund.

(c) This section does not prohibit a state official from distributing money to a person or
entity other than the state in litigation or potential litigation in which the state is a defendant
or potential defendant.

(d) State agencies may accept funds as directed by a federal court for any restitution or
monetary penalty under United States Code, title 18, section 3663(a)(3), or United States
Code, title 18, section 3663A(a)(3). Funds received must be deposited in a special revenue
account and are appropriated to the commissioner of the agency for the purpose as directed
by the federal court.

(e) Tobacco settlement revenues as defined in section 16A.98, subdivision 1, paragraph
(t), may be deposited as provided in section 16A.98, subdivision 12.

(f) Any money received by the state resulting from a settlement agreement or an assurance
of discontinuance entered into by the attorney general of the state, or a court order in litigation
brought by the attorney general of the state, on behalf of the state or a state agency, related
to alleged violations of consumer fraud laws in the marketing, sale, or distribution of opioids
in this state or other alleged illegal actions that contributed to the excessive use of opioids,
must be deposited in the settlement account established in the opiate epidemic response
fund under section 256.043, subdivision 1. This paragraph does not apply to attorney fees
and costs awarded to the state or the Attorney General's Office, to contract attorneys hired
by the state or Attorney General's Office, or to other state agency attorneys.

(g) Notwithstanding paragraph (f), if money is received from a settlement agreement or
an assurance of discontinuance entered into by the attorney general of the state or a court
order in litigation brought by the attorney general of the state on behalf of the state or a state
agency against a consulting firm working for an opioid manufacturer or opioid wholesale
drug distributor, the commissioner shall deposit any money received into the settlement
account established within the opiate epidemic response fund under section 256.042,
subdivision 1. Notwithstanding section 256.043, subdivision 3a, paragraph (a), any amount
deposited into the settlement account in accordance with this paragraph shall be appropriated
to the commissioner of human services to award as grants as specified by the opiate epidemic
response advisory council in accordance with section 256.043, subdivision 3a, paragraph
(d).

new text begin (h) Any money received by the state resulting from a settlement agreement or an assurance
of discontinuance entered into by the attorney general of the state, or a court order in litigation
brought by the attorney general of the state on behalf of the state or a state agency related
to alleged violations of consumer fraud laws in the marketing, sale, or distribution of
electronic nicotine delivery systems in this state or other alleged illegal actions that
contributed to the exacerbation of youth nicotine use, must be deposited in the tobacco use
prevention account under section 144.398. This paragraph does not apply to: (1) attorney
fees and costs awarded or paid to the state or the Attorney General's Office; (2) contract
attorneys hired by the state or Attorney General's Office; or (3) other state agency attorneys.
The commissioner of management and budget must transfer to the tobacco use prevention
account, any money subject to this paragraph that is received by the state before the enactment
of this paragraph.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective retroactively from April 1, 2023, and
applies to settlement agreements or assurances of discontinuance entered into, or court
orders issued, on or after that date.
new text end

Sec. 5.

Minnesota Statutes 2022, section 103I.005, subdivision 17a, is amended to read:

Subd. 17a.

deleted text begin Temporary boringdeleted text end new text begin Submerged closed loop heat exchangernew text end .

deleted text begin "Temporary
boring"deleted text end new text begin "Submerged closed loop heat exchanger"new text end means deleted text begin an excavation that is 15 feet or
more in depth, is sealed within 72 hours of the time of construction, and is drilled, cored,
washed, driven, dug, jetted, or otherwise constructed todeleted text end new text begin a heating and cooling device thatnew text end :

(1) deleted text begin conduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoringdeleted text end new text begin is installed in a water supply wellnew text end ;

(2) deleted text begin monitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistancedeleted text end new text begin utilizes the convective flow of groundwater as the primary medium of heat
exchangenew text end ;

(3) deleted text begin measure groundwater levels, including use of a piezometerdeleted text end new text begin contains water as the
heat transfer fluidnew text end ; and

(4) deleted text begin determine groundwater flow direction or velocitydeleted text end new text begin operates using a nonconsumptive
recirculationnew text end .

new text begin A submerged closed loop heat exchanger includes other necessary appurtenances such as
submersible pumps, a heat exchanger, and piping.
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. 6.

Minnesota Statutes 2022, section 103I.005, is amended by adding a subdivision
to read:

new text begin Subd. 17b.new text end

new text begin Temporary boring.new text end

new text begin "Temporary boring" means an excavation that is 15
feet or more in depth, is sealed within 72 hours of the time of construction, and is drilled,
cored, washed, driven, dug, jetted, or otherwise constructed to:
new text end

new text begin (1) conduct physical, chemical, or biological testing of groundwater, including
groundwater quality monitoring;
new text end

new text begin (2) monitor or measure physical, chemical, radiological, or biological parameters of
earth materials or earth fluids, including hydraulic conductivity, bearing capacity, or
resistance;
new text end

new text begin (3) measure groundwater levels, including use of a piezometer; and
new text end

new text begin (4) determine groundwater flow direction or velocity.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 7.

Minnesota Statutes 2022, section 103I.005, subdivision 20a, is amended to read:

Subd. 20a.

Water supply well.

"Water supply well" means a well that is not a dewatering
well or environmental well and includes wells used:

(1) for potable water supply;

(2) for irrigation;

(3) for agricultural, commercial, or industrial water supply;

(4) for heating or cooling; deleted text begin and
deleted text end

(5) new text begin for containing a submerged closed loop heat exchanger; and
new text end

new text begin (6) new text end for testing water yield for irrigation, commercial or industrial uses, residential supply,
or public water supply.

new text begin EFFECTIVE DATE.new text end

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

Sec. 8.

Minnesota Statutes 2022, section 103I.208, subdivision 2, is amended to read:

Subd. 2.

Permit fee.

The permit fee to be paid by a property owner is:

(1) for a water supply well that is not in use under a maintenance permit, $175 annually;

(2) for an environmental well that is unsealed under a maintenance permit, $175 annually
except no fee is required for an environmental well owned by a federal agency, state agency,
or local unit of government that is unsealed under a maintenance permit. "Local unit of
government" means a statutory or home rule charter city, town, county, or soil and water
conservation district, watershed district, an organization formed for the joint exercise of
powers under section 471.59, a community health board, or other special purpose district
or authority with local jurisdiction in water and related land resources management;

(3) for environmental wells that are unsealed under a maintenance permit, $175 annually
per site regardless of the number of environmental wells located on site;

(4) for a groundwater thermal exchange device, in addition to the notification fee for
water supply wells, $275, which includes the state core function fee;

(5) for a bored geothermal heat exchanger with less than ten tons of heating/cooling
capacity, $275;

(6) for a bored geothermal heat exchanger with ten to 50 tons of heating/cooling capacity,
$515;

(7) for a bored geothermal heat exchanger with greater than 50 tons of heating/cooling
capacity, $740;

(8) for a dewatering well that is unsealed under a maintenance permit, $175 annually
for each dewatering well, except a dewatering project comprising more than five dewatering
wells shall be issued a single permit for $875 annually for dewatering wells recorded on
the permit; deleted text begin and
deleted text end

(9) for an elevator boring, $275 for each boringnew text begin ; and
new text end

new text begin (10) for a submerged closed loop heat exchanger system, in addition to the notification
fee for water supply wells, $3,250, which includes the state core function feenew 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. 9.

Minnesota Statutes 2022, section 103I.208, is amended by adding a subdivision
to read:

new text begin Subd. 3.new text end

new text begin Rules.new text end

new text begin The commissioner shall adopt rules to implement requirements for the
permitting and installation of submerged closed loop heat exchangers according to chapter
14. The commissioner may use the monitoring data required by section 107, to amend rules
governing the installation of submerged closed loop heat exchanger systems. Rules for
which notice is published in the State Register before December 31, 2025, may be adopted
using the expedited rulemaking process in section 14.389, subdivision 5.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 10.

new text begin [103I.209] SUBMERGED CLOSED LOOP HEAT EXCHANGER SYSTEM;
REQUIREMENTS.
new text end

new text begin Subdivision 1.new text end

new text begin Permit required.new text end

new text begin After the effective date of this section, a person must
not install a submerged closed loop heat exchanger in a water supply well without a permit
granted by the commissioner. A submerged closed loop heat exchanger system approved
by a variance granted by the commissioner prior to the effective date of this section may
continue to operate without obtaining a permit under this section or section 103I.210.
new text end

new text begin Subd. 2.new text end

new text begin Construction.new text end

new text begin (a) A water supply well constructed to house a submerged closed
loop heat exchanger must be constructed by a licensed well contractor and the submerged
closed loop heat exchanger must be installed by a licensed well contractor.
new text end

new text begin (b) The commissioner may consider a variance under Minnesota Rules, part 4725.0410,
to the screen configuration requirements under Minnesota Rules, part 4725.2750, to allow
any combination of screen, casing, leader, riser, sump, or other piping so long as the screen
configuration does not interconnect aquifers or extend through a confining layer. The
commissioner must consider rules for these screen configurations during the expedited
rulemaking process authorized by section 103I.208, subdivision 3.
new text end

new text begin (c) A water supply well used for a submerged closed loop heat exchanger must comply
with the requirements of this chapter and Minnesota Rules, chapter 4725.
new text end

new text begin Subd. 3.new text end

new text begin Heat transfer fluid.new text end

new text begin Water used as heat transfer fluid must be sourced from a
potable supply. The heat transfer fluid may be amended with additives to inhibit corrosion
or microbial activity. Any additive used must be ANSI/NSF-60 certified.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective the day following final enactment and
expires on December 31 of the year that the permanent rules are adopted pursuant to section
103I.208, subdivision 3.
new text end

Sec. 11.

new text begin [103I.210] SUBMERGED CLOSED LOOP HEAT EXCHANGER SYSTEM;
TEMPORARY PERMITS.
new text end

new text begin Subdivision 1.new text end

new text begin Definition.new text end

new text begin For purposes of this section, "permit holder" means persons
who receive a permit under this section and includes the property owner and licensed well
contractor.
new text end

new text begin Subd. 2.new text end

new text begin Permit; limitations.new text end

new text begin (a) The commissioner must issue a permit for the
installation of a submerged closed loop heat exchanger system as provided in this section.
The property owner or the property owner's agent must submit to the commissioner a permit
application on a form provided by the commissioner, or in a format approved by the
commissioner. The application must be legible and must contain:
new text end

new text begin (1) the name, license number, and signature of the well contractor installing the
submerged closed loop heat exchanger;
new text end

new text begin (2) the name, address, and signature of the owner of the submerged closed loop heat
exchanger system, and property owner, if different;
new text end

new text begin (3) the township number, range number, section, and one quartile, and the property street
address if assigned, of the proposed submerged closed loop heat exchanger system;
new text end

new text begin (4) a description of existing wells to be utilized or any wells proposed to be constructed
including the unique well numbers, locations, well depth, diameters of bore holes and casing,
depth of casing, grouting methods and materials, and dates of construction;
new text end

new text begin (5) the specifications for piping including the materials to be used for piping, the closed
loop water treatment protocol, and the provisions for pressure testing the system;
new text end

new text begin (6) a diagram of the proposed system; and
new text end

new text begin (7) any additional information the commissioner deems necessary to protect the public
health and safety of the groundwater.
new text end

new text begin (b) The fees collected under this subdivision must be deposited in the state government
special revenue fund.
new text end

new text begin (c) Permit holders must allow for the inspection of the submerged closed loop heat
exchanger system by the commissioner during working hours.
new text end

new text begin (d) The commissioner must not limit the number of permits available for submerged
closed loop heat exchanger systems or the size of systems. A system may consist of more
than one submerged closed loop heat exchanger. A variance is not required to install or
operate a submerged closed loop heat exchanger in the water supply well.
new text end

new text begin (e) Permit holders must comply with this section, this chapter, and Minnesota Rules,
chapter 4725.
new text end

new text begin (f) A permit holder must inform the Minnesota Duty Officer of the failure or leak of a
submerged closed loop heat exchanger.
new text end

new text begin (g) A water supply well containing a submerged closed loop heat exchanger must meet
the isolation distance requirements under Minnesota Rules, part 4725.4450. The
commissioner may consider a variance under Minnesota Rules, part 4725.0410, to the
isolation distance requirements under Minnesota Rules, part 4725.4450, for a water supply
well containing a submerged closed loop heat exchanger for the sole purpose of heating
and cooling if the property on which the water supply well will be located has limited space
and a water supply well cannot be constructed to meet isolation distance requirements. The
commissioner shall consider including isolation distance requirements during the expedited
rulemaking process authorized by section 103I.208, subdivision 3.
new text end

new text begin Subd. 3.new text end

new text begin Permit conditions.new text end

new text begin Permit holders must construct, install, operate, maintain,
and report on the submerged closed loop heat exchanger system to comply with permit
conditions identified by the commissioner, which must address:
new text end

new text begin (1) notification to the commissioner at intervals specified in the permit conditions;
new text end

new text begin (2) material and design specifications and standards;
new text end

new text begin (3) heat exchange fluid requirements;
new text end

new text begin (4) signage requirements;
new text end

new text begin (5) backflow prevention requirements;
new text end

new text begin (6) pressure tests of the system;
new text end

new text begin (7) documentation of the system construction;
new text end

new text begin (8) requirements for maintenance and repair of the system;
new text end

new text begin (9) removal of the system upon termination of use or failure;
new text end

new text begin (10) disclosure of the system at the time of property transfer;
new text end

new text begin (11) requirement to obtain approval from the commissioner prior to deviation of the
approved plans and conditions; and
new text end

new text begin (12) any additional information the commissioner deems necessary to protect public
health and safety of the groundwater.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 12.

new text begin [115.7411] ADVISORY COUNCIL ON WATER SUPPLY SYSTEMS AND
WASTEWATER TREATMENT FACILITIES.
new text end

new text begin Subdivision 1.new text end

new text begin Purpose; membership.new text end

new text begin The Advisory Council on Water Supply Systems
and Wastewater Treatment Facilities shall advise the commissioners of health and the
Pollution Control Agency regarding classification of water supply systems and wastewater
treatment facilities, qualifications and competency evaluation of water supply system
operators and wastewater treatment facility operators, and additional laws, rules, and
procedures that may be desirable for regulating the operation of water supply systems and
of wastewater treatment facilities. The advisory council is composed of 11 voting members,
of whom:
new text end

new text begin (1) one member must be from the Department of Health, Division of Environmental
Health, appointed by the commissioner of health;
new text end

new text begin (2) one member must be from the Pollution Control Agency appointed by the
commissioner of the Pollution Control Agency;
new text end

new text begin (3) three members must be certified water supply system operators, appointed by the
commissioner of health, one of whom must represent a nonmunicipal community or
nontransient noncommunity water supply system;
new text end

new text begin (4) three members must be certified wastewater treatment facility operators, appointed
by the commissioner of the Pollution Control Agency;
new text end

new text begin (5) one member must be a representative from an organization representing municipalities,
appointed by the commissioner of health with the concurrence of the commissioner of the
Pollution Control Agency; and
new text end

new text begin (6) two members must be members of the public who are not associated with water
supply systems or wastewater treatment facilities. One must be appointed by the
commissioner of health and the other by the commissioner of the Pollution Control Agency.
Consideration should be given to one of these members being a representative of academia
knowledgeable in water or wastewater matters.
new text end

new text begin Subd. 2.new text end

new text begin Geographic representation.new text end

new text begin At least one of the water supply system operators
and at least one of the wastewater treatment facility operators must be from outside the
seven-county metropolitan area and one wastewater treatment facility operator must be
from the Metropolitan Council.
new text end

new text begin Subd. 3.new text end

new text begin Terms; compensation.new text end

new text begin The terms of the appointed members and the
compensation and removal of all members are governed by section 15.059.
new text end

new text begin Subd. 4.new text end

new text begin Officers.new text end

new text begin When new members are appointed to the council, a chair must be
elected at the next council meeting. The Department of Health representative shall serve as
secretary of the council.
new text end

Sec. 13.

Minnesota Statutes 2022, section 121A.335, is amended to read:

121A.335 LEAD IN SCHOOL DRINKING WATER.

Subdivision 1.

Model plan.

The commissioners of health and education shall jointly
develop a model plan to require school districts to accurately and efficiently test for the
presence of lead in water in public school buildings serving students in kindergarten through
grade 12. To the extent possible, the commissioners shall base the plan on the standards
established by the United States Environmental Protection Agency. The plan may be based
on the technical guidance in the Department of Health's document, "Reducing Lead in
Drinking Water: A Technical Guidance for Minnesota's School and Child Care Facilities."new text begin
The plan must include recommendations for remediation efforts when testing reveals the
presence of lead at or above five parts per billion.
new text end

Subd. 2.

School plans.

new text begin (a) new text end By July 1, 2018, the board of each school district or charter
school must adopt the commissioners' model plan or develop and adopt an alternative plan
to accurately and efficiently test for the presence of lead in water in school buildings serving
prekindergarten students and students in kindergarten through grade 12.

new text begin (b) By July 1, 2024, a school district or charter school must revise its plan to include its
policies and procedures for ensuring consistent water quality throughout the district's or
charter school's facilities. The plan must document the routine water management strategies
and procedures used in each building or facility to maintain water quality and reduce exposure
to lead. A district or charter school must base the plan on the United States Environmental
Protection Agency's "Ensuring Drinking Water Quality in Schools During and After Extended
Closures" fact sheet and the United States Environmental Protection Agency's "3Ts Toolkit
for Reducing Lead in Drinking Water in Schools and Child Care Facilities" manual. A
district or charter school's plan must be publicly available upon request.
new text end

Subd. 3.

Frequency of testing.

(a) The plan under subdivision 2 must include a testing
schedule for every building serving prekindergarten through grade 12 students. The schedule
must require that each building be tested at least once every five years. A school district or
charter school must begin testing school buildings by July 1, 2018, and complete testing of
all buildings that serve students within five years.

(b) A school district or charter school that finds lead at a specific location providing
cooking or drinking water within a facility must formulate, make publicly available, and
implement a plan that is consistent with established guidelines and recommendations to
ensure that student exposure to lead is deleted text begin minimizeddeleted text end new text begin reduced to below five parts per billion as
verified by a retestnew text end . This includes, when a school district or charter school finds the presence
of lead deleted text begin at a level where action should be taken as set by the guidancedeleted text end new text begin at or above five parts
per billionnew text end in any water deleted text begin sourcedeleted text end new text begin fixturenew text end that can provide cooking or drinking water,
immediately shutting off the water deleted text begin sourcedeleted text end new text begin fixturenew text end or making it unavailable until the hazard
has been deleted text begin minimizeddeleted text end new text begin remediated as verified by a retestnew text end .

new text begin (c) A school district or charter school must test for the presence of lead after completing
remediation activities required under this section to confirm that the water contains lead at
a level below five parts per billion.
new text end

Subd. 4.

Ten-year facilities plan.

A school district may include lead testing and
remediation as a part of its ten-year facilities plan under section 123B.595.

Subd. 5.

Reporting.

new text begin (a) new text end A school district or charter school deleted text begin that has tested its buildings
for the presence of lead shall make the results of the testing available to the public for review
and must notify parents of the availability of the information. School districts and charter
schools must follow the actions outlined in guidance from the commissioners of health and
education.deleted text end new text begin must send parents an annual notice that includes the district's or charter school's
annual testing and remediation plan, information about how to find test results, and a
description of remediation efforts on the district website. The district or charter school must
update the lead testing and remediation information on its website at least annually. In
addition to the annual notice, the district or charter school must include in an official school
handbook or official school policy guide information on how parents may find the test
results and a description of remediation efforts on the district or charter school website and
how often this information is updated.
new text end

new text begin (b)new text end If a test conducted under subdivision 3, paragraph (a), reveals the presence of lead
new text begin at ornew text end above deleted text begin a level where action should be taken as set by the guidancedeleted text end new text begin five parts per billionnew text end ,
the school district or charter school must, within 30 days of receiving the test result, either
remediate the presence of lead to below deleted text begin the level set in guidancedeleted text end new text begin five parts per billionnew text end ,
verified by retest, or directly notify parents of the test result. deleted text begin The school district or charter
school must make the water source unavailable until the hazard has been minimized.
deleted text end

new text begin (c) Starting July 1, 2024, school districts and charter schools must report their test results
and remediation activities to the commissioner of health in the form and manner determined
by the commissioner in consultation with school districts and charter schools, by July 1 of
each year. The commissioner of health must post and annually update the test results and
remediation efforts on the department website by school site.
new text end

new text begin (d) A district or charter school must maintain a record of lead testing results and
remediation activities for at least 15 years.
new text end

new text begin Subd. 6.new text end

new text begin Public water systems.new text end

new text begin (a) A district or charter school is not financially
responsible for remediation of documented elevated lead levels in drinking water caused
by the presence of lead infrastructure owned by a public water supply utility providing water
to the school facility, such as lead service lines, meters, galvanized service lines downstream
of lead, or lead connectors. The district or charter school must communicate with the public
water system regarding its documented significant contribution to lead contamination in
school drinking water and request from the public water system a plan for reducing the lead
contamination.
new text end

new text begin (b) If the infrastructure is jointly owned by a district or charter school and a public water
supply utility, the district or charter school must attempt to coordinate any needed
replacements of lead service lines with the public water supply utility.
new text end

new text begin (c) A district or charter school may defer its remediation activities under this section
until after the elevated lead level in the public water system's infrastructure is remediated
and postremediation testing does not detect an elevated lead level in the drinking water that
passes through that infrastructure. A district or charter school may also defer its remediation
activities if the public water supply exceeds the federal Safe Drinking Water Act lead action
level or is in violation of the Safe Drinking Water Act Lead and Copper Rule.
new text end

new text begin Subd. 7.new text end

new text begin Commissioner recommendations.new text end

new text begin By January 1, 2026, and every five years
thereafter, the commissioner of health must report to the legislative committees having
jurisdiction over health and kindergarten through grade 12 education any recommended
changes to this section. The recommendations must be based on currently available scientific
evidence regarding the effects of lead in drinking water.
new text end

Sec. 14.

new text begin [144.0526] MINNESOTA ONE HEALTH ANTIMICROBIAL
STEWARDSHIP COLLABORATIVE.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish the Minnesota
One Health Antimicrobial Stewardship Collaborative. The commissioner shall appoint a
director to execute operations, conduct health education, and provide technical assistance.
new text end

new text begin Subd. 2.new text end

new text begin Commissioner's duties.new text end

new text begin The commissioner of health shall oversee a program
to:
new text end

new text begin (1) maintain the position of director of One Health Antimicrobial Stewardship to lead
state antimicrobial stewardship initiatives across human, animal, and environmental health;
new text end

new text begin (2) communicate to professionals and the public the interconnectedness of human, animal,
and environmental health, especially related to preserving the efficacy of antibiotic
medications, which are a shared resource;
new text end

new text begin (3) leverage new and existing partnerships. The commissioner of health shall consult
and collaborate with academic institutions, industry and community organizations, and
organizations and agencies in fields including but not limited to health care, veterinary
medicine, and animal agriculture to inform strategies for education, practice improvement,
and research in all settings where antimicrobial products are used;
new text end

new text begin (4) ensure that veterinary settings have education and strategies needed to practice
appropriate antibiotic prescribing, implement clinical antimicrobial stewardship programs,
and prevent transmission of antimicrobial-resistant microbes; and
new text end

new text begin (5) support collaborative research and programmatic initiatives to improve the
understanding of the impact of antimicrobial use and resistance in the natural environment.
new text end

new text begin Subd. 3.new text end

new text begin Biennial report.new text end

new text begin By January 15, 2025, and every two years thereafter, the
commissioner of health shall report to the chairs and ranking minority members of the
legislative committees with primary jurisdiction over health policy and finance on the work
accomplished by the commissioner under this section and the collaborative research
conducted in the previous two years and on program goals for the upcoming two years.
new text end

Sec. 15.

new text begin [144.0528] COMPREHENSIVE DRUG OVERDOSE AND MORBIDITY
PREVENTION ACT.
new text end

new text begin Subdivision 1.new text end

new text begin Definition.new text end

new text begin For the purpose of this section, "drug overdose and morbidity"
means health problems that people experience after inhaling, ingesting, or injecting medicines
in quantities that exceed prescription status; medicines taken that are prescribed to a different
person; medicines that have been adulterated or adjusted by contaminants intentionally or
unintentionally; or nonprescription drugs in amounts that result in morbidity or mortality.
new text end

new text begin Subd. 2.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish a comprehensive
drug overdose and morbidity program to conduct comprehensive drug overdose and morbidity
prevention activities, epidemiologic investigations and surveillance, and evaluation to
monitor, address, and prevent drug overdoses statewide through integrated strategies that
include the following:
new text end

new text begin (1) advance access to evidence-based nonnarcotic pain management services;
new text end

new text begin (2) implement culturally specific interventions and prevention programs with population
and community groups in greatest need, including those who are pregnant and their infants;
new text end

new text begin (3) enhance overdose prevention and supportive services for people experiencing
homelessness. This strategy includes funding for emergency and short-term housing subsidies
through the homeless overdose prevention hub and expanding support for syringe services
programs serving people experiencing homelessness statewide;
new text end

new text begin (4) equip employers to promote health and well-being of employees by addressing
substance misuse and drug overdose;
new text end

new text begin (5) improve outbreak detection and identification of substances involved in overdoses
through the expansion of the Minnesota Drug Overdose and Substance Use Surveillance
Activity (MNDOSA);
new text end

new text begin (6) implement Tackling Overdose With Networks (TOWN) community prevention
programs;
new text end

new text begin (7) identify, address, and respond to drug overdose and morbidity in those who are
pregnant or have just given birth through multitiered approaches that may:
new text end

new text begin (i) promote medication-assisted treatment options;
new text end

new text begin (ii) support programs that provide services in accord with evidence-based care models
for mental health and substance abuse disorder;
new text end

new text begin (iii) collaborate with interdisciplinary and professional organizations that focus on quality
improvement initiatives related to substance use disorder; and
new text end

new text begin (iv) implement substance use disorder-related recommendations from the maternal
mortality review committee, as appropriate; and
new text end

new text begin (8) design a system to assess, address, and prevent the impacts of drug overdose and
morbidity on those who are pregnant, their infants, and children. Specifically, the
commissioner of health may:
new text end

new text begin (i) inform health care providers and the public of the prevalence, risks, conditions, and
treatments associated with substance use disorders involving or affecting pregnancies,
infants, and children; and
new text end

new text begin (ii) identify communities, families, infants, and children affected by substance use
disorder in order to recommend focused interventions, prevention, and services.
new text end

new text begin Subd. 3.new text end

new text begin Partnerships.new text end

new text begin The commissioner of health may consult with sovereign Tribal
nations, the Minnesota Departments of Human Services, Corrections, Public Safety, and
Education, local public health agencies, care providers and insurers, community organizations
that focus on substance abuse risks and recovery, individuals affected by substance use
disorders, and any other individuals, entities, and organizations as necessary to carry out
the goals of this section.
new text end

new text begin Subd. 4.new text end

new text begin Grants authorized.new text end

new text begin (a) The commissioner of health may award grants, as
funding allows, to entities and organizations focused on addressing and preventing the
negative impacts of drug overdose and morbidity. Examples of activities the commissioner
may consider for these grant awards include:
new text end

new text begin (1) developing, implementing, or promoting drug overdose and morbidity prevention
programs and activities;
new text end

new text begin (2) community outreach and other efforts addressing the root causes of drug overdose
and morbidity;
new text end

new text begin (3) identifying risk and protective factors relating to drug overdose and morbidity that
contribute to identification, development, or improvement of prevention strategies and
community outreach;
new text end

new text begin (4) developing or providing trauma-informed drug overdose and morbidity prevention
and services;
new text end

new text begin (5) developing or providing culturally and linguistically appropriate drug overdose and
morbidity prevention and services, and programs that target and serve historically underserved
communities;
new text end

new text begin (6) working collaboratively with educational institutions, including school districts, to
implement drug overdose and morbidity prevention strategies for students, teachers, and
administrators;
new text end

new text begin (7) working collaboratively with sovereign Tribal nations, care providers, nonprofit
organizations, for-profit organizations, government entities, community-based organizations,
and other entities to implement substance misuse and drug overdose prevention strategies
within their communities; and
new text end

new text begin (8) creating or implementing quality improvement initiatives to improve drug overdose
and morbidity treatment and outcomes.
new text end

new text begin (b) Any organization or government entity receiving grant money under this section
must collect and make available to the commissioner of health aggregate data related to the
activity funded by the program under this section. The commissioner of health shall use the
information and data from the program evaluation to inform the administration of existing
Department of Health programming and the development of Department of Health policies,
programs, and procedures.
new text end

new text begin Subd. 5.new text end

new text begin Promotion; administration. new text end

new text begin In fiscal years 2026 and beyond, the commissioner
may spend up to 25 percent of the total funding appropriated for the comprehensive drug
overdose and morbidity program in each fiscal year to promote, administer, support, and
evaluate the programs authorized under this section and to provide technical assistance to
program grantees.
new text end

new text begin Subd. 6.new text end

new text begin External contributions.new text end

new text begin The commissioner may accept contributions from
governmental and nongovernmental sources and may apply for grants to supplement state
appropriations for the programs authorized under this section. Contributions and grants
received from the sources identified in this subdivision to advance the purpose of this section
are appropriated to the commissioner for the comprehensive drug overdose and morbidity
program.
new text end

new text begin Subd. 7.new text end

new text begin Program evaluation. new text end

new text begin Beginning February 28, 2024, the commissioner of health
shall report every even-numbered year to the legislative committees with jurisdiction over
health detailing the expenditures of funds authorized under this section. The commissioner
shall use the data to evaluate the effectiveness of the program. The commissioner must
include in the report:
new text end

new text begin (1) the number of organizations receiving grant money under this section;
new text end

new text begin (2) the number of individuals served by the grant programs;
new text end

new text begin (3) a description and analysis of the practices implemented by program grantees; and
new text end

new text begin (4) best practices recommendations to prevent drug overdose and morbidity, including
culturally relevant best practices and recommendations focused on historically underserved
communities.
new text end

new text begin Subd. 8.new text end

new text begin Measurement.new text end

new text begin Notwithstanding any law to the contrary, the commissioner of
health shall assess and evaluate grants and contracts awarded using available data sources,
including but not limited to the Minnesota All Payer Claims Database (MN APCD), the
Minnesota Behavioral Risk Factor Surveillance System (BRFSS), the Minnesota Student
Survey, vital records, hospitalization data, syndromic surveillance, and the Minnesota
Electronic Health Record Consortium.
new text end

Sec. 16.

new text begin [144.0752] CULTURAL COMMUNICATIONS.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish:
new text end

new text begin (1) a cultural communications program that advances culturally and linguistically
appropriate communication services for communities most impacted by health disparities
that include limited English proficient (LEP) populations, refugees, immigrant communities,
American Indians, populations of color, LGBTQ+ populations, persons who are deaf,
deafblind, or hard of hearing and who use American Sign Language, and people living with
disabilities; and
new text end

new text begin (2) a position that works with department and division leadership to ensure that the
department follows the National Standards for Culturally and Linguistically Appropriate
Services (CLAS) Standards.
new text end

new text begin Subd. 2.new text end

new text begin Commissioner's duties.new text end

new text begin The commissioner of health shall oversee a program
to:
new text end

new text begin (1) align the department services, policies, procedures, and governance with the National
CLAS Standards, establish culturally and linguistically appropriate goals, policies, and
management accountability, and apply them throughout the organization's planning and
operations;
new text end

new text begin (2) ensure the department services respond to the cultural and linguistic diversity of
Minnesotans and that the department partners with the community to design, implement,
and evaluate policies, practices, and services that are aligned with the national cultural and
linguistic appropriateness standard; and
new text end

new text begin (3) ensure the department leadership, workforce, and partners embed culturally and
linguistically appropriate policies and practices into leadership and public health program
planning, intervention, evaluation, and dissemination.
new text end

new text begin Subd. 3.new text end

new text begin Eligible contractors.new text end

new text begin The commissioner may enter into contracts to implement
this section. Organizations eligible to receive contract funding under this section include:
new text end

new text begin (1) master contractors that are selected through the state to provide language and
communication services; and
new text end

new text begin (2) organizations that are able to provide services for languages that master contractors
are unable to cover.
new text end

Sec. 17.

new text begin [144.0754] OFFICE OF AFRICAN AMERICAN HEALTH; DUTIES.
new text end

new text begin (a) The commissioner shall establish the Office of African American Health to address
the unique public health needs of African American Minnesotans. The office must work to
develop solutions and systems to address identified health disparities of African American
Minnesotans arising from a context of cumulative and historical discrimination and
disadvantages in multiple systems, including but not limited to housing, education,
employment, gun violence, incarceration, environmental factors, and health care
discrimination. The office shall:
new text end

new text begin (1) convene the African American Health State Advisory Council under section 144.0755
to advise the commissioner on issues and to develop specific, targeted policy solutions to
improve the health of African American Minnesotans, with a focus on United States born
African Americans;
new text end

new text begin (2) based upon input from and collaboration with the African American Health State
Advisory Council, health indicators, and identified disparities, conduct analysis and develop
policy and program recommendations and solutions targeted at improving African American
health outcomes;
new text end

new text begin (3) coordinate and conduct community engagement across multiple systems, sectors,
and communities to address racial disparities in labor force participation, educational
achievement, and involvement with the criminal justice system that impact African American
health and well-being;
new text end

new text begin (4) conduct data analysis and research to support policy goals and solutions;
new text end

new text begin (5) award and administer African American health special emphasis grants to health and
community-based organizations to plan and develop programs targeted at improving African
American health outcomes, based upon needs identified by the council, health indicators,
and identified disparities and addressing historical trauma and systems of United States
born African American Minnesotans; and
new text end

new text begin (6) develop and administer Department of Health immersion experiences for students
in secondary education and community colleges to improve diversity of the public health
workforce and introduce career pathways that contribute to reducing health disparities.
new text end

new text begin (b) By January 15, 2025, and every two years thereafter, the commissioner of health
shall report to the chairs and ranking minority members of the legislative committees with
primary jurisdiction over health policy and finance on the work accomplished by the Office
of African American Health during the previous two years and on goals of the office for
the upcoming two years.
new text end

Sec. 18.

new text begin [144.0755] AFRICAN AMERICAN HEALTH STATE ADVISORY
COUNCIL.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment; members.new text end

new text begin (a) The commissioner of health shall establish
and administer the African American Health State Advisory Council. The African American
Health State Advisory Council shall include no fewer than 12 or more than 20 members
from any of the following groups:
new text end

new text begin (1) representatives of community-based organizations serving or advocating for African
American citizens;
new text end

new text begin (2) at-large community leaders or elders, as nominated by other council members;
new text end

new text begin (3) African American individuals who provide and receive health care services;
new text end

new text begin (4) African American secondary or college students;
new text end

new text begin (5) health or human service professionals serving African American communities or
clients;
new text end

new text begin (6) representatives with research or academic expertise in racial equity; and
new text end

new text begin (7) other members that the commissioner deems appropriate to facilitate the goals and
duties of the council.
new text end

new text begin (b) The commissioner shall make recommendations for council membership and, after
considering recommendations from the council, shall appoint a chair or chairs of the council.
Council members shall be appointed by the governor.
new text end

new text begin Subd. 2.new text end

new text begin Terms.new text end

new text begin A term shall be for two years and appointees may be reappointed to
serve two additional terms. The commissioner shall recommend appointments to replace
members vacating their positions in a timely manner, no more than three months after the
council reviews panel recommendations.
new text end

new text begin Subd. 3.new text end

new text begin Duties of commissioner.new text end

new text begin The commissioner or commissioner's designee shall:
new text end

new text begin (1) maintain and actively engage with the council established in this section;
new text end

new text begin (2) based on recommendations of the council, review identified department or other
related policies or practices that maintain health inequities and disparities that particularly
affect African Americans in Minnesota;
new text end

new text begin (3) in partnership with the council, recommend or implement action plans and resources
necessary to address identified disparities and advance African American health equity;
new text end

new text begin (4) support interagency collaboration to advance African American health equity; and
new text end

new text begin (5) support member participation in the council, including participation in educational
and community engagement events across Minnesota that specifically address African
American health equity.
new text end

new text begin Subd. 4.new text end

new text begin Duties of council.new text end

new text begin The council shall:
new text end

new text begin (1) identify health disparities found in African American communities and contributing
factors;
new text end

new text begin (2) recommend to the commissioner for review any statutes, rules, or administrative
policies or practices that would address African American health disparities;
new text end

new text begin (3) recommend policies and strategies to the commissioner of health to address disparities
specifically affecting African American health;
new text end

new text begin (4) form work groups of council members who are persons who provide and receive
services and representatives of advocacy groups;
new text end

new text begin (5) provide the work groups with clear guidelines, standardized parameters, and tasks
for the work groups to accomplish; and
new text end

new text begin (6) annually submit to the commissioner a report that summarizes the activities of the
council, identifies disparities specially affecting the health of African American Minnesotans,
and makes recommendations to address identified disparities.
new text end

new text begin Subd. 5.new text end

new text begin Duties of council members.new text end

new text begin The members of the council shall:
new text end

new text begin (1) attend scheduled meetings with no more than three absences per year, participate in
scheduled meetings, and prepare for meetings by reviewing meeting notes;
new text end

new text begin (2) maintain open communication channels with respective constituencies;
new text end

new text begin (3) identify and communicate issues and risks that may impact the timely completion
of tasks;
new text end

new text begin (4) participate in any activities the council or commissioner deems appropriate and
necessary to facilitate the goals and duties of the council; and
new text end

new text begin (5) participate in work groups to carry out council duties.
new text end

new text begin Subd. 6.new text end

new text begin Staffing; office space; equipment.new text end

new text begin The commissioner shall provide the advisory
council with staff support, office space, and access to office equipment and services.
new text end

new text begin Subd. 7.new text end

new text begin Reimbursement.new text end

new text begin Compensation and reimbursement for travel and expenses
incurred for council activities are governed by section 15.059, subdivision 3.
new text end

Sec. 19.

new text begin [144.0756] AFRICAN AMERICAN HEALTH SPECIAL EMPHASIS GRANT
PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish the African
American health special emphasis grant program administered by the Office of African
American Health. The purposes of the program are to:
new text end

new text begin (1) identify disparities impacting African American health arising from cumulative and
historical discrimination and disadvantages in multiple systems, including but not limited
to housing, education, employment, gun violence, incarceration, environmental factors, and
health care discrimination; and
new text end

new text begin (2) develop community-based solutions that incorporate a multisector approach to
addressing identified disparities impacting African American health.
new text end

new text begin Subd. 2.new text end

new text begin Requests for proposals; accountability; data collection.new text end

new text begin As directed by the
commissioner of health, the Office of African American Health shall:
new text end

new text begin (1) develop a request for proposals for an African American health special emphasis
grant program in consultation with community stakeholders;
new text end

new text begin (2) provide outreach, technical assistance, and program development guidance to potential
qualifying organizations or entities;
new text end

new text begin (3) review responses to requests for proposals in consultation with community
stakeholders and award grants under this section;
new text end

new text begin (4) establish a transparent and objective accountability process in consultation with
community stakeholders, focused on outcomes that grantees agree to achieve;
new text end

new text begin (5) provide grantees with access to summary and other public data to assist grantees in
establishing and implementing effective community-led solutions; and
new text end

new text begin (6) collect and maintain data on outcomes reported by grantees.
new text end

new text begin Subd. 3.new text end

new text begin Eligible grantees.new text end

new text begin Organizations eligible to receive grant funding under this
section include nonprofit organizations or entities that work with African American
communities or are focused on addressing disparities impacting the health of African
American communities.
new text end

new text begin Subd. 4.new text end

new text begin Strategic consideration and priority of proposals; grant awards.new text end

new text begin In
developing the requests for proposals and awarding the grants, the commissioner and the
Office of African American Health shall consider building upon the existing capacity of
communities and on developing capacity where it is lacking. Proposals shall focus on
addressing health equity issues specific to United States-born African American communities;
addressing the health impact of historical trauma; reducing health disparities experienced
by United States-born African American communities; and incorporating a multisector
approach to addressing identified disparities.
new text end

new text begin Subd. 5.new text end

new text begin Report.new text end

new text begin Grantees must report grant program outcomes to the commissioner on
the forms and according to timelines established by the commissioner.
new text end

Sec. 20.

new text begin [144.0757] OFFICE OF AMERICAN INDIAN HEALTH.
new text end

new text begin Subdivision 1.new text end

new text begin Duties.new text end

new text begin The Office of American Indian Health is established to address
unique public health needs of American Indian Tribal communities in Minnesota. The office
shall:
new text end

new text begin (1) coordinate with Minnesota's Tribal Nations and urban American Indian
community-based organizations to identify underlying causes of health disparities, address
unique health needs of Minnesota's Tribal communities, and develop public health approaches
to achieve health equity;
new text end

new text begin (2) strengthen capacity of American Indian and community-based organizations and
Tribal Nations to address identified health disparities and needs;
new text end

new text begin (3) administer state and federal grant funding opportunities targeted to improve the
health of American Indians;
new text end

new text begin (4) provide overall leadership for targeted development of holistic health and wellness
strategies to improve health and to support Tribal and urban American Indian public health
leadership and self-sufficiency;
new text end

new text begin (5) provide technical assistance to Tribal and American Indian urban community leaders
to develop culturally appropriate activities to address public health emergencies;
new text end

new text begin (6) develop and administer the department immersion experiences for American Indian
students in secondary education and community colleges to improve diversity of the public
health workforce and introduce career pathways that contribute to reducing health disparities;
and
new text end

new text begin (7) identify and promote workforce development strategies for Department of Health
staff to work with the American Indian population and Tribal Nations more effectively in
Minnesota.
new text end

new text begin Subd. 2.new text end

new text begin Grants and contracts.new text end

new text begin To carry out these duties, the office may contract with
or provide grants to qualifying entities.
new text end

new text begin Subd. 3.new text end

new text begin Reporting.new text end

new text begin By January 15, 2025, and every two years thereafter, the
commissioner of health shall report to the chairs and ranking minority members of the
legislative committees with primary jurisdiction over health policy and finance on the work
accomplished by the Office of American Indian Health during the previous two years and
on goals of the office for the upcoming two years.
new text end

Sec. 21.

new text begin [144.0758] AMERICAN INDIAN HEALTH SPECIAL EMPHASIS GRANTS.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish the American
Indian health special emphasis grant program. The purposes of the program are to:
new text end

new text begin (1) plan and develop programs targeted to address continuing and persistent health
disparities of Minnesota's American Indian population and improve American Indian health
outcomes based upon needs identified by health indicators and identified disparities;
new text end

new text begin (2) identify disparities in American Indian health arising from cumulative and historical
discrimination; and
new text end

new text begin (3) plan and develop community-based solutions with a multisector approach to
addressing identified disparities in American Indian health.
new text end

new text begin Subd. 2.new text end

new text begin Commissioner's duties.new text end

new text begin The commissioner of health shall:
new text end

new text begin (1) develop a request for proposals for an American Indian health special emphasis grant
program in consultation with Minnesota's Tribal Nations and urban American Indian
community-based organizations based upon needs identified by the community, health
indicators, and identified disparities;
new text end

new text begin (2) provide outreach, technical assistance, and program development guidance to potential
qualifying organizations or entities;
new text end

new text begin (3) review responses to requests for proposals in consultation with community
stakeholders and award grants under this section;
new text end

new text begin (4) establish a transparent and objective accountability process in consultation with
community stakeholders focused on outcomes that grantees agree to achieve;
new text end

new text begin (5) provide grantees with access to data to assist grantees in establishing and
implementing effective community-led solutions; and
new text end

new text begin (6) collect and maintain data on outcomes reported by grantees.
new text end

new text begin Subd. 3.new text end

new text begin Eligible grantees.new text end

new text begin Organizations eligible to receive grant funding under this
section are Minnesota's Tribal Nations and urban American Indian community-based
organizations.
new text end

new text begin Subd. 4.new text end

new text begin Strategic consideration and priority of proposals; grant awards.new text end

new text begin In
developing the proposals and awarding the grants, the commissioner shall consider building
upon the existing capacity of Minnesota's Tribal Nations and urban American Indian
community-based organizations and on developing capacity where it is lacking. Proposals
may focus on addressing health equity issues specific to Tribal and urban American Indian
communities; addressing the health impact of historical trauma; reducing health disparities
experienced by American Indian communities; and incorporating a multisector approach
to addressing identified disparities.
new text end

new text begin Subd. 5.new text end

new text begin Report.new text end

new text begin Grantees must report grant program outcomes to the commissioner on
the forms and according to the timelines established by the commissioner.
new text end

Sec. 22.

new text begin [144.0759] PUBLIC HEALTH AMERICORPS.
new text end

new text begin The commissioner may award a grant to a statewide, nonprofit organization to support
Public Health AmeriCorps members. The organization awarded the grant shall provide the
commissioner with any information needed by the commissioner to evaluate the program
in the form and according to timelines specified by the commissioner.
new text end

Sec. 23.

Minnesota Statutes 2022, section 144.122, is amended to read:

144.122 LICENSE, PERMIT, AND SURVEY FEES.

(a) The state commissioner of health, by rule, may prescribe procedures and fees for
filing with the commissioner as prescribed by statute and for the issuance of original and
renewal permits, licenses, registrations, and certifications issued under authority of the
commissioner. The expiration dates of the various licenses, permits, registrations, and
certifications as prescribed by the rules shall be plainly marked thereon. Fees may include
application and examination fees and a penalty fee for renewal applications submitted after
the expiration date of the previously issued permit, license, registration, and certification.
The commissioner may also prescribe, by rule, reduced fees for permits, licenses,
registrations, and certifications when the application therefor is submitted during the last
three months of the permit, license, registration, or certification period. Fees proposed to
be prescribed in the rules shall be first approved by the Department of Management and
Budget. All fees proposed to be prescribed in rules shall be reasonable. The fees shall be
in an amount so that the total fees collected by the commissioner will, where practical,
approximate the cost to the commissioner in administering the program. All fees collected
shall be deposited in the state treasury and credited to the state government special revenue
fund unless otherwise specifically appropriated by law for specific purposes.

(b) The commissioner may charge a fee for voluntary certification of medical laboratories
and environmental laboratories, and for environmental and medical laboratory services
provided by the department, without complying with paragraph (a) or chapter 14. Fees
charged for environment and medical laboratory services provided by the department must
be approximately equal to the costs of providing the services.

(c) The commissioner may develop a schedule of fees for diagnostic evaluations
conducted at clinics held by the services for children with disabilities program. All receipts
generated by the program are annually appropriated to the commissioner for use in the
maternal and child health program.

(d) The commissioner shall set license fees for hospitals and nursing homes that are not
boarding care homes at the following levels:

Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and American Osteopathic Association (AOA) hospitals	$7,655 plus $16 per bed
Non-JCAHO and non-AOA hospitals	$5,280 plus $250 per bed
Nursing home	$183 plus $91 per bed until June 30, 2018. $183 plus $100 per bed between July 1, 2018, and June 30, 2020. $183 plus $105 per bed beginning July 1, 2020.

The commissioner shall set license fees for outpatient surgical centers, boarding care
homes, supervised living facilities, assisted living facilities, and assisted living facilities
with dementia care at the following levels:

Outpatient surgical centers	$3,712
Boarding care homes	$183 plus $91 per bed
Supervised living facilities	$183 plus $91 per bed.
Assisted living facilities with dementia care	$3,000 plus $100 per resident.
Assisted living facilities	$2,000 plus $75 per resident.

Fees collected under this paragraph are nonrefundable. The fees are nonrefundable even if
received before July 1, 2017, for licenses or registrations being issued effective July 1, 2017,
or later.

(e) Unless prohibited by federal law, the commissioner of health shall charge applicants
the following fees to cover the cost of any initial certification surveys required to determine
a provider's eligibility to participate in the Medicare or Medicaid program:

Prospective payment surveys for hospitals	$	900
Swing bed surveys for nursing homes	$	1,200
Psychiatric hospitals	$	1,400
Rural health facilities	$	1,100
Portable x-ray providers	$	500
Home health agencies	$	1,800
Outpatient therapy agencies	$	800
End stage renal dialysis providers	$	2,100
Independent therapists	$	800
Comprehensive rehabilitation outpatient facilities	$	1,200
Hospice providers	$	1,700
Ambulatory surgical providers	$	1,800
Hospitals	$	4,200
Other provider categories or additional resurveys required to complete initial certification	Actual surveyor costs: average surveyor cost x number of hours for the survey process.

These fees shall be submitted at the time of the application for federal certification and
shall not be refunded. All fees collected after the date that the imposition of fees is not
prohibited by federal law shall be deposited in the state treasury and credited to the state
government special revenue fund.

(f) Notwithstanding section 16A.1283, the commissioner may adjust the fees assessed
on assisted living facilities and assisted living facilities with dementia care under paragraph
(d), in a revenue-neutral manner in accordance with the requirements of this paragraph:

(1) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
to ten percent lower than the applicable fee in paragraph (d) if residents who receive home
and community-based waiver services under chapter 256S and section 256B.49 comprise
more than 50 percent of the facility's capacity in the calendar year prior to the year in which
the renewal application is submitted; and

(2) a facility seeking to renew a license shall pay a renewal fee in an amount that is up
to ten percent higher than the applicable fee in paragraph (d) if residents who receive home
and community-based waiver services under chapter 256S and section 256B.49 comprise
less than 50 percent of the facility's capacity during the calendar year prior to the year in
which the renewal application is submitted.

The commissioner may annually adjust the percentages in clauses (1) and (2), to ensure this
paragraph is implemented in a revenue-neutral manner. The commissioner shall develop a
method for determining capacity thresholds in this paragraph in consultation with the
commissioner of human services and must coordinate the administration of this paragraph
with the commissioner of human services for purposes of verification.

new text begin (g) The commissioner shall charge hospitals an annual licensing base fee of $1,826 per
hospital, plus an additional $23 per licensed bed or bassinet fee. Revenue shall be deposited
to the state government special revenue fund and credited toward trauma hospital designations
under sections 144.605 and 144.6071.
new text end

Sec. 24.

new text begin [144.1462] COMMUNITY HEALTH WORKERS; GRANTS AUTHORIZED.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall support collaboration
and coordination between state and community partners to develop, refine, and expand the
community health workers profession in Minnesota; equip community health workers to
address health needs; and to improve health outcomes. This work must address the social
conditions that impact community health and well-being in public safety, social services,
youth and family services, schools, and neighborhood associations.
new text end

new text begin Subd. 2.new text end

new text begin Grants and contracts authorized; eligibility.new text end

new text begin The commissioner of health
shall award grants or enter into contracts to expand and strengthen the community health
worker workforce across Minnesota. The grant recipients or contractor shall include at least
one not-for-profit community organization serving, convening, and supporting community
health workers statewide.
new text end

new text begin Subd. 3.new text end

new text begin Evaluation.new text end

new text begin The commissioner of health shall design, conduct, and evaluate
the community health worker initiative using measures such as workforce capacity,
employment opportunity, reach of services, and return on investment, as well as descriptive
measures of the existing community health worker models as they compare with the national
community health workers' landscape. These initial measures point to longer-term change
in social determinants of health and rates of death and injury by suicide, overdose, firearms,
alcohol, and chronic disease.
new text end

new text begin Subd. 4.new text end

new text begin Report.new text end

new text begin Grant recipients and contractors must report program outcomes to the
department annually and by the guidelines established by the commissioner.
new text end

Sec. 25.

Minnesota Statutes 2022, section 144.1505, is amended to read:

144.1505 HEALTH PROFESSIONALS CLINICAL TRAINING EXPANSION
new text begin AND RURAL AND UNDERSERVED CLINICAL ROTATIONS new text end GRANT deleted text begin PROGRAMdeleted text end new text begin
PROGRAMSnew text end .

Subdivision 1.

Definitions.

For purposes of this section, the following definitions apply:

(1) "eligible advanced practice registered nurse program" means a program that is located
in Minnesota and is currently accredited as a master's, doctoral, or postgraduate level
advanced practice registered nurse program by the Commission on Collegiate Nursing
Education or by the Accreditation Commission for Education in Nursing, or is a candidate
for accreditation;

(2) "eligible dental therapy program" means a dental therapy education program or
advanced dental therapy education program that is located in Minnesota and is either:

(i) approved by the Board of Dentistry; or

(ii) currently accredited by the Commission on Dental Accreditation;

(3) "eligible mental health professional program" means a program that is located in
Minnesota and is listed as a mental health professional program by the appropriate accrediting
body for clinical social work, psychology, marriage and family therapy, or licensed
professional clinical counseling, or is a candidate for accreditation;

(4) "eligible pharmacy program" means a program that is located in Minnesota and is
currently accredited as a doctor of pharmacy program by the Accreditation Council on
Pharmacy Education;

(5) "eligible physician assistant program" means a program that is located in Minnesota
and is currently accredited as a physician assistant program by the Accreditation Review
Commission on Education for the Physician Assistant, or is a candidate for accreditation;

(6) "mental health professional" means an individual providing clinical services in the
treatment of mental illness who meets one of the qualifications under section 245.462,
subdivision 18; deleted text begin and
deleted text end

new text begin (7) "eligible physician training program" means a physician residency training program
located in Minnesota and that is currently accredited by the accrediting body or has presented
a credible plan as a candidate for accreditation;
new text end

new text begin (8) "eligible dental program" means a dental education program or a dental residency
training program located in Minnesota and that is currently accredited by the accrediting
body or has presented a credible plan as a candidate for accreditation; and
new text end

deleted text begin (7)deleted text end new text begin (9)new text end "project" means a project to establish or expand clinical training for physician
assistants, advanced practice registered nurses, pharmacists, dental therapists, advanced
dental therapists, or mental health professionals in Minnesota.

Subd. 2.

deleted text begin Programdeleted text end new text begin Programsnew text end .

(a) new text begin For advanced practice provider clinical training
expansion grants, new text end the commissioner of health shall award health professional training site
grants to eligible physician assistant, advanced practice registered nurse, pharmacy, dental
therapy, and mental health professional programs to plan and implement expanded clinical
training. A planning grant shall not exceed $75,000, and a training grant shall not exceed
$150,000 for the first year, $100,000 for the second year, and $50,000 for the third year per
program.

new text begin (b) For health professional rural and underserved clinical rotations grants, the
commissioner of health shall award health professional training site grants to eligible
physician, physician assistant, advanced practice registered nurse, pharmacy, dentistry,
dental therapy, and mental health professional programs to augment existing clinical training
programs to add rural and underserved rotations or clinical training experiences, such as
credential or certificate rural tracks or other specialized training. For physician and dentist
training, the expanded training must include rotations in primary care settings such as
community clinics, hospitals, health maintenance organizations, or practices in rural
communities.
new text end

deleted text begin (b)deleted text end new text begin (c)new text end Funds may be used for:

(1) establishing or expanding new text begin rotations and new text end clinical training deleted text begin for physician assistants,
advanced practice registered nurses, pharmacists, dental therapists, advanced dental therapists,
and mental health professionals in Minnesotadeleted text end ;

(2) recruitment, training, and retention of students and faculty;

(3) connecting students with appropriate clinical training sites, internships, practicums,
or externship activities;

(4) travel and lodging for students;

(5) faculty, student, and preceptor salaries, incentives, or other financial support;

(6) development and implementation of cultural competency training;

(7) evaluations;

(8) training site improvements, fees, equipment, and supplies required to establish,
maintain, or expand a deleted text begin physician assistant, advanced practice registered nurse, pharmacy,
dental therapy, or mental health professionaldeleted text end training program; and

(9) supporting clinical education in which trainees are part of a primary care team model.

Subd. 3.

Applications.

Eligible physician assistant, advanced practice registered nurse,
pharmacy, dental therapy, new text begin dental, physician,new text end and mental health professional programs seeking
a grant shall apply to the commissioner. Applications must include a description of the
number of additional students who will be trained using grant funds; attestation that funding
will be used to support an increase in the number of clinical training slots; a description of
the problem that the proposed project will address; a description of the project, including
all costs associated with the project, sources of funds for the project, detailed uses of all
funds for the project, and the results expected; and a plan to maintain or operate any
component included in the project after the grant period. The applicant must describe
achievable objectives, a timetable, and roles and capabilities of responsible individuals in
the organization.new text begin Applicants applying under subdivision 2, paragraph (b), must include
information about length of training and training site settings, geographic location of rural
sites, and rural populations expected to be served.
new text end

Subd. 4.

Consideration of applications.

The commissioner shall review each application
to determine whether or not the application is complete and whether the program and the
project are eligible for a grant. In evaluating applications, the commissioner shall score each
application based on factors including, but not limited to, the applicant's clarity and
thoroughness in describing the project and the problems to be addressed, the extent to which
the applicant has demonstrated that the applicant has made adequate provisions to ensure
proper and efficient operation of the training program once the grant project is completed,
the extent to which the proposed project is consistent with the goal of increasing access to
primary care and mental health services for rural and underserved urban communities, the
extent to which the proposed project incorporates team-based primary care, and project
costs and use of funds.

Subd. 5.

Program oversight.

The commissioner shall determine the amount of a grant
to be given to an eligible program based on the relative score of each eligible program's
applicationnew text begin , including rural locations as applicable under subdivision 2, paragraph (b)new text end , other
relevant factors discussed during the review, and the funds available to the commissioner.
Appropriations made to the program do not cancel and are available until expended. During
the grant period, the commissioner may require and collect from programs receiving grants
any information necessary to evaluate the program.

Sec. 26.

new text begin [144.1507] PRIMARY CARE RESIDENCY TRAINING GRANT
PROGRAM.
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.
new text end

new text begin (b) "Eligible program" means a program that meets the following criteria:
new text end

new text begin (1) is located in Minnesota;
new text end

new text begin (2) trains medical residents in the specialties of family medicine, general internal
medicine, general pediatrics, psychiatry, geriatrics, or general surgery in rural residency
training programs or in community-based ambulatory care centers that primarily serve the
underserved; and
new text end

new text begin (3) is accredited by the Accreditation Council for Graduate Medical Education or presents
a credible plan to obtain accreditation.
new text end

new text begin (c) "Rural residency training program" means a residency program that provides an
initial year of training in an accredited residency program in Minnesota. The subsequent
years of the residency program are based in rural communities, utilizing local clinics and
community hospitals, with specialty rotations in nearby regional medical centers.
new text end

new text begin (d) "Community-based ambulatory care centers" means federally qualified health centers,
community mental health centers, rural health clinics, health centers operated by the Indian
Health Service, an Indian Tribe or Tribal organization, or an urban American Indian
organization or an entity receiving funds under Title X of the Public Health Service Act.
new text end

new text begin (e) "Eligible project" means a project to establish and maintain a rural residency training
program.
new text end

new text begin Subd. 2.new text end

new text begin Rural residency training program.new text end

new text begin (a) The commissioner of health shall
award rural residency training program grants to eligible programs to plan, implement, and
sustain rural residency training programs. A rural residency training program grant shall
not exceed $250,000 per year for up to three years for planning and development, and
$225,000 per resident per year for each year thereafter to sustain the program.
new text end

new text begin (b) Funds may be spent to cover the costs of:
new text end

new text begin (1) planning related to establishing accredited rural residency training programs;
new text end

new text begin (2) obtaining accreditation by the Accreditation Council for Graduate Medical Education
or another national body that accredits rural residency training programs;
new text end

new text begin (3) establishing new rural residency training programs;
new text end

new text begin (4) recruitment, training, and retention of new residents and faculty related to the new
rural residency training program;
new text end

new text begin (5) travel and lodging for new residents;
new text end

new text begin (6) faculty, new resident, and preceptor salaries related to new rural residency training
programs;
new text end

new text begin (7) training site improvements, fees, equipment, and supplies required for new rural
residency training programs; and
new text end

new text begin (8) supporting clinical education in which trainees are part of a primary care team model.
new text end

new text begin Subd. 3.new text end

new text begin Applications for rural residency training program grants.new text end

new text begin Eligible programs
seeking a grant shall apply to the commissioner. Applications must include the number of
new primary care rural residency training program slots planned, under development or
under contract; a description of the training program, including location of the established
residency program and rural training sites; a description of the project, including all costs
associated with the project; all sources of funds for the project; detailed uses of all funds
for the project; the results expected; proof of eligibility for federal graduate medical education
funding, if applicable; and a plan to seek the funding. The applicant must describe achievable
objectives, a timetable, and the roles and capabilities of responsible individuals in the
organization.
new text end

new text begin Subd. 4.new text end

new text begin Consideration of grant applications.new text end

new text begin The commissioner shall review each
application to determine if the residency program application is complete, if the proposed
rural residency program and residency slots are eligible for a grant, and if the program is
eligible for federal graduate medical education funding, and when the funding is available.
If eligible programs are not eligible for federal graduate medical education funding, the
commissioner may award continuation funding to the eligible program beyond the initial
grant period. The commissioner shall award grants to support training programs in family
medicine, general internal medicine, general pediatrics, psychiatry, geriatrics, general
surgery, and other primary care focus areas.
new text end

new text begin Subd. 5.new text end

new text begin Program oversight.new text end

new text begin During the grant period, the commissioner may require
and collect from grantees any information necessary to evaluate the program. Notwithstanding
section 16A.28, subdivision 6, encumbrances for grants under this section issued by June
30 of each year may be certified for a period of up to five years beyond the year in which
the funds were originally appropriated.
new text end

Sec. 27.

new text begin [144.1508] CLINICAL HEALTH CARE TRAINING.
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.
new text end

new text begin (b) "Accredited clinical training" means the clinical training provided by a medical
education program that is accredited through an organization recognized by the Department
of Education, the Centers for Medicare and Medicaid Services, or another national body
that reviews the accrediting organizations for multiple disciplines and whose standards for
recognizing accrediting organizations are reviewed and approved by the commissioner of
health.
new text end

new text begin (c) "Clinical medical education program" means the accredited clinical training of
physicians, medical students, residents, doctors of pharmacy practitioners, doctors of
chiropractic, dentists, advanced practice nurses, clinical nurse specialists, certified registered
nurse anesthetists, nurse practitioners, certified nurse midwives, physician assistants, dental
therapists and advanced dental therapists, psychologists, clinical social workers, community
paramedics, community health workers, and other medical professions as determined by
the commissioner.
new text end

new text begin (d) "Commissioner" means the commissioner of health.
new text end

new text begin (e) "Eligible entity" means an organization that is located in Minnesota, provides a
clinical medical education experience, and hosts students, residents, or other trainee types
as determined by the commissioner, and is from an accredited Minnesota teaching program
and institution.
new text end

new text begin (f) "Eligible trainee FTEs" means the number of trainees, as measured by full-time
equivalent counts, that are training in Minnesota at an entity with either currently active
medical assistance enrollment status and a National Provider Identification (NPI) number
or documentation that they provide sliding fee services. Training may occur in an inpatient
or ambulatory patient care setting or alternative setting as determined by the commissioner.
Training that occurs in nursing facility settings is not eligible for funding under this section.
new text end

new text begin (g) "Teaching institution" means a hospital, medical center, clinic, or other organization
that conducts a clinical medical education program in Minnesota that is accountable to the
accrediting body.
new text end

new text begin (h) "Trainee" means a student, resident, fellow, or other postgraduate involved in a
clinical medical education program from an accredited Minnesota teaching program and
institution.
new text end

new text begin Subd. 2.new text end

new text begin Application process.new text end

new text begin (a) An eligible entity hosting clinical trainees from a
clinical medical education program and teaching institution is eligible for funds under
subdivision 3, if the entity:
new text end

new text begin (1) is funded in part by sliding fee scale services or enrolled in the Minnesota health
care program;
new text end

new text begin (2) faces increased financial pressure as a result of competition with nonteaching patient
care entities; and
new text end

new text begin (3) emphasizes primary care or specialties that are in undersupply in rural or underserved
areas of Minnesota.
new text end

new text begin (b) An entity hosting a clinical medical education program for advanced practice nursing
is eligible for funds under subdivision 3, if the program meets the eligibility requirements
in paragraph (a), clauses (1) to (3), and is sponsored by the University of Minnesota
Academic Health Center, the Mayo Foundation, or an institution that is part of the Minnesota
State Colleges and Universities system or members of the Minnesota Private College Council.
new text end

new text begin (c) An application must be submitted to the commissioner by an eligible entity through
the teaching institution and contain the following information:
new text end

new text begin (1) the official name and address and the site addresses of the clinical medical education
programs where eligible trainees are hosted;
new text end

new text begin (2) the name, title, and business address of those persons responsible for administering
the funds;
new text end

new text begin (3) for each applicant, the type and specialty orientation of trainees in the program; the
name, entity address, medical assistance provider number, and national provider identification
number of each training site used in the program, as appropriate; the federal tax identification
number of each training site, where available; the total number of eligible trainee FTEs at
each site; and
new text end

new text begin (4) other supporting information the commissioner deems necessary.
new text end

new text begin (d) An applicant that does not provide information requested by the commissioner shall
not be eligible for funds for the current funding cycle.
new text end

new text begin Subd. 3.new text end

new text begin Distribution of funds.new text end

new text begin (a) The commissioner may distribute funds for clinical
training in areas of Minnesota and for the professions listed in subdivision 1, paragraph (c),
determined by the commissioner as a high need area and profession shortage area. The
commissioner shall annually distribute medical education funds to qualifying applicants
under this section based on the costs to train, service level needs, and profession or training
site shortages. Use of funds is limited to related clinical training costs for eligible programs.
new text end

new text begin (b) To ensure the quality of clinical training, eligible entities must demonstrate that they
hold contracts in good standing with eligible educational institutions that specify the terms,
expectations, and outcomes of the clinical training conducted at sites. Funds shall be
distributed in an administrative process determined by the commissioner to be efficient.
new text end

new text begin Subd. 4.new text end

new text begin Report.new text end

new text begin (a) Teaching institutions receiving funds under this section must sign
and submit a medical education grant verification report (GVR) to verify funding was
distributed as specified in the GVR. If the teaching institution fails to submit the GVR by
the stated deadline, the teaching institution is required to return the full amount of funds
received to the commissioner within 30 days of receiving notice from the commissioner.
The commissioner shall distribute returned funds to the appropriate training sites in
accordance with the commissioner's approval letter.
new text end

new text begin (b) Teaching institutions receiving funds under this section must provide any other
information the commissioner deems appropriate to evaluate the effectiveness of the use of
funds for medical education.
new text end

Sec. 28.

Minnesota Statutes 2022, section 144.218, subdivision 1, is amended to read:

Subdivision 1.

Adoption.

Upon receipt of a certified copy of an order, decree, or
certificate of adoption, the state registrar shall register a replacement vital record in the new
name of the adopted person. The original record of birth is deleted text begin confidentialdeleted text end new text begin private datanew text end pursuant
to section 13.02, subdivision deleted text begin 3deleted text end new text begin 12new text end , and shall not be disclosed except pursuant to court order
or section 144.2252. The information contained on the original birth record, except for the
registration number, shall be provided on request to a parent who is named on the original
birth record. Upon the receipt of a certified copy of a court order of annulment of adoption
the state registrar shall restore the original vital record to its original place in the file.

new text begin EFFECTIVE DATE.new text end

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

Sec. 29.

Minnesota Statutes 2022, section 144.218, subdivision 2, is amended to read:

Subd. 2.

Adoption of foreign persons.

In proceedings for the adoption of a person who
was born in a foreign country, the court, upon evidence presented by the commissioner of
human services from information secured at the port of entry or upon evidence from other
reliable sources, may make findings of fact as to the date and place of birth and parentage.
Upon receipt of certified copies of the court findings and the order or decree of adoption,
a certificate of adoption, or a certified copy of a decree issued under section 259.60, the
state registrar shall register a birth record in the new name of the adopted person. The
certified copies of the court findings and the order or decree of adoption, certificate of
adoption, or decree issued under section 259.60 are deleted text begin confidentialdeleted text end new text begin private datanew text end , pursuant to
section 13.02, subdivision deleted text begin 3deleted text end new text begin 12new text end , and shall not be disclosed except pursuant to court order
or section 144.2252. The birth record shall state the place of birth as specifically as possible
and that the vital record is not evidence of United States citizenship.

new text begin EFFECTIVE DATE.new text end

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

Sec. 30.

Minnesota Statutes 2022, section 144.222, subdivision 1, is amended to read:

Subdivision 1.

Fetal death report required.

A fetal death report must be filed within
five days of the death of a fetus for whom 20 or more weeks of gestation have elapsed,
except for abortions defined under section deleted text begin 145.4241deleted text end new text begin 145.411, subdivision 5new text end . A fetal death
report must be prepared in a format prescribed by the state registrar and filed in accordance
with Minnesota Rules, parts 4601.0100 to 4601.2600 by:

(1) a person in charge of an institution or that person's authorized designee if a fetus is
delivered in the institution or en route to the institution;

(2) a physician, certified nurse midwife, or other licensed medical personnel in attendance
at or immediately after the delivery if a fetus is delivered outside an institution; or

(3) a parent or other person in charge of the disposition of the remains if a fetal death
occurred without medical attendance at or immediately after the delivery.

new text begin EFFECTIVE DATE.new text end

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

Sec. 31.

Minnesota Statutes 2022, section 144.225, subdivision 2, is amended to read:

Subd. 2.

Data about births.

(a) Except as otherwise provided in this subdivision, data
pertaining to the birth of a child to a woman who was not married to the child's father when
the child was conceived nor when the child was born, including the original record of birth
and the certified vital record, are confidential data. At the time of the birth of a child to a
woman who was not married to the child's father when the child was conceived nor when
the child was born, the mother may designate demographic data pertaining to the birth as
public. Notwithstanding the designation of the data as confidential, it may be disclosed:

(1) to a parent or guardian of the child;

(2) to the child when the child is 16 years of age or older, except as provided in clause
(3);

(3) to the child if the child is a homeless youth;

(4) under paragraph (b), (e), or (f); or

(5) pursuant to a court order. For purposes of this section, a subpoena does not constitute
a court order.

(b) deleted text begin Unless the child is adopted,deleted text end Data pertaining to the birth of a child that are not
accessible to the public become public data if 100 years have elapsed since the birth of the
child who is the subject of the data, or as provided under section 13.10, whichever occurs
first.

(c) If a child is adopted, data pertaining to the child's birth are governed by the provisions
relating to adoption new text begin and birth new text end records, including sections 13.10, subdivision 5; 144.218,
subdivision 1; new text begin and new text end 144.2252deleted text begin ; and 259.89deleted text end .

(d) The name and address of a mother under paragraph (a) and the child's date of birth
may be disclosed to the county social services, Tribal health department, or public health
member of a family services collaborative for purposes of providing services under section
124D.23.

(e) The commissioner of human services shall have access to birth records for:

(1) the purposes of administering medical assistance and the MinnesotaCare program;

(2) child support enforcement purposes; and

(3) other public health purposes as determined by the commissioner of health.

(f) Tribal child support programs shall have access to birth records for child support
enforcement purposes.

new text begin EFFECTIVE DATE.new text end

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

Sec. 32.

Minnesota Statutes 2022, section 144.2252, is amended to read:

144.2252 ACCESS TO ORIGINAL BIRTH RECORD AFTER ADOPTION.

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

(a) deleted text begin Whenever an adopted person requests the state registrar
to disclose the information on the adopted person's original birth record, the state registrar
shall act according to section 259.89.deleted text end new text begin For purposes of this section, the following terms have
the meanings given.
new text end

new text begin (b) "Person related to the adopted person" means:
new text end

new text begin (1) the spouse, child, or grandchild of an adopted person, if the spouse, child, or
grandchild is at least 18 years of age; or
new text end

new text begin (2) the legal representative of an adopted person.
new text end

new text begin The definition under this paragraph only applies when the adopted person is deceased.
new text end

new text begin (c) "Original birth record" means a copy of the original birth record for a person who is
born in Minnesota and whose original birth record was sealed and replaced by a replacement
birth record after the state registrar received a certified copy of an order, decree, or certificate
of adoption.
new text end

new text begin Subd. 2.new text end

new text begin Release of original birth record.new text end

new text begin (a) The state registrar must provide to an
adopted person who is 18 years of age or older or a person related to the adopted person a
copy of the adopted person's original birth record and any evidence of the adoption previously
filed with the state registrar. To receive a copy of an original birth record under this
subdivision, the adopted person or person related to the adopted person must make the
request to the state registrar in writing. The copy of the original birth record must clearly
indicate that it may not be used for identification purposes. All procedures, fees, and waiting
periods applicable to a nonadopted person's request for a copy of a birth record apply in the
same manner as requests made under this section.
new text end

new text begin (b) If a contact preference form is attached to the original birth record as authorized
under section 144.2253, the state registrar must provide a copy of the contact preference
form along with the copy of the adopted person's original birth record.
new text end

deleted text begin (b)deleted text end new text begin (c)new text end The state registrar shall provide a transcript of an adopted person's original birth
record to an authorized representative of a federally recognized American Indian Tribe for
the sole purpose of determining the adopted person's eligibility for enrollment or membership.
Information contained in the birth record may not be used to provide the adopted person
information about the person's birth parents, except as provided in this section or section
259.83.

new text begin (d) For a replacement birth record issued under section 144.218, the adopted person or
a person related to the adopted person may obtain from the state registrar copies of the order
or decree of adoption, certificate of adoption, or decree issued under section 259.60, as filed
with the state registrar.
new text end

new text begin Subd. 3.new text end

new text begin Adult adoptions.new text end

new text begin Notwithstanding section 144.218, a person adopted as an
adult may access the person's birth records that existed before the person's adult adoption.
Access to the existing birth records shall be the same access that was permitted prior to the
adult adoption.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 33.

new text begin [144.2253] BIRTH PARENT CONTACT PREFERENCE FORM.
new text end

new text begin (a) The commissioner must make available to the public a contact preference form as
described in paragraph (b).
new text end

new text begin (b) The contact preference form must provide the following information to be completed
at the option of a birth parent:
new text end

new text begin (1) "I would like to be contacted."
new text end

new text begin (2) "I would prefer to be contacted only through an intermediary."
new text end

new text begin (3) "I prefer not to be contacted at this time. If I decide later that I would like to be
contacted, I will submit an updated contact preference form to the Minnesota Department
of Health."
new text end

new text begin (c) A contact preference form must include space where the birth parent may include
information that the birth parent feels is important for the adopted person to know.
new text end

new text begin (d) If a birth parent of an adopted person submits a completed contact preference form
to the commissioner, the commissioner must:
new text end

new text begin (1) match the contact preference form to the adopted person's original birth record; and
new text end

new text begin (2) attach the contact preference form to the original birth record as required under
section 144.2252.
new text end

new text begin (e) A contact preference form submitted to the commissioner under this section is private
data on an individual as defined in section 13.02, subdivision 12, except that the contact
preference form may be released as provided under section 144.2252, subdivision 2.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 34.

new text begin [144.2254] PREVIOUSLY FILED CONSENTS TO DISCLOSURE AND
AFFIDAVITS OF NONDISCLOSURE.
new text end

new text begin (a) The commissioner must inform a person applying for an original birth record under
section 144.2252 of the existence of an unrevoked consent to disclosure or an affidavit of
nondisclosure on file with the department, including the name of the birth parent who filed
the consent or affidavit. If a birth parent authorized the release of the birth parent's address
on an unrevoked consent to disclosure, the commissioner shall provide the address to the
person who requests the original birth record.
new text end

new text begin (b) A birth parent's consent to disclosure or affidavit of nondisclosure filed with the
commissioner of health expires and has no force or effect beginning on June 30, 2024.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 35.

Minnesota Statutes 2022, section 144.226, subdivision 3, is amended to read:

Subd. 3.

Birth record surcharge.

(a) In addition to any fee prescribed under subdivision
1, there shall be a nonrefundable surcharge of $3 for each certified birth or stillbirth record
and for a certification that the vital record cannot be found. The state registrar or local
issuance office shall forward this amount to the commissioner of management and budget
new text begin each month following the collection of the surcharge new text end for deposit into the account for the
children's trust fund for the prevention of child abuse established under section 256E.22.
This surcharge shall not be charged under those circumstances in which no fee for a certified
birth or stillbirth record is permitted under subdivision 1, paragraph (b). Upon certification
by the commissioner of management and budget that the assets in that fund exceed
$20,000,000, this surcharge shall be discontinued.

(b) In addition to any fee prescribed under subdivision 1, there shall be a nonrefundable
surcharge of $10 for each certified birth record. The state registrar or local issuance office
shall forward this amount to the commissioner of management and budget new text begin each month
following the collection of the surcharge new text end for deposit in the general fund.

Sec. 36.

Minnesota Statutes 2022, section 144.226, subdivision 4, is amended to read:

Subd. 4.

Vital records surcharge.

In addition to any fee prescribed under subdivision
1, there is a nonrefundable surcharge of $4 for each certified and noncertified birth, stillbirth,
or death record, and for a certification that the record cannot be found. The local issuance
office or state registrar shall forward this amount to the commissioner of management and
budget new text begin each month following the collection of the surcharge new text end to be deposited into the state
government special revenue fund.

Sec. 37.

new text begin [144.3431] NONRESIDENTIAL MENTAL HEALTH SERVICES.
new text end

new text begin (a) A minor who is age 16 or older may give effective consent for nonresidential mental
health services, and the consent of no other person is required. For purposes of this section,
"nonresidential mental health services" means outpatient services as defined in section
245.4871, subdivision 29, provided to a minor who is not residing in a hospital, inpatient
unit, or licensed residential treatment facility or program.
new text end

new text begin (b) This section does not preclude a minor from providing effective consent for mental
health or other health services according to the authority in section 144.344 or other
applicable law.
new text end

Sec. 38.

new text begin [144.3885] LABOR TRAFFICKING SERVICES GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health must establish a labor
trafficking services grant program to provide comprehensive, trauma-informed, and culturally
specific services for victims of labor trafficking or labor exploitation.
new text end

new text begin Subd. 2.new text end

new text begin Eligibility; application.new text end

new text begin To be eligible for a grant under this section, applicants
must be a nonprofit organization or a nongovernmental organization serving victims of
labor trafficking or labor exploitation; a local public health department; a social service
agency; a Tribal government; a local unit of government; a school or school district; a health
care organization; or another interested agency demonstrating experience or expertise in
working with victims of labor trafficking exploitation. An entity seeking a grant under this
section must apply to the commissioner at a time and in a manner specified by the
commissioner. The commissioner must review each application to determine if the application
is complete, the entity is eligible for a grant, and the proposed project is an allowable use
of grant funds. The commissioner must determine the grant amount awarded to applicants
that the commissioner determines will receive a grant.
new text end

new text begin Subd. 3.new text end

new text begin Reporting.new text end

new text begin (a) The grantee must submit a report to the commissioner in a
manner and on a timeline specified by the commissioner on how the grant funds were spent
and how many individuals were served.
new text end

new text begin (b) By January 15 of each year, the commissioner must submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health policy
and finance. The report must include the names of the grant recipients, how the grant funds
were spent, and how many individuals were served.
new text end

Sec. 39.

new text begin [144.398] TOBACCO USE PREVENTION ACCOUNT; ESTABLISHMENT
AND USES.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

new text begin (a) As used in this section, the terms in this subdivision have
the meanings given.
new text end

new text begin (b) "Electronic delivery device" has the meaning given in section 609.685, subdivision
1, paragraph (c).
new text end

new text begin (c) "Nicotine delivery product" has the meaning given in section 609.6855, subdivision
1, paragraph (c).
new text end

new text begin (d) "Tobacco" has the meaning given in section 609.685, subdivision 1, paragraph (a).
new text end

new text begin (e) "Tobacco-related devices" has the meaning given in section 609.685, subdivision 1,
paragraph (b).
new text end

new text begin Subd. 2.new text end

new text begin Account created.new text end

new text begin A tobacco use prevention account is created in the special
revenue fund. Pursuant to section 16A.151, subdivision 2, paragraph (h), the commissioner
of management and budget shall deposit into the account any money received by the state
resulting from a settlement agreement or an assurance of discontinuance entered into by the
attorney general of the state, or a court order in litigation brought by the attorney general
of the state on behalf of the state or a state agency related to alleged violations of consumer
fraud laws in the marketing, sale, or distribution of electronic nicotine delivery systems in
this state or other alleged illegal actions that contributed to the exacerbation of youth nicotine
use.
new text end

new text begin Subd. 3.new text end

new text begin Appropriations from tobacco use prevention account. new text end

new text begin (a) Each fiscal year,
the amount of money in the tobacco use prevention account is appropriated to the
commissioner of health for:
new text end

new text begin (1) tobacco and electronic delivery device use prevention and cessation projects consistent
with the duties specified in section 144.392;
new text end

new text begin (2) a public information program under section 144.393;
new text end

new text begin (3) the development of health promotion and health education materials about tobacco
and electronic delivery device use prevention and cessation;
new text end

new text begin (4) tobacco and electronic delivery device use prevention activities under section 144.396;
and
new text end

new text begin (5) statewide tobacco cessation services under section 144.397.
new text end

new text begin (b) In activities funded under this subdivision, the commissioner of health must:
new text end

new text begin (1) prioritize preventing persons under the age of 21 from using commercial tobacco,
electronic delivery devices, tobacco-related devices, and nicotine delivery products;
new text end

new text begin (2) promote racial and health equity; and
new text end

new text begin (3) use strategies that are evidence-based or based on promising practices.
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. 40.

new text begin [144.587] REQUIREMENTS FOR SCREENING FOR ELIGIBILITY FOR
HEALTH COVERAGE OR ASSISTANCE.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

new text begin (a) The terms defined in this subdivision apply to this section
and sections 144.588 to 144.589.
new text end

new text begin (b) "Charity care" means the provision of free or discounted care to a patient according
to a hospital's financial assistance policies.
new text end

new text begin (c) "Hospital" means a private, nonprofit, or municipal hospital licensed under sections
144.50 to 144.56.
new text end

new text begin (d) "Insurance affordability program" has the meaning given in section 256B.02,
subdivision 19.
new text end

new text begin (e) "Navigator" has the meaning given in section 62V.02, subdivision 9.
new text end

new text begin (f) "Presumptive eligibility" has the meaning given in section 256B.057, subdivision
12.
new text end

new text begin (g) "Revenue recapture" means the use of the procedures in chapter 270A to collect debt.
new text end

new text begin (h) "Uninsured service or treatment" means any service or treatment that is not covered
by:
new text end

new text begin (1) a health plan, contract, or policy that provides health coverage to a patient; or
new text end

new text begin (2) any other type of insurance coverage, including but not limited to no-fault automobile
coverage, workers' compensation coverage, or liability coverage.
new text end

new text begin (i) "Unreasonable burden" includes requiring a patient to apply for enrollment in a state
or federal program for which the patient is obviously or categorically ineligible or has been
found to be ineligible in the previous 12 months.
new text end

new text begin Subd. 2.new text end

new text begin Screening.new text end

new text begin (a) A hospital participating in the hospital presumptive eligibility
program under section 256B.057, subdivision 12, must determine whether a patient who is
uninsured or whose insurance coverage status is not known by the hospital is eligible for
hospital presumptive eligibility coverage.
new text end

new text begin (b) For any uninsured patient, including any patient the hospital determines is eligible
for hospital presumptive eligibility coverage, and for any patient whose insurance coverage
status is not known to the hospital, a hospital must:
new text end

new text begin (1) if it is a certified application counselor organization, schedule an appointment for
the patient with a certified application counselor to occur prior to discharge unless the
occurrence of the appointment would delay discharge;
new text end

new text begin (2) if the occurrence of the appointment under clause (1) would delay discharge or if
the hospital is not a certified application counselor organization, schedule prior to discharge
an appointment for the patient with a MNsure-certified navigator to occur after discharge
unless the scheduling of an appointment would delay discharge; or
new text end

new text begin (3) if the scheduling of an appointment under clause (2) would delay discharge or if the
patient declines the scheduling of an appointment under clause (1) or (2), provide the patient
with contact information for available MNsure-certified navigators who can meet the needs
of the patient.
new text end

new text begin (c) For any uninsured patient, including any patient the hospital determines is eligible
for hospital presumptive eligibility coverage, and any patient whose insurance coverage
status is not known to the hospital, a hospital must screen the patient for eligibility for charity
care from the hospital. The hospital must attempt to complete the screening process for
charity care in person or by telephone within 30 days after the patient receives services at
the hospital or at the emergency department associated with the hospital.
new text end

new text begin Subd. 3.new text end

new text begin Charity care.new text end

new text begin (a) Upon completion of the screening process in subdivision 2,
paragraph (c), the hospital must determine whether the patient is ineligible or potentially
eligible for charity care. When a hospital evaluates a patient's eligibility for charity care,
hospital requests to the responsible party for verification of assets or income shall be limited
to:
new text end

new text begin (1) information that is reasonably necessary and readily available to determine eligibility;
and
new text end

new text begin (2) facts that are relevant to determine eligibility.
new text end

new text begin A hospital must not demand duplicate forms of verification of assets.
new text end

new text begin (b) If the patient is not ineligible for charity care, the hospital must assist the patient
with applying for charity care and refer the patient to the appropriate department in the
hospital for follow-up. A hospital may not impose application procedures for charity care
that place an unreasonable burden on the individual patient, taking into account the individual
patient's physical, mental, intellectual, or sensory deficiencies or language barriers that may
hinder the patient's ability to comply with application procedures.
new text end

new text begin (c) A hospital may not initiate any of the actions described in subdivision 4 while the
patient's application for charity care is pending.
new text end

new text begin Subd. 4.new text end

new text begin Prohibited actions.new text end

new text begin A hospital must not initiate one or more of the following
actions until the hospital determines that the patient is ineligible for charity care or denies
an application for charity care:
new text end

new text begin (1) offering to enroll or enrolling the patient in a payment plan;
new text end

new text begin (2) changing the terms of a patient's payment plan;
new text end

new text begin (3) offering the patient a loan or line of credit, application materials for a loan or line of
credit, or assistance with applying for a loan or line of credit, for the payment of medical
debt;
new text end

new text begin (4) referring a patient's debt for collections, including in-house collections, third-party
collections, revenue recapture, or any other process for the collection of debt;
new text end

new text begin (5) denying health care services to the patient or any member of the patient's household
because of outstanding medical debt, regardless of whether the services are deemed necessary
or may be available from another provider; or
new text end

new text begin (6) accepting a credit card payment of over $500 for the medical debt owed to the hospital.
new text end

new text begin Subd. 5.new text end

new text begin Notice.new text end

new text begin (a) A hospital must post notice of the availability of charity care from
the hospital in at least the following locations: (1) areas of the hospital where patients are
admitted or registered; (2) emergency departments; and (3) the portion of the hospital's
financial services or billing department that is accessible to patients. The posted notice must
be in all languages spoken by more than five percent of the population in the hospital's
service area.
new text end

new text begin (b) A hospital must make available on the hospital's website the current version of the
hospital's charity care policy, a plain-language summary of the policy, and the hospital's
charity care application form. The summary and application form must be available in all
languages spoken by more than five percent of the population in the hospital's service area.
new text end

new text begin Subd. 6.new text end

new text begin Patient may decline services.new text end

new text begin A patient may decline to complete an insurance
affordability program application to schedule an appointment with a certified application
counselor, to schedule an appointment with a MNsure-certified navigator, to accept
information about navigator services, to participate in the charity care screening process,
or to apply for charity care.
new text end

new text begin Subd. 7.new text end

new text begin Enforcement.new text end

new text begin In addition to the enforcement of this section by the
commissioner, the attorney general may enforce this section under section 8.31.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective November 1, 2023, and applies to services
and treatments provided on or after that date.
new text end

Sec. 41.

new text begin [144.588] CERTIFICATION OF EXPERT REVIEW.
new text end

new text begin Subdivision 1.new text end

new text begin Requirement; action to collect medical debt or garnish wages or bank
accounts.new text end

new text begin (a) In an action against a patient or guarantor for collection of medical debt owed
to a hospital or for garnishment of the patient's or guarantor's wages or bank accounts to
collect medical debt owed to a hospital, the hospital must serve on the defendant with the
summons and complaint an affidavit of expert review certifying that:
new text end

new text begin (1) unless the patient declined to participate, the hospital complied with the requirements
in section 144.587;
new text end

new text begin (2) there is a reasonable basis to believe that the patient owes the debt;
new text end

new text begin (3) all known third-party payors have been properly billed by the hospital, such that any
remaining debt is the financial responsibility of the patient, and the hospital will not bill the
patient for any amount that an insurance company is obligated to pay;
new text end

new text begin (4) the patient has been given a reasonable opportunity to apply for charity care, if the
facts and circumstances suggest that the patient may be eligible for charity care;
new text end

new text begin (5) where the patient has indicated an inability to pay the full amount of the debt in one
payment and provided reasonable verification of the inability to pay the full amount of the
debt in one payment if requested by the hospital, the hospital has offered the patient a
reasonable payment plan;
new text end

new text begin (6) there is no reasonable basis to believe that the patient's or guarantor's wages or funds
at a financial institution are likely to be exempt from garnishment; and
new text end

new text begin (7) in the case of a default judgment proceeding, there is not a reasonable basis to believe:
new text end

new text begin (i) that the patient may already consider that the patient has adequately answered the
complaint by calling or writing to the hospital, its debt collection agency, or its attorney;
new text end

new text begin (ii) that the patient is potentially unable to answer the complaint due to age, disability,
or medical condition; or
new text end

new text begin (iii) the patient may not have received service of the complaint.
new text end

new text begin (b) The affidavit of expert review must be completed by a designated employee of the
hospital seeking to initiate the action or garnishment.
new text end

new text begin Subd. 2.new text end

new text begin Requirement; referral to third-party debt collection agency.new text end

new text begin (a) In order to
refer a patient's account to a third-party debt collection agency, a hospital must complete
an affidavit of expert review certifying that:
new text end

new text begin (1) unless the patient declined to participate, the hospital complied with the requirements
in section 144.587;
new text end

new text begin (2) there is a reasonable basis to believe that the patient owes the debt;
new text end

new text begin (b) The affidavit of expert review must be completed by a designated employee of the
hospital seeking to refer the patient's account to a third-party debt collection agency.
new text end

new text begin Subd. 3.new text end

new text begin Penalty for noncompliance.new text end

new text begin Failure to comply with subdivision 1 shall result,
upon motion, in mandatory dismissal with prejudice of the action to collect the medical
debt or to garnish the patient's or guarantor's wages or bank accounts. Failure to comply
with subdivision 2 shall subject a hospital to a fine assessed by the commissioner of health.
In addition to the enforcement of this section by the commissioner, the attorney general
may enforce this section under section 8.31.
new text end

new text begin Subd. 4.new text end

new text begin Collection agency; immunity.new text end

new text begin A collection agency, as defined in section
332.31, subdivision 3, is not liable under section 144.588, subdivision 3, for inaccuracies
in an affidavit of expert review completed by a designated employee of the hospital.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective November 1, 2023, and applies to actions
and referrals to third-party debt collection agencies stemming from services and treatments
provided on or after that date.
new text end

Sec. 42.

new text begin [144.589] BILLING OF UNINSURED PATIENTS.
new text end

new text begin Subdivision 1.new text end

new text begin Limits on charges.new text end

new text begin A hospital must not charge a patient whose annual
household income is less than $125,000 for any uninsured service or treatment in an amount
that exceeds the lowest total amount the provider would be reimbursed for that service or
treatment from a nongovernmental third-party payor. The lowest total amount the provider
would be reimbursed for that service or treatment from a nongovernmental third-party payor
includes both the amount the provider would be reimbursed directly from the
nongovernmental third-party payor and the amount the provider would be reimbursed from
the insured's policyholder under any applicable co-payments, deductibles, and coinsurance.
This statute supersedes the language in the Minnesota Attorney General Hospital Agreement.
new text end

new text begin Subd. 2.new text end

new text begin Enforcement.new text end

new text begin In addition to the enforcement of this section by the
commissioner, the attorney general may enforce this section under section 8.31.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective November 1, 2023, and applies to services
and treatments provided on or after that date.
new text end

Sec. 43.

Minnesota Statutes 2022, section 144.615, subdivision 7, is amended to read:

Subd. 7.

Limitations of services.

(a) The following limitations apply to the services
performed at a birth center:

(1) surgical procedures must be limited to those normally accomplished during an
uncomplicated birth, including episiotomy and repair;new text begin and
new text end

deleted text begin (2) no abortions may be administered; and
deleted text end

deleted text begin (3)deleted text end new text begin (2)new text end no general or regional anesthesia may be administered.

(b) Notwithstanding paragraph (a), local anesthesia may be administered at a birth center
if the administration of the anesthetic is performed within the scope of practice of a health
care professional.

new text begin EFFECTIVE DATE.new text end

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

Sec. 44.

Minnesota Statutes 2022, section 144.651, is amended by adding a subdivision
to read:

new text begin Subd. 10a.new text end

new text begin Designated support person for pregnant patient.new text end

new text begin (a) Subject to paragraph
(c), a health care provider and a health care facility must allow, at a minimum, one designated
support person of a pregnant patient's choosing to be physically present while the patient
is receiving health care services including during a hospital stay.
new text end

new text begin (b) For purposes of this subdivision, "designated support person" means any person
chosen by the patient to provide comfort to the patient including but not limited to the
patient's spouse, partner, family member, or another person related by affinity. Certified
doulas and traditional midwives may not be counted toward the limit of one designated
support person.
new text end

new text begin (c) A facility may restrict or prohibit the presence of a designed support person in
treatment rooms, procedure rooms, and operating rooms when such a restriction or prohibition
is strictly necessary to meet the appropriate standard of care. A facility may also restrict or
prohibit the presence of a designated support person if the designated support person is
acting in a violent or threatening manner toward others. Any restriction or prohibition of a
designated support person by the facility is subject to the facility's written internal grievance
procedure required by subdivision 20.
new text end

Sec. 45.

Minnesota Statutes 2022, section 144.9501, subdivision 9, is amended to read:

Subd. 9.

Elevated blood lead level.

"Elevated blood lead level" means a diagnostic
blood lead test with a result that is equal to or greater than deleted text begin tendeleted text end new text begin 3.5new text end micrograms of lead per
deciliter of whole blood in any person, unless the commissioner finds that a lower
concentration is necessary to protect public health.

Sec. 46.

new text begin [144.9821] ADVANCING HEALTH EQUITY THROUGH CAPACITY
BUILDING AND RESOURCE ALLOCATION.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment of grant program.new text end

new text begin (a) The commissioner of health shall
establish an annual grant program to award infrastructure capacity building grants to help
metro and rural community and faith-based organizations serving people of color, American
Indians, LGBTQIA+ communities, and people living with disabilities in Minnesota who
have been disproportionately impacted by health and other inequities to be better equipped
and prepared for success in procuring grants and contracts at the department and addressing
inequities.
new text end

new text begin (b) The commissioner of health shall create a framework at the department to maintain
equitable practices in grantmaking to ensure that internal grantmaking and procurement
policies and practices prioritize equity, transparency, and accessibility to include:
new text end

new text begin (1) a tracking system for the department to better monitor and evaluate equitable
procurement and grantmaking processes and their impacts; and
new text end

new text begin (2) technical assistance and coaching to department leadership in grantmaking and
procurement processes and programs and providing tools and guidance to ensure equitable
and transparent competitive grantmaking processes and award distribution across
communities most impacted by inequities and develop measures to track progress over time.
new text end

new text begin Subd. 2.new text end

new text begin Commissioner's duties.new text end

new text begin The commissioner of health shall:
new text end

new text begin (1) in consultation with community stakeholders, community health boards and Tribal
nations, develop a request for proposals for an infrastructure capacity building grant program
to help community-based organizations, including faith-based organizations, to be better
equipped and prepared for success in procuring grants and contracts at the department and
beyond;
new text end

new text begin (2) provide outreach, technical assistance, and program development support to increase
capacity for new and existing community-based organizations and other service providers
in order to better meet statewide needs particularly in greater Minnesota and areas where
services to reduce health disparities have not been established;
new text end

new text begin (3) in consultation with community stakeholders, review responses to requests for
proposals and award grants under this section;
new text end

new text begin (4) ensure communication with the ethnic councils, Minnesota Indian Affairs Council,
Minnesota Council on Disability, Minnesota Commission of the Deaf, DeafBlind, and Hard
of Hearing, and the governor's office on the request for proposal process;
new text end

new text begin (5) in consultation with community stakeholders, establish a transparent and objective
accountability process focused on outcomes that grantees agree to achieve;
new text end

new text begin (6) maintain data on outcomes reported by grantees; and
new text end

new text begin (7) establish a process or mechanism to evaluate the success of the capacity building
grant program and to build the evidence base for effective community-based organizational
capacity building in reducing disparities.
new text end

new text begin Subd. 3.new text end

new text begin Eligible grantees.new text end

new text begin Organizations eligible to receive grant funding under this
section include: organizations or entities that work with diverse communities such as people
of color, American Indians, LGBTQIA+ communities, and people with disabilities in metro
and rural communities.
new text end

new text begin Subd. 4.new text end

new text begin Strategic consideration and priority of proposals; eligible populations;
grant awards.new text end

new text begin (a) The commissioner, in consultation with community stakeholders, shall
develop a request for proposals for equity in procurement and grantmaking capacity building
grant program to help community-based organizations, including faith-based organizations
to be better equipped and prepared for success in procuring grants and contracts at the
department and addressing inequities.
new text end

new text begin (b) In awarding the grants, the commissioner shall provide strategic consideration and
give priority to proposals from organizations or entities led by populations of color or
American Indians, and those serving communities of color, American Indians, LGBTQIA+
communities, and disability communities.
new text end

new text begin Subd. 5.new text end

new text begin Geographic distribution of grants.new text end

new text begin The commissioner shall ensure that grant
funds are prioritized and awarded to organizations and entities that are within counties that
have a higher proportion of Black or African American, nonwhite Latino(a), LGBTQIA+,
and disability communities to the extent possible.
new text end

new text begin Subd. 6.new text end

new text begin Report.new text end

new text begin Grantees must report grant program outcomes to the commissioner on
the forms and according to the timelines established by the commissioner.
new text end

Sec. 47.

Minnesota Statutes 2022, section 144G.16, subdivision 7, is amended to read:

Subd. 7.

Finesnew text begin and penaltiesnew text end .

new text begin (a) new text end The deleted text begin feedeleted text end new text begin finenew text end for failure to comply with the notification
requirements in section 144G.52, subdivision 7, is $1,000.

new text begin (b) Fines and penalties collected under this section shall be deposited in a dedicated
special revenue account. On an annual basis, the balance in the special revenue account
shall be appropriated to the commissioner to implement the recommendations of the advisory
council established in section 144A.4799.
new text end

Sec. 48.

Minnesota Statutes 2022, section 144G.18, is amended to read:

144G.18 NOTIFICATION OF CHANGES IN INFORMATION.

new text begin Subdivision 1.new text end

new text begin Notification.new text end

A provisional licensee or licensee shall notify the
commissioner in writing prior to a change in the manager or authorized agent and within
60 calendar days after any change in the information required in section 144G.12, subdivision
1, clause (1), (3), (4), (17), or (18).

new text begin Subd. 2.new text end

new text begin Fines and penalties.new text end

new text begin (a) The fine for failure to comply with the notification
requirements of this section is $1,000.
new text end

new text begin (b) Fines and penalties collected under this subdivision shall be deposited in a dedicated
special revenue account. On an annual basis, the balance in the special revenue account
shall be appropriated to the commissioner to implement the recommendations of the advisory
council established in section 144A.4799.
new text end

Sec. 49.

Minnesota Statutes 2022, section 144G.57, subdivision 8, is amended to read:

Subd. 8.

deleted text begin Finedeleted text end new text begin Fines and penaltiesnew text end .

new text begin (a) new text end The commissioner may impose a fine for failure
to follow the requirements of this section.

new text begin (b) The fine for failure to comply with this section is $1,000.
new text end

new text begin (c) Fines and penalties collected under this section shall be deposited in a dedicated
special revenue account. On an annual basis, the balance in the special revenue account
shall be appropriated to the commissioner to implement the recommendations of the advisory
council established in section 144A.4799.
new text end

Sec. 50.

new text begin [145.361] LONG COVID AND RELATED CONDITIONS; ASSESSMENT
AND MONITORING.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

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

new text begin (b) "Long COVID" means health problems that people experience four or more weeks
after being infected with SARS-CoV-2, the virus that causes COVID-19. Long COVID is
also called post-COVID conditions, long-haul COVID, chronic COVID, post-acute COVID,
or post-acute sequelae of COVID-19 (PASC).
new text end

new text begin (c) "Related conditions" means conditions associated with or sequelae of long COVID,
including but not limited to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)
and dysautonomia, and postural orthostatic tachycardia syndrome (POTS).
new text end

new text begin Subd. 2.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish a program to conduct
community assessments and epidemiologic investigations to monitor and address impacts
of long COVID and related conditions. The purposes of these activities are to:
new text end

new text begin (1) monitor trends in: incidence, prevalence, mortality, and health outcomes; changes
in disability status, employment, and quality of life; and service needs of individuals with
long COVID or related conditions and to detect potential public health problems, predict
risks, and assist in investigating long COVID and related conditions health inequities;
new text end

new text begin (2) more accurately target information and resources for communities and patients and
their families;
new text end

new text begin (3) inform health professionals and citizens about risks and early detection;
new text end

new text begin (4) promote evidence-based practices around long COVID and related conditions
prevention and management and to address public concerns and questions about long COVID
and related conditions; and
new text end

new text begin (5) research and track related conditions.
new text end

new text begin Subd. 3.new text end

new text begin Partnerships.new text end

new text begin The commissioner of health shall, in consultation with health
care professionals, the commissioner of human services, local public health entities, health
insurers, employers, schools, survivors of long COVID or related conditions, and community
organizations serving people at high risk of long COVID or related conditions, identify
priority actions and activities to address the needs for communication, services, resources,
tools, strategies, and policies to support survivors of long COVID or related conditions and
their families.
new text end

new text begin Subd. 4.new text end

new text begin Grants and contracts.new text end

new text begin The commissioner of health shall coordinate and
collaborate with community and organizational partners to implement evidence-informed
priority actions through community-based grants and contracts. The commissioner of health
shall award grants and enter into contracts to organizations that serve communities
disproportionately impacted by COVID-19, long COVID, or related conditions, including
but not limited to rural and low-income areas, Black and African Americans, African
immigrants, American Indians, Asian American-Pacific Islanders, Latino(a) communities,
LGBTQ+ communities, and persons with living disabilities. Organizations may also address
intersectionality within the groups. The commissioner shall award grants and award contracts
to eligible organizations to plan, construct, and disseminate resources and information to
support survivors of long COVID or related conditions, including caregivers, health care
providers, ancillary health care workers, workplaces, schools, communities, and local and
Tribal public health.
new text end

Sec. 51.

Minnesota Statutes 2022, section 145.411, subdivision 1, is amended to read:

Subdivision 1.

Terms.

As used in sections 145.411 to deleted text begin 145.416deleted text end new text begin 145.415new text end , the terms defined
in this section have the meanings given to them.

new text begin EFFECTIVE DATE.new text end

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

Sec. 52.

Minnesota Statutes 2022, section 145.411, subdivision 5, is amended to read:

Subd. 5.

Abortion.

"Abortion" includes an act, procedure or use of any instrument,
medicine or drug which is supplied or prescribed for or administered to deleted text begin a pregnant womandeleted text end new text begin
an individual with the intention of terminating, andnew text end which results in the termination ofnew text begin ,new text end
pregnancy.

new text begin EFFECTIVE DATE.new text end

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

Sec. 53.

Minnesota Statutes 2022, section 145.4131, subdivision 1, is amended to read:

Subdivision 1.

Forms.

(a) Within 90 days of July 1, 1998, the commissioner shall prepare
a reporting form for use by physicians or facilities performing abortions. A copy of this
section shall be attached to the form. A physician or facility performing an abortion shall
obtain a form from the commissioner.

(b) The form shall require the following information:

(1) the number of abortions performed by the physician in the previous calendar year,
reported by month;

(2) the method used for each abortion;

(3) the approximate gestational age expressed in one of the following increments:

(i) less than nine weeks;

(ii) nine to ten weeks;

(iii) 11 to 12 weeks;

(iv) 13 to 15 weeks;

(v) 16 to 20 weeks;

(vi) 21 to 24 weeks;

(vii) 25 to 30 weeks;

(viii) 31 to 36 weeks; or

(ix) 37 weeks to term;

(4) the age of the woman at the time the abortion was performed;

deleted text begin (5) the specific reason for the abortion, including, but not limited to, the following:
deleted text end

deleted text begin (i) the pregnancy was a result of rape;
deleted text end

deleted text begin (ii) the pregnancy was a result of incest;
deleted text end

deleted text begin (iii) economic reasons;
deleted text end

deleted text begin (iv) the woman does not want children at this time;
deleted text end

deleted text begin (v) the woman's emotional health is at stake;
deleted text end

deleted text begin (vi) the woman's physical health is at stake;
deleted text end

deleted text begin (vii) the woman will suffer substantial and irreversible impairment of a major bodily
function if the pregnancy continues;
deleted text end

deleted text begin (viii) the pregnancy resulted in fetal anomalies; or
deleted text end

deleted text begin (ix) unknown or the woman refused to answer;
deleted text end

deleted text begin (6) the number of prior induced abortions;
deleted text end

deleted text begin (7) the number of prior spontaneous abortions;
deleted text end

deleted text begin (8) whether the abortion was paid for by:
deleted text end

deleted text begin (i) private coverage;
deleted text end

deleted text begin (ii) public assistance health coverage; or
deleted text end

deleted text begin (iii) self-pay;
deleted text end

deleted text begin (9) whether coverage was under:
deleted text end

deleted text begin (i) a fee-for-service plan;
deleted text end

deleted text begin (ii) a capitated private plan; or
deleted text end

deleted text begin (iii) other;
deleted text end

deleted text begin (10)deleted text end new text begin (5)new text end complications, if any, for each abortion and for the aftermath of each abortion.
Space for a description of any complications shall be available on the form;

deleted text begin (11)deleted text end new text begin (6)new text end the medical specialty of the physician performing the abortion;new text begin and
new text end

deleted text begin (12)deleted text end new text begin (7)new text end if the abortion was performed via telehealth, the facility code for the patient and
the facility code for the physiciandeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (13) whether the abortion resulted in a born alive infant, as defined in section 145.423,
subdivision 4, and:
deleted text end

deleted text begin (i) any medical actions taken to preserve the life of the born alive infant;
deleted text end

deleted text begin (ii) whether the born alive infant survived; and
deleted text end

deleted text begin (iii) the status of the born alive infant, should the infant survive, if known.
deleted text end

Sec. 54.

Minnesota Statutes 2022, section 145.4131, subdivision 2, is amended to read:

Subd. 2.

Submission.

A physician performing an abortion or a facility at which an
abortion is performed shall complete and submit the form to the commissioner no later than
deleted text begin April 1deleted text end new text begin September 30new text end for abortions performed in the previous calendar year. The annual
report to the commissioner shall include the methods used to dispose of fetal tissue and
remains.

Sec. 55.

Minnesota Statutes 2022, section 145.4134, is amended to read:

145.4134 COMMISSIONER'S PUBLIC REPORT.

(a) By deleted text begin July 1deleted text end new text begin December 31new text end of each year, deleted text begin except for 1998 and 1999 information,deleted text end the
commissioner shall issue a public report providing statistics for the previous calendar year
compiled from the data submitted under sections 145.4131 to 145.4133 and sections 145.4241
to 145.4249. deleted text begin For 1998 and 1999 information, the report shall be issued October 1, 2000.deleted text end
Each report shall provide the statistics for all previous calendar years, adjusted to reflect
any additional information from late or corrected reports. The commissioner shall ensure
that none of the information included in the public reports can reasonably lead to
identification of an individual having performed or having had an abortion. All data included
on the forms under deleted text begin sectionsdeleted text end new text begin sectionnew text end 145.4131 deleted text begin to 145.4133 and sections 145.4241 to 145.4249deleted text end
must be included in the public report, except that the commissioner shall maintain as
confidential, data which alone or in combination may constitute information from which
an individual having performed or having had an abortion may be identified using
epidemiologic principles.

(b) The commissioner may, by rules adopted under chapter 14, alter the submission
dates established under deleted text begin sectionsdeleted text end new text begin sectionnew text end 145.4131 deleted text begin to 145.4133deleted text end for administrative convenience,
fiscal savings, or other valid reason, provided that physicians or facilities deleted text begin and the
commissioner of human servicesdeleted text end submit the required information once each year and the
commissioner issues a report once each year.

new text begin EFFECTIVE DATE.new text end

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

Sec. 56.

Minnesota Statutes 2022, section 145.423, subdivision 1, is amended to read:

Subdivision 1.

Recognition; deleted text begin medicaldeleted text end care.

deleted text begin A born alivedeleted text end new text begin Annew text end infant deleted text begin as a result of an
abortiondeleted text end new text begin who is born alivenew text end shall be fully recognized as a human person, and accorded
immediate protection under the law. All reasonable measures consistent with good medical
practice, including the compilation of appropriate medical records, shall be taken by the
responsible medical personnel to deleted text begin preserve the life and health of the born alive infantdeleted text end new text begin care
for the infant who is born alivenew 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. 57.

new text begin [145.561] 988 SUICIDE AND CRISIS LIFELINE.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

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

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

new text begin (c) "Department" means the Department of Health.
new text end

new text begin (d) "988" means the universal telephone number designated as the universal telephone
number within the United States for the purpose of the national suicide prevention and
mental health crisis hotline system operating through the 988 Suicide and Crisis Lifeline,
or its successor, maintained by the Assistant Secretary for Mental Health and Substance
Use under section 520E-3 of the Public Health Service Act (United States Code, title 42,
sections 290bb-36c).
new text end

new text begin (e) "988 administrator" means the administrator of the national 988 Suicide and Crisis
Lifeline maintained by the Assistant Secretary for Mental Health and Substance Use under
section 520E-3 of the Public Health Service Act.
new text end

new text begin (f) "988 contact" means a communication with the 988 Suicide and Crisis Lifeline system
within the United States via modalities offered including call, chat, or text.
new text end

new text begin (g) "988 Lifeline Center" means a state-identified center that is a member of the Suicide
and Crisis Lifeline network that responds to statewide or regional 988 contacts.
new text end

new text begin (h) "988 Suicide and Crisis Lifeline" or "988 Lifeline" means the national suicide
prevention and mental health crisis hotline system maintained by the Assistant Secretary
for Mental Health and Substance Use under section 520E-3 of the Public Health Service
Act (United States Code, title 42, sections 290bb-36c).
new text end

new text begin (i) "Veterans Crisis Line" means the Veterans Crisis Line maintained by the Secretary
of Veterans Affairs under United States Code, title 38, section 170F(h).
new text end

new text begin Subd. 2.new text end

new text begin 988 Lifeline.new text end

new text begin (a) The commissioner shall administer the designation of and
oversight for a 988 Lifeline center or a network of 988 Lifeline centers to answer contacts
from individuals accessing the Suicide and Crisis Lifeline from any jurisdiction within the
state 24 hours per day, seven days per week.
new text end

new text begin (b) The designated 988 Lifeline Center must:
new text end

new text begin (1) have an active agreement with the 988 Suicide and Crisis Lifeline program for
participation in the network and the department;
new text end

new text begin (2) meet the 988 Lifeline program requirements and best practice guidelines for
operational and clinical standards;
new text end

new text begin (3) provide data and reports, and participate in evaluations and related quality
improvement activities as required by the 988 Lifeline program and the department;
new text end

new text begin (4) identify or adapt technology that is demonstrated to be interoperable across mobile
crisis and public safety answering points used in the state for the purpose of crisis care
coordination;
new text end

new text begin (5) facilitate crisis and outgoing services, including mobile crisis teams in accordance
with guidelines established by the 988 Lifeline program and the department;
new text end

new text begin (6) actively collaborate and coordinate service linkages with mental health and substance
use disorder treatment providers, local community mental health centers including certified
community behavioral health clinics and community behavioral health centers, mobile crisis
teams, and community based and hospital emergency departments;
new text end

new text begin (7) offer follow-up services to individuals accessing the 988 Lifeline Center that are
consistent with guidance established by the 988 Lifeline program and the department; and
new text end

new text begin (8) meet the requirements set by the 988 Lifeline program and the department for serving
at-risk and specialized populations.
new text end

new text begin (c) The commissioner shall adopt rules to allow appropriate information sharing and
communication between and across crisis and emergency response systems.
new text end

new text begin (d) The commissioner, having primary oversight of suicide prevention, shall work with
the 988 Lifeline program, veterans crisis line, and other SAMHSA-approved networks for
the purpose of ensuring consistency of public messaging about 988 services.
new text end

new text begin (e) The commissioner shall work with representatives from 988 Lifeline Centers and
public safety answering points, other public safety agencies, and the commissioner of public
safety to facilitate the development of protocols and procedures for interactions between
988 and 911 services across Minnesota. Protocols and procedures shall be developed
following available national standards and guidelines.
new text end

new text begin (f) The commissioner shall provide an annual public report on 988 Lifeline usage,
including data on answer rates, abandoned calls, and referrals to 911 emergency response.
new text end

new text begin Subd. 3.new text end

new text begin 988 special revenue account.new text end

new text begin (a) A 988 special revenue account is established
as a dedicated account in the special revenue fund to create and maintain a statewide 988
suicide and crisis lifeline system according to the National Suicide Hotline Designation Act
of 2020, the Federal Communications Commission's report and order FCC 20-100 adopted
July 16, 2020, and national guidelines for crisis care.
new text end

new text begin (b) The 988 special revenue account shall consist of:
new text end

new text begin (1) a 988 telecommunications fee imposed under subdivision 4;
new text end

new text begin (2) a prepaid wireless 988 fee imposed under section 403.161;
new text end

new text begin (3) transfers of state money into the account;
new text end

new text begin (4) grants and gifts intended for deposit in the account;
new text end

new text begin (5) interest, premiums, gains, and other earnings of the account; and
new text end

new text begin (6) money from any other source that is deposited in or transferred to the account.
new text end

new text begin (c) The account shall be administered by the commissioner. Money in the account shall
only be used to offset costs that are or may reasonably be attributed to:
new text end

new text begin (1) implementing, maintaining, and improving the 988 suicide and crisis lifeline, including
staff and technology infrastructure enhancements needed to achieve the operational standards
and best practices set forth by the 988 administrator and the department;
new text end

new text begin (2) data collection, reporting, participation in evaluations, public promotion, and related
quality improvement activities as required by the 988 administrator and the department;
and
new text end

new text begin (3) administration, oversight, and evaluation of the account.
new text end

new text begin (d) Money in the account:
new text end

new text begin (1) does not cancel at the end of any state fiscal year and is carried forward in subsequent
state fiscal years;
new text end

new text begin (2) is not subject to transfer to any other account or fund or to transfer, assignment, or
reassignment for any use or purpose other than the purposes specified in this subdivision;
and
new text end

new text begin (3) is appropriated to the commissioner for the purposes specified in this subdivision.
new text end

new text begin (e) The commissioner shall submit an annual report to the legislature and to the Federal
Communications Commission on deposits to and expenditures from the account.
Notwithstanding section 144.05, subdivision 7, the reports required under this paragraph
do not expire.
new text end

new text begin Subd. 4.new text end

new text begin 988 telecommunications fee.new text end

new text begin (a) In compliance with the National Suicide
Hotline Designation Act of 2020, the commissioner shall impose a monthly statewide fee
on each subscriber of a wireline, wireless, or IP-enabled voice service at a rate that provides
for the robust creation, operation, and maintenance of a statewide 988 suicide prevention
and crisis system.
new text end

new text begin (b) The commissioner shall annually recommend to the Public Utilities Commission an
adequate and appropriate fee to implement this section. The amount of the fee must comply
with the limits in paragraph (c). The commissioner shall provide telecommunication service
providers and carriers a minimum of 45 days' notice of each fee change.
new text end

new text begin (c) The amount of the 988 telecommunications fee must not be more than 25 cents per
month on or after January 1, 2024, for each consumer access line, including trunk equivalents
as designated by the commission pursuant to section 403.11, subdivision 1. The 988
telecommunications fee must be the same for all subscribers.
new text end

new text begin (d) Each wireline, wireless, and IP-enabled voice telecommunication service provider
shall collect the 988 telecommunications fee and transfer the amounts collected to the
commissioner of public safety in the same manner as provided in section 403.11, subdivision
1, paragraph (d).
new text end

new text begin (e) The commissioner of public safety shall deposit the money collected from the 988
telecommunications fee to the 988 special revenue account established in subdivision 3.
new text end

new text begin (f) All 988 telecommunications fee revenue must be used to supplement, and not supplant,
federal, state, and local funding for suicide prevention.
new text end

new text begin (g) The 988 telecommunications fee amount shall be adjusted as needed to provide for
continuous operation of the lifeline centers and 988 hotline, volume increases, and
maintenance.
new text end

new text begin (h) The commissioner shall annually report to the Federal Communications Commission
on revenue generated by the 988 telecommunications fee.
new text end

new text begin Subd. 5.new text end

new text begin 988 fee for prepaid wireless telecommunications services.new text end

new text begin (a) The 988
telecommunications fee established in subdivision 4 does not apply to prepaid wireless
telecommunications services. Prepaid wireless telecommunications services are subject to
the prepaid wireless 988 fee established in section 403.161, subdivision 1, paragraph (c).
new text end

new text begin (b) Collection, remittance, and deposit of prepaid wireless 988 fees are governed by
sections 403.161 and 403.162.
new text end

new text begin Subd. 6.new text end

new text begin 988 Lifeline operating budget; data to legislature.new text end

new text begin The commissioner shall
provide a biennial report for maintaining the 988 system to the legislature as part of the
biennial departmental earnings report process under section 16A.1285, subdivision 3. The
report must include data on direct and indirect expenditures to maintain the 988 system,
988 fees collected, the balance in the 988 account, and the most recent forecast of revenues
to and expenditures from the 988 account.
new text end

new text begin Subd. 7.new text end

new text begin Waiver.new text end

new text begin A wireless telecommunications service provider or wire-line
telecommunications service provider may petition the commissioner for a waiver of all or
portions of the requirements of this section. The commissioner may grant a waiver upon a
demonstration by the petitioner that the requirement is economically infeasible.
new text end

Sec. 58.

Minnesota Statutes 2022, section 145.87, subdivision 4, is amended to read:

Subd. 4.

deleted text begin Administrative costsdeleted text end new text begin Administrationnew text end .

The commissioner may deleted text begin use up to seven
percent of the annual appropriation under this section todeleted text end provide training and technical
assistance and deleted text begin todeleted text end administer and evaluate the program. The commissioner may contract for
training, capacity-building support for grantees or potential grantees, technical assistance,
and evaluation support.

Sec. 59.

new text begin [145.903] SCHOOL-BASED HEALTH CENTERS.
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.
new text end

new text begin (b) "School-based health center" or "comprehensive school-based health center" means
a safety net health care delivery model that is located in or near a school facility and that
offers comprehensive health care, including preventive and behavioral health services,
provided by licensed and qualified health professionals in accordance with federal, state,
and local law. When not located on school property, the school-based health center must
have an established relationship with one or more schools in the community and operate to
primarily serve those student groups.
new text end

new text begin (c) "Sponsoring organization" means any of the following that operate a school-based
health center:
new text end

new text begin (1) health care providers;
new text end

new text begin (2) community clinics;
new text end

new text begin (3) hospitals;
new text end

new text begin (4) federally qualified health centers and look-alikes as defined in section 145.9269;
new text end

new text begin (5) health care foundations or nonprofit organizations;
new text end

new text begin (6) higher education institutions; or
new text end

new text begin (7) local health departments.
new text end

new text begin Subd. 2.new text end

new text begin Expansion of Minnesota school-based health centers.new text end

new text begin (a) The commissioner
of health shall administer a program to provide grants to school districts and school-based
health centers to support existing centers and facilitate the growth of school-based health
centers in Minnesota.
new text end

new text begin (b) Grant funds distributed under this subdivision shall be used to support new or existing
school-based health centers that:
new text end

new text begin (1) operate in partnership with a school or school district and with the permission of the
school or school district board;
new text end

new text begin (2) provide health services through a sponsoring organization that meets the requirements
in subdivision 1, paragraph (c); and
new text end

new text begin (3) provide health services to all students and youth within a school or school district,
regardless of ability to pay, insurance coverage, or immigration status, and in accordance
with federal, state, and local law.
new text end

new text begin (c) The commissioner of health shall administer a grant to a nonprofit organization to
facilitate a community of practice among school-based health centers to improve quality,
equity, and sustainability of care delivered through school-based health centers; encourage
cross-sharing among school-based health centers; support existing clinics; and expand
school-based health centers in new communities in Minnesota.
new text end

new text begin (d) Grant recipients shall report their activities and annual performance measures as
defined by the commissioner in a format and time specified by the commissioner.
new text end

new text begin (e) The commissioners of health and of education shall coordinate the projects and
initiatives funded under this section with other efforts at the local, state, or national level
to avoid duplication and promote coordinated efforts.
new text end

new text begin Subd. 3.new text end

new text begin School-based health center services.new text end

new text begin (a) Services provided by a school-based
health center may include but are not limited to:
new text end

new text begin (1) preventive health care;
new text end

new text begin (2) chronic medical condition management, including diabetes and asthma care;
new text end

new text begin (3) mental health care and crisis management;
new text end

new text begin (4) acute care for illness and injury;
new text end

new text begin (5) oral health care;
new text end

new text begin (6) vision care;
new text end

new text begin (7) nutritional counseling;
new text end

new text begin (8) substance abuse counseling;
new text end

new text begin (9) referral to a specialist, medical home, or hospital for care;
new text end

new text begin (10) additional services that address social determinants of health; and
new text end

new text begin (11) emerging services such as mobile health and telehealth.
new text end

new text begin (b) Services provided by a school-based health center must not replace the daily student
support provided in the school by educational student service providers, including but not
limited to licensed school nurses, educational psychologists, school social workers, and
school counselors.
new text end

new text begin Subd. 4.new text end

new text begin Sponsoring organizations.new text end

new text begin A sponsoring organization that agrees to operate
a school-based health center must enter into a memorandum of agreement with the school
or school district. The memorandum of agreement must require the sponsoring organization
to be financially responsible for the operation of school-based health centers in the school
or school district and must identify the costs that are the responsibility of the school or
school district, such as Internet access, custodial services, utilities, and facility maintenance.
To the greatest extent possible, a sponsoring organization must bill private insurers, medical
assistance, and other public programs for services provided in the school-based health
centers in order to maintain the financial sustainability of school-based health centers.
new text end

Sec. 60.

Minnesota Statutes 2022, section 145.924, is amended to read:

145.924 deleted text begin AIDSdeleted text end new text begin HIVnew text end PREVENTION GRANTS.

(a) The commissioner may award grants to community health boards as defined in section
145A.02, subdivision 5, state agencies, state councils, or nonprofit corporations to provide
evaluation and counseling services to populations at risk for acquiring human
immunodeficiency virus infection, including, but not limited to, deleted text begin minoritiesdeleted text end new text begin communities of
colornew text end , adolescents, deleted text begin intravenous drug usersdeleted text end new text begin women, people who inject drugsnew text end , and deleted text begin homosexual
mendeleted text end new text begin gay, bisexual, and transgender individualsnew text end .

(b) The commissioner may award grants to agencies experienced in providing services
to communities of color, for the design of innovative outreach and education programs for
targeted groups within the community who may be at risk of acquiring the human
immunodeficiency virus infection, including deleted text begin intravenous drug usersdeleted text end new text begin people who inject drugsnew text end
and their partners, adolescents, new text begin women, and new text end gay deleted text begin anddeleted text end new text begin ,new text end bisexualnew text begin , and transgendernew text end individuals
deleted text begin and womendeleted text end . Grants shall be awarded on a request for proposal basis and shall include funds
for administrative costs. Priority for grants shall be given to agencies or organizations that
have experience in providing service to the particular community which the grantee proposes
to serve; that have policy makers representative of the targeted population; that have
experience in dealing with issues relating to HIV/AIDS; and that have the capacity to deal
effectively with persons of differing sexual orientations. For purposes of this paragraph,
the "communities of color" are: the American-Indian community; the Hispanic community;
the African-American community; and the Asian-Pacific new text begin Islander new text end community.

(c) All state grants awarded under this section for programs targeted to adolescents shall
include the promotion of abstinence from sexual activity and drug use.

new text begin (d) The commissioner shall administer a grant program to provide funds to organizations,
including Tribal health agencies, to assist with HIV outbreaks.
new text end

Sec. 61.

Minnesota Statutes 2022, section 145.925, is amended to read:

145.925 deleted text begin FAMILY PLANNINGdeleted text end new text begin SEXUAL AND REPRODUCTIVE HEALTH
SERVICESnew text end GRANTS.

Subdivision 1.

deleted text begin Eligible organizations; purposedeleted text end new text begin Goal and establishmentnew text end .

deleted text begin The
commissioner of health may make special grants to cities, counties, groups of cities or
counties, or nonprofit corporations to provide prepregnancy family planning services.deleted text end new text begin (a)
It is the goal of the state to increase access to sexual and reproductive health services for
people who experience barriers, whether geographic, cultural, financial, or other, in access
to such services. The commissioner of health shall administer grants to facilitate access to
sexual and reproductive health services for people of reproductive age, particularly those
from populations that experience barriers to these services.
new text end

new text begin (b) The commissioner of health shall coordinate with other efforts at the local, state, or
national level to avoid duplication and promote complementary efforts in sexual and
reproductive health service promotion among people of reproductive age.
new text end

deleted text begin Subd. 1a.deleted text end

deleted text begin Family planning services; defined.deleted text end

deleted text begin "Family planning services" means
counseling by trained personnel regarding family planning; distribution of information
relating to family planning, referral to licensed physicians or local health agencies for
consultation, examination, medical treatment, genetic counseling, and prescriptions for the
purpose of family planning; and the distribution of family planning products, such as charts,
thermometers, drugs, medical preparations, and contraceptive devices. For purposes of
sections 145A.01 to 145A.14, family planning shall mean voluntary action by individuals
to prevent or aid conception but does not include the performance, or make referrals for
encouragement of voluntary termination of pregnancy.
deleted text end

deleted text begin Subd. 2.deleted text end

deleted text begin Prohibition.deleted text end

deleted text begin The commissioner shall not make special grants pursuant to this
section to any nonprofit corporation which performs abortions. No state funds shall be used
under contract from a grantee to any nonprofit corporation which performs abortions. This
provision shall not apply to hospitals licensed pursuant to sections 144.50 to 144.56, or
health maintenance organizations certified pursuant to chapter 62D.
deleted text end

new text begin Subd. 2a.new text end

new text begin Sexual and reproductive health services defined.new text end

new text begin For purposes of this section,
"sexual and reproductive health services" means services that promote a state of complete
physical, mental, and social well-being in relation to sexuality, reproduction, and the
reproductive system and its functions and processes, and not merely the absence of disease
or infirmity. These services must be provided in accord with nationally recognized standards
and include but are not limited to sexual and reproductive health counseling, voluntary and
informed decision-making on sexual and reproductive health, information on and provision
of contraceptive methods, sexual and reproductive health screenings and treatment, pregnancy
testing and counseling, and other preconception services.
new text end

Subd. 3.

deleted text begin Minorsdeleted text end new text begin Grants authorizednew text end .

deleted text begin No funds provided by grants made pursuant to
this section shall be used to support any family planning services for any unemancipated
minor in any elementary or secondary school building.deleted text end new text begin (a) The commissioner of health shall
award grants to eligible community organizations, including nonprofit organizations,
community health boards, and Tribal communities in rural and metropolitan areas of the
state to support, sustain, expand, or implement reproductive and sexual health programs for
people of reproductive age to increase access to and availability of medically accurate sexual
and reproductive health services.
new text end

new text begin (b) The commissioner of health shall establish application scoring criteria to use in the
evaluation of applications submitted for award under this section. These criteria shall include
but are not limited to the degree to which applicants' programming responds to demographic
factors relevant to paragraph (f) and subdivision 1, paragraph (a).
new text end

new text begin (c) When determining whether to award a grant or the amount of a grant under this
section, the commissioner of health may identify and stratify geographic regions based on
the region's need for sexual and reproductive health services. In this stratification, the
commissioner may consider data on the prevalence of poverty and other factors relevant to
a geographic region's need for sexual and reproductive health services.
new text end

new text begin (d) The commissioner of health may consider geographic and Tribal communities'
representation in the award of grants.
new text end

new text begin (e) Current recipients of funding under this section shall not be afforded priority over
new applicants.
new text end

new text begin (f) Grant funds shall be used to support new or existing sexual and reproductive health
programs that provide person-centered, accessible services; that are culturally and
linguistically appropriate, inclusive of all people, and trauma-informed; that protect the
dignity of the individual; and that ensure equitable, quality services consistent with nationally
recognized standards of care. These services shall include:
new text end

new text begin (1) education and outreach on medically accurate sexual and reproductive health
information;
new text end

new text begin (2) contraceptive counseling, provision of contraceptive methods, and follow-up;
new text end

new text begin (3) screening, testing, and treatment of sexually transmitted infections and other sexual
or reproductive concerns; and
new text end

new text begin (4) referral and follow-up for medical, financial, mental health, and other services in
accord with a service recipient's needs.
new text end

Subd. 4.

Parental notification.

Except as provided in sections 144.341 and 144.342,
any person employed to provide family planning services who is paid in whole or in part
from funds provided under this section who advises an abortion or sterilization to any
unemancipated minor shall, following such a recommendation, so notify the parent or
guardian of the reasons for such an action.

deleted text begin Subd. 5.deleted text end

deleted text begin Rules.deleted text end

deleted text begin The commissioner of health shall promulgate rules for approval of plans
and budgets of prospective grant recipients, for the submission of annual financial and
statistical reports, and the maintenance of statements of source and application of funds by
grant recipients. The commissioner of health may not require that any home rule charter or
statutory city or county apply for or receive grants under this subdivision as a condition for
the receipt of any state or federal funds unrelated to family planning services.
deleted text end

Subd. 6.

Public services; individual deleted text begin and employeedeleted text end rights.

The request of any person
for deleted text begin family planningdeleted text end new text begin sexual and reproductive healthnew text end services or the refusal to accept any
service shall in no way affect the right of the person to receive public assistance, public
health services, or any other public service. Nothing in this section shall abridge the right
of the deleted text begin individualdeleted text end new text begin personnew text end to make decisions concerning deleted text begin family planningdeleted text end new text begin sexual and
reproductive healthnew text end , nor shall any deleted text begin individualdeleted text end new text begin personnew text end be required to state a reason for refusing
any offer of deleted text begin family planningdeleted text end new text begin sexual and reproductive healthnew text end services.

deleted text begin Any employee of the agencies engaged in the administration of the provisions of this
section may refuse to accept the duty of offering family planning services to the extent that
the duty is contrary to personal beliefs. A refusal shall not be grounds for dismissal,
suspension, demotion, or any other discrimination in employment. The directors or
supervisors of the agencies shall reassign the duties of employees in order to carry out the
provisions of this section.
deleted text end

All information gathered by any agency, entity, or individual conducting programs in
deleted text begin family planningdeleted text end new text begin sexual and reproductive healthnew text end is private data on individuals within the
meaning of section 13.02, subdivision 12.new text begin For any person or entity meeting the definition
of a "provider" under section 144.291, subdivision 2, paragraph (i), all sexual and
reproductive health services information provided to, gathered about, or received from a
person under this section is also subject to the Minnesota Health Records Act, in sections
144.291 to 144.298.
new text end

deleted text begin Subd. 7.deleted text end

deleted text begin Family planning services; information required.deleted text end

deleted text begin A grant recipient shall
inform any person requesting counseling on family planning methods or procedures of:
deleted text end

deleted text begin (1) Any methods or procedures which may be followed, including identification of any
which are experimental or any which may pose a health hazard to the person;
deleted text end

deleted text begin (2) A description of any attendant discomforts or risks which might reasonably be
expected;
deleted text end

deleted text begin (3) A fair explanation of the likely results, should a method fail;
deleted text end

deleted text begin (4) A description of any benefits which might reasonably be expected of any method;
deleted text end

deleted text begin (5) A disclosure of appropriate alternative methods or procedures;
deleted text end

deleted text begin (6) An offer to answer any inquiries concerning methods of procedures; and
deleted text end

deleted text begin (7) An instruction that the person is free either to decline commencement of any method
or procedure or to withdraw consent to a method or procedure at any reasonable time.
deleted text end

deleted text begin Subd. 8.deleted text end

deleted text begin Coercion; penalty.deleted text end

deleted text begin Any person who receives compensation for services under
any program receiving financial assistance under this section, who coerces or endeavors to
coerce any person to undergo an abortion or sterilization procedure by threatening the person
with the loss of or disqualification for the receipt of any benefit or service under a program
receiving state or federal financial assistance shall be guilty of a misdemeanor.
deleted text end

deleted text begin Subd. 9.deleted text end

deleted text begin Amount of grant; rules.deleted text end

deleted text begin Notwithstanding any rules to the contrary, including
rules proposed in the State Register on April 1, 1991, the commissioner, in allocating grant
funds for family planning special projects, shall not limit the total amount of funds that can
be allocated to an organization. The commissioner shall allocate to an organization receiving
grant funds on July 1, 1997, at least the same amount of grant funds for the 1998 to 1999
grant cycle as the organization received for the 1996 to 1997 grant cycle, provided the
organization submits an application that meets grant funding criteria. This subdivision does
not affect any procedure established in rule for allocating special project money to the
different regions. The commissioner shall revise the rules for family planning special project
grants so that they conform to the requirements of this subdivision. In adopting these
revisions, the commissioner is not subject to the rulemaking provisions of chapter 14, but
is bound by section 14.386, paragraph (a), clauses (1) and (3). Section 14.386, paragraph
(b), does not apply to these rules.
deleted text end

Sec. 62.

new text begin [145.9273] TESTING FOR LEAD IN DRINKING WATER IN CHILD
CARE SETTINGS.
new text end

new text begin Subdivision 1.new text end

new text begin Requirement to test.new text end

new text begin (a) By July 1, 2024, licensed or certified child care
providers must develop a plan to accurately and efficiently test for the presence of lead in
drinking water in child care facilities following either the Department of Health's document
"Reducing Lead in Drinking Water: A Technical Guidance for Minnesota's School and
Child Care Facilities" or the Environmental Protection Agency's "3Ts: Training, Testing,
Taking Action" guidance materials.
new text end

new text begin (b) For purposes of this section, "licensed or certified child care provider" means a child
care center licensed under Minnesota Rules, chapter 9503, or a certified license-exempt
child care center under chapter 245H.
new text end

new text begin Subd. 2.new text end

new text begin Scope and frequency of testing.new text end

new text begin The plan under subdivision 1 must include
testing every building serving children and all water fixtures used for consumption of water,
including water used in food preparation. All taps must be tested at least once every five
years. A licensed or certified child care provider must begin testing in buildings by July 1,
2024, and complete testing in all buildings that serve students within five years.
new text end

new text begin Subd. 3.new text end

new text begin Remediation of lead in drinking water.new text end

new text begin The plan under subdivision 1 must
include steps to remediate if lead is present in drinking water. A licensed or certified child
care provider that finds lead at concentrations at or exceeding five parts per billion at a
specific location providing water to children within its facilities must take action to reduce
lead exposure following guidance and verify the success of remediation by retesting the
location for lead. Remediation actions are actions that reduce lead levels from the drinking
water fixture as demonstrated by testing. This includes using certified filters, implementing
and documenting a building-wide flushing program, and replacing or removing fixtures
with elevated lead levels.
new text end

new text begin Subd. 4.new text end

new text begin Reporting results.new text end

new text begin (a) A licensed or certified child care provider that tested its
buildings for the presence of lead shall make the results of the testing and any remediation
steps taken available to parents and staff and notify them of the availability of results.
Reporting shall occur no later than 30 days from receipt of results and annually thereafter.
new text end

new text begin (b) Beginning July 1, 2024, a licensed or certified child care provider must report the
provider's test results and remediation activities to the commissioner of health annually on
or before July 1 of each year.
new text end

Sec. 63.

new text begin [145.9275] LEAD REMEDIATION IN SCHOOL AND CHILD CARE
SETTINGS GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment; purpose.new text end

new text begin The commissioner of health shall develop a
grant program for the purpose of remediating identified sources of lead in drinking water
in schools and licensed child care settings.
new text end

new text begin Subd. 2.new text end

new text begin Grants authorized.new text end

new text begin The commissioner shall award grants through a request
for proposals process to schools and licensed child care settings. Priority shall be given to
schools and licensed child care settings with higher levels of lead detected in water samples,
evidence of lead service lines, or lead plumbing materials and school districts that serve
disadvantaged communities.
new text end

new text begin Subd. 3.new text end

new text begin Grant allocation.new text end

new text begin Grantees must use the funds to address sources of lead
contamination in their facilities including but not limited to service connections and premise
plumbing, and to implement best practices for water management within the building.
new text end

Sec. 64.

new text begin [145.9571] HEALTHY BEGINNINGS, HEALTHY FAMILIES ACT.
new text end

new text begin Sections 145.9571 to 145.9576 are the Healthy Beginnings, Healthy Families Act.
new text end

Sec. 65.

new text begin [145.9572] MINNESOTA PERINATAL QUALITY COLLABORATIVE.
new text end

new text begin Subdivision 1.new text end

new text begin Duties.new text end

new text begin The Minnesota perinatal quality collaborative is established to
improve pregnancy outcomes for pregnant people and newborns through efforts to:
new text end

new text begin (1) advance evidence-based and evidence-informed clinics and other health service
practices and processes through quality care review, chart audits, and continuous quality
improvement initiatives that enable equitable outcomes;
new text end

new text begin (2) review current data, trends, and research on best practices to inform and prioritize
quality improvement initiatives;
new text end

new text begin (3) identify methods that incorporate antiracism into individual practice and organizational
guidelines in the delivery of perinatal health services;
new text end

new text begin (4) support quality improvement initiatives to address substance use disorders in pregnant
people and infants with neonatal abstinence syndrome or other effects of substance use;
new text end

new text begin (5) provide a forum to discuss state-specific system and policy issues to guide quality
improvement efforts that improve population-level perinatal outcomes;
new text end

new text begin (6) reach providers and institutions in a multidisciplinary, collaborative, and coordinated
effort across system organizations to reinforce a continuum of care model; and
new text end

new text begin (7) support health care facilities in monitoring interventions through rapid data collection
and applying system changes to provide improved care in perinatal health.
new text end

new text begin Subd. 2.new text end

new text begin Grants authorized.new text end

new text begin The commissioner of health must, within available
appropriations, award one grant to a nonprofit organization to support efforts that improve
maternal and infant health outcomes aligned with the purpose outlined in subdivision 1.
The commissioner must give preference to a nonprofit organization that has the ability to
provide these services throughout the state. The commissioner must provide content expertise
to the grant recipient to further the accomplishment of the purpose.
new text end

Sec. 66.

new text begin [145.9573] MINNESOTA PARTNERSHIP TO PREVENT INFANT
MORTALITY.
new text end

new text begin (a) The commissioner of health must establish the Minnesota partnership to prevent
infant mortality program that is a statewide partnership program to engage communities,
exchange best practices, share summary data on infant health, and promote policies to
improve birth outcomes and eliminate preventable infant mortality.
new text end

new text begin (b) The goal of the Minnesota partnership to prevent infant mortality program is to:
new text end

new text begin (1) build a statewide multisectoral partnership including the state government, local
public health agencies, Tribes, private sector, and community nonprofit organizations with
the shared goal of decreasing infant mortality rates among populations with significant
disparities, including among Black, American Indian, other nonwhite communities, and
rural populations;
new text end

new text begin (2) address the leading causes of poor infant health outcomes such as premature birth,
infant sleep-related deaths, and congenital anomalies through strategies to change social
and environmental determinants of health; and
new text end

new text begin (3) promote the development, availability, and use of data-informed, community-driven
strategies to improve infant health outcomes.
new text end

Sec. 67.

new text begin [145.9574] GRANTS.
new text end

new text begin Subdivision 1.new text end

new text begin Improving pregnancy and infant outcomes grant.new text end

new text begin The commissioner
of health must, within available appropriations, make a grant to a nonprofit organization to
create or sustain a multidisciplinary network of representatives of health care systems, health
care providers, academic institutions, local and state agencies, and community partners that
will collaboratively improve pregnancy and infant outcomes through evidence-based,
population-level quality improvement initiatives.
new text end

new text begin Subd. 2.new text end

new text begin Improving infant health grants.new text end

new text begin (a) The commissioner of health must award
grants to eligible applicants to convene, coordinate, and implement data-driven strategies
and culturally relevant activities to improve infant health by reducing preterm birth,
sleep-related infant deaths, and congenital malformations and address social and
environmental determinants of health. Eligible entities include community nonprofit
organizations, Tribal governments, and community health boards. In accordance with
available funding, the commissioner may award grants on a noncompetitive basis to the 11
sovereign Tribal governments if their respective proposals demonstrate the ability to
implement programs designed to achieve the purposes in subdivision 1 and meet other
requirements of this section. An eligible applicant must submit a complete application to
the commissioner of health by the deadline established by the commissioner. The
commissioner must award all other grants competitively to eligible applicants in metropolitan
and rural areas of the state and may consider geographic representation in grant awards.
new text end

new text begin (b) Grantee activities must:
new text end

new text begin (1) address the leading cause or causes of infant mortality;
new text end

new text begin (2) be based on community input;
new text end

new text begin (3) focus on policy, systems, and environmental changes that support infant health; and
new text end

new text begin (4) address the health disparities and inequities that are experienced in the grantee's
community.
new text end

new text begin (c) The commissioner must review each application to determine whether the application
is complete and whether the applicant and the project are eligible for a grant. In evaluating
applications according to this subdivision, the commissioner must establish criteria including
but not limited to: the eligibility of the applicant's project under this section; the applicant's
thoroughness and clarity in describing the infant health issues grant funds are intended to
address; a description of the applicant's proposed project; the project's likelihood to achieve
the grant's purposes as described in this section; a description of the population demographics
and service area of the proposed project; and evidence of efficiencies and effectiveness
gained through collaborative efforts.
new text end

new text begin (d) Grant recipients must report their activities to the commissioner in a format and at
a time specified by the commissioner.
new text end

Sec. 68.

new text begin [145.9575] DEVELOPMENTAL AND SOCIAL-EMOTIONAL SCREENING
WITH FOLLOW-UP.
new text end

new text begin Subdivision 1.new text end

new text begin Developmental and social-emotional screening with follow-up.new text end

new text begin The
goal of the developmental and social-emotional screening is to identify young children at
risk for developmental and behavioral concerns and provide follow-up services to connect
families and young children to appropriate community-based resources and programs. The
commissioner of health must work with the commissioners of human services and education
to implement this section and promote interagency coordination with other early childhood
programs including those that provide screening and assessment.
new text end

new text begin Subd. 2.new text end

new text begin Duties.new text end

new text begin The commissioner must:
new text end

new text begin (1) increase the awareness of developmental and social-emotional screening with
follow-up in coordination with community and state partners;
new text end

new text begin (2) expand existing electronic screening systems to administer developmental and
social-emotional screening to children from birth to kindergarten entrance;
new text end

new text begin (3) provide screening for developmental and social-emotional delays based on current
recommended best practices;
new text end

new text begin (4) review and share the results of the screening with the parent or guardian and support
families in their role as caregivers by providing anticipatory guidance around typical growth
and development;
new text end

new text begin (5) refer and connect children and families with appropriate community-based services
and resources when any developmental or social-emotional concerns are identified through
screening; and
new text end

new text begin (6) establish performance measures and collect, analyze, and share program data regarding
population-level outcomes of developmental and social-emotional screening, referrals to
community-based services, and follow-up services.
new text end

new text begin Subd. 3.new text end

new text begin Grants.new text end

new text begin The commissioner must award grants to support follow-up services
for children with developmental or social-emotional concerns identified through screening
in order to link children and their families to appropriate community-based services and
resources. Grants may also be awarded to train and utilize cultural liaisons to help families
navigate the screening and follow-up process in a culturally and linguistically responsive
manner. Eligible grantees include community-based organizations, community health boards,
and Tribal Nations. The commissioner must provide technical assistance, content expertise,
and training to grant recipients to ensure that follow-up services are effectively provided.
new text end

Sec. 69.

new text begin [145.9576] MODEL JAIL PRACTICES.
new text end

new text begin Subdivision 1.new text end

new text begin Model jail practices for incarcerated parents.new text end

new text begin (a) The commissioner
of health may make grants to counties and groups of counties to implement model jail
practices and to county governments, Tribal governments, or nonprofit organizations in
corresponding geographic areas to build partnerships with county jails to support children
of incarcerated parents and their caregivers.
new text end

new text begin (b) "Model jail practices" means a set of practices that correctional administrators can
implement to remove barriers that may prevent children from cultivating or maintaining
relationships with their incarcerated parents during and immediately after incarceration
without compromising the safety or security of the correctional facility.
new text end

new text begin Subd. 2.new text end

new text begin Grants authorized; model jail practices.new text end

new text begin (a) The commissioner of health may
award grants to eligible county jails to implement model jail practices and separate grants
to county governments, Tribal governments, or nonprofit organizations in corresponding
geographic areas to build partnerships with county jails to support children of incarcerated
parents and their caregivers.
new text end

new text begin (b) Grantee activities include but are not limited to:
new text end

new text begin (1) parenting classes or groups;
new text end

new text begin (2) family-centered intake and assessment of inmate programs;
new text end

new text begin (3) family notification, information, and communication strategies;
new text end

new text begin (4) correctional staff training;
new text end

new text begin (5) policies and practices for family visits; and
new text end

new text begin (6) family-focused reentry planning.
new text end

new text begin (c) Grant recipients must report their activities to the commissioner in a format and at
a time specified by the commissioner.
new text end

new text begin Subd. 3.new text end

new text begin Technical assistance and oversight; model jail practices.new text end

new text begin (a) The
commissioner may provide content expertise, training to grant recipients, and advice on
evidence-based strategies, including evidence-based training to support incarcerated parents.
new text end

new text begin (b) For the purposes of carrying out the grant program under subdivision 2, including
for administrative purposes, the commissioner may award contracts to appropriate entities
to assist in training and provide technical assistance to grantees.
new text end

new text begin (c) Contracts awarded under paragraph (b) may be used to provide technical assistance
and training in the areas of:
new text end

new text begin (1) evidence-based training for incarcerated parents;
new text end

new text begin (2) partnership building and community engagement;
new text end

new text begin (3) evaluation of process and outcomes of model jail practices; and
new text end

new text begin (4) expert guidance on reducing the harm caused to children of incarcerated parents and
application of model jail practices.
new text end

Sec. 70.

new text begin [145.987] HEALTH EQUITY ADVISORY AND LEADERSHIP (HEAL)
COUNCIL.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment; composition of advisory council.new text end

new text begin The health equity
advisory and leadership (HEAL) council consists of 18 members appointed by the
commissioner of health who will provide representation from the following groups:
new text end

new text begin (1) African American and African heritage communities;
new text end

new text begin (2) Asian American and Pacific Islander communities;
new text end

new text begin (3) Latina/o/x communities;
new text end

new text begin (4) American Indian communities and Tribal governments and nations;
new text end

new text begin (5) disability communities;
new text end

new text begin (6) lesbian, gay, bisexual, transgender, and queer (LGBTQ) communities; and
new text end

new text begin (7) representatives who reside outside the seven-county metropolitan area.
new text end

new text begin Subd. 2.new text end

new text begin Organization and meetings.new text end

new text begin (a) Terms, compensation, and removal of members
of the advisory council shall be as provided in section 15.059, subdivisions 2 to 4, except
that terms for advisory council members shall be for two years. Members may be reappointed
to serve up to two additional terms. Notwithstanding section 15.059, subdivision 6, the
advisory council shall not expire. The commissioner shall recommend appointments to
replace members vacating their positions in a timely manner, no more than three months
after the advisory council reviews panel recommendations.
new text end

new text begin (b) The commissioner must convene meetings at least quarterly and must provide meeting
space and administrative support to the advisory council. Subcommittees may be convened
as necessary. Advisory council meetings are subject to the Open Meeting Law under chapter
13D.
new text end

new text begin Subd. 3.new text end

new text begin Duties.new text end

new text begin The advisory council shall:
new text end

new text begin (1) advise the commissioner on health equity issues and the health equity priorities and
concerns of the populations specified in subdivision 1;
new text end

new text begin (2) assist the agency in efforts to advance health equity, including consulting in specific
agency policies and programs, providing ideas and input about potential budget and policy
proposals, and recommending review of agency policies, standards, or procedures that may
create or perpetuate health inequities; and
new text end

new text begin (3) assist the agency in developing and monitoring meaningful performance measures
related to advancing health equity.
new text end

new text begin Subd. 4.new text end

new text begin Expiration.new text end

new text begin The advisory council shall remain in existence until health inequities
in the state are eliminated. Health inequities will be considered eliminated when race,
ethnicity, income, gender, gender identity, geographic location, or other identity or social
marker will no longer be predictors of health outcomes in the state. Section 145.928 describes
nine health disparities that must be considered when determining whether health inequities
have been eliminated in the state.
new text end

new text begin Subd. 5.new text end

new text begin Annual report.new text end

new text begin By January 15 each year, the commissioner or a designee, in
collaboration with the advisory council, must submit a report to the chairs and ranking
minority members of the legislative committees with jurisdiction over health policy and
finance summarizing the work of the advisory council over the previous year and setting
goals for the upcoming year.
new text end

Sec. 71.

new text begin [145.988] HELP ME CONNECT RESOURCE AND REFERRAL SYSTEM
FOR CHILDREN.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment; purpose.new text end

new text begin The commissioner shall establish the Help Me
Connect resource and referral system for children as a comprehensive, collaborative resource
and referral system for children from the prenatal stage through age eight, and their families.
The commissioner of health shall work collaboratively with the commissioners of human
services and education to implement this section.
new text end

new text begin Subd. 2.new text end

new text begin Duties.new text end

new text begin (a) The Help Me Connect system shall facilitate collaboration across
sectors, including child health, early learning and education, child welfare, and family
supports by:
new text end

new text begin (1) providing early childhood provider outreach to support knowledge of and access to
local resources that provide early detection and intervention services;
new text end

new text begin (2) identifying and providing access to early childhood and family support navigation
specialists that can support families and their children's needs; and
new text end

new text begin (3) linking children and families to appropriate community-based services.
new text end

new text begin (b) The Help Me Connect system shall provide community outreach that includes support
for, and participation in, the Help Me Connect system, including disseminating information
on the system and compiling and maintaining a current resource directory that includes but
is not limited to primary and specialty medical care providers, early childhood education
and child care programs, developmental disabilities assessment and intervention programs,
mental health services, family and social support programs, child advocacy and legal services,
public health services and resources, and other appropriate early childhood information.
new text end

new text begin (c) The Help Me Connect system shall maintain a centralized access point for parents
and professionals to obtain information, resources, and other support services.
new text end

new text begin (d) The Help Me Connect system shall collect data to increase understanding of the
current and ongoing system of support and resources for expectant families and children
through age eight and their families, including identification of gaps in service, barriers to
finding and receiving appropriate services, and lack of resources.
new text end

Sec. 72.

Minnesota Statutes 2022, section 145A.131, subdivision 1, is amended to read:

Subdivision 1.

Funding formula for community health boards.

(a) Base funding for
each community health board eligible for a local public health grant under section 145A.03,
subdivision 7, shall be determined by each community health board's fiscal year 2003
allocations, prior to unallotment, for the following grant programs: community health
services subsidy; state and federal maternal and child health special projects grants; family
home visiting grants; TANF MN ENABL grants; TANF youth risk behavior grants; and
available women, infants, and children grant funds in fiscal year 2003, prior to unallotment,
distributed based on the proportion of WIC participants served in fiscal year 2003 within
the CHS service area.

(b) Base funding for a community health board eligible for a local public health grant
under section 145A.03, subdivision 7, as determined in paragraph (a), shall be adjusted by
the percentage difference between the base, as calculated in paragraph (a), and the funding
available for the local public health grant.

(c) Multicounty or multicity community health boards shall receive a local partnership
base of up to $5,000 per year for each county or city in the case of a multicity community
health board included in the community health board.

(d) The State Community Healthnew text begin Servicesnew text end Advisory Committee may recommend a
formula to the commissioner to use in distributing funds to community health boards.

(e) Notwithstanding any adjustment in paragraph (b), community health boards, all or
a portion of which are located outside of the counties of Anoka, Chisago, Carver, Dakota,
Hennepin, Isanti, Ramsey, Scott, Sherburne, Washington, and Wright, are eligible to receive
an increase equal to ten percent of the grant award to the community health board under
paragraph (a) starting July 1, 2015. The increase in calendar year 2015 shall be prorated for
the last six months of the year. For calendar years beginning on or after January 1, 2016,
the amount distributed under this paragraph shall be adjusted each year based on available
funding and the number of eligible community health boards.

new text begin (f) Funding for foundational public health responsibilities must be distributed based on
a formula determined by the commissioner in consultation with the State Community Health
Services Advisory Committee. These funds must be used as described in subdivision 5.
new text end

Sec. 73.

Minnesota Statutes 2022, section 145A.131, subdivision 2, is amended to read:

Subd. 2.

Local match.

(a) A community health board that receives a local public health
grant shall provide at least a 75 percent match for the state funds received through the local
public health grant described in subdivision 1 and subject to paragraphs (b) to deleted text begin (d)deleted text end new text begin (f)new text end .

(b) Eligible funds must be used to meet match requirements. Eligible funds include funds
from local property taxes, reimbursements from third parties, fees, other local funds, and
donations or nonfederal grants that are used for community health services described in
section 145A.02, subdivision 6.

(c) When the amount of local matching funds for a community health board is less than
the amount required under paragraph (a), the local public health grant provided for that
community health board under this section shall be reduced proportionally.

(d) A city organized under the provision of sections 145A.03 to 145A.131 that levies a
tax for provision of community health services is exempt from any county levy for the same
services to the extent of the levy imposed by the city.

Sec. 74.

Minnesota Statutes 2022, section 145A.131, subdivision 5, is amended to read:

Subd. 5.

Use of funds.

new text begin (a) new text end Community health boards may use new text begin the base funding of new text end their
local public health grant fundsnew text begin as described in subdivision 1, paragraphs (a) to (e),new text end to address
the areas of public health responsibility and local priorities developed through the community
health assessment and community health improvement planning process.

new text begin (b) Except as otherwise provided in this paragraph, funding for foundational public
health responsibilities as described in subdivision 1, paragraph (f), must be used to fulfill
foundational public health responsibilities as defined by the commissioner in consultation
with the state community health service advisory committee. If a community health board
can demonstrate foundational public health responsibilities are fulfilled, the board may use
funds for local priorities developed through the community health assessment and community
health improvement planning process.
new text end

Sec. 75.

new text begin [145A.135] LOCAL AND TRIBAL PUBLIC HEALTH EMERGENCY
PREPAREDNESS AND RESPONSE GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health must establish a local and
Tribal public health emergency preparedness and response grant program.
new text end

new text begin Subd. 2.new text end

new text begin Funding formula; use.new text end

new text begin (a) The commissioner must distribute funding for
emergency preparedness and response activities to community health boards and Tribal
public health departments based on a formula determined by the commissioner, in
consultation with the State Community Health Services Advisory Committee.
new text end

new text begin (b) Grant proceeds must align with the Centers for Disease Control and Prevention's
issued report: Public Health Emergency Preparedness and Response Capabilities: National
Standards for State, Local, Tribal, and Territorial Public Health.
new text end

new text begin Subd. 3.new text end

new text begin Reporting.new text end

new text begin (a) Each grantee must submit a report to the commissioner, in a
manner and on a timeline specified by the commissioner, on how the grant funds were spent
and the purposes for which they were spent.
new text end

new text begin (b) By January 15 of each year, the commissioner must submit a report to the chairs and
ranking minority members of the legislative committees with jurisdiction over health policy
and finance. The report must include information on how the grant funds were distributed
and used at the local and Tribal level.
new text end

Sec. 76.

Minnesota Statutes 2022, section 145A.14, is amended by adding a subdivision
to read:

new text begin Subd. 2b.new text end

new text begin Grants to tribes.new text end

new text begin The commissioner must distribute grants to Tribal
governments for foundational public health responsibilities as defined by each Tribal
government.
new text end

Sec. 77.

Minnesota Statutes 2022, section 148.261, subdivision 1, is amended to read:

Subdivision 1.

Grounds listed.

The board may deny, revoke, suspend, limit, or condition
the license and registration of any person to practice advanced practice, professional, or
practical nursing under sections 148.171 to 148.285, or to otherwise discipline a licensee
or applicant as described in section 148.262. The following are grounds for disciplinary
action:

(1) Failure to demonstrate the qualifications or satisfy the requirements for a license
contained in sections 148.171 to 148.285 or rules of the board. In the case of a person
applying for a license, the burden of proof is upon the applicant to demonstrate the
qualifications or satisfaction of the requirements.

(2) Employing fraud or deceit in procuring or attempting to procure a permit, license,
or registration certificate to practice advanced practice, professional, or practical nursing
or attempting to subvert the licensing examination process. Conduct that subverts or attempts
to subvert the licensing examination process includes, but is not limited to:

(i) conduct that violates the security of the examination materials, such as removing
examination materials from the examination room or having unauthorized possession of
any portion of a future, current, or previously administered licensing examination;

(ii) conduct that violates the standard of test administration, such as communicating with
another examinee during administration of the examination, copying another examinee's
answers, permitting another examinee to copy one's answers, or possessing unauthorized
materials; or

(iii) impersonating an examinee or permitting an impersonator to take the examination
on one's own behalf.

(3) Conviction of a felony or gross misdemeanor reasonably related to the practice of
professional, advanced practice registered, or practical nursing. Conviction as used in this
subdivision includes a conviction of an offense that if committed in this state would be
considered a felony or gross misdemeanor without regard to its designation elsewhere, or
a criminal proceeding where a finding or verdict of guilt is made or returned but the
adjudication of guilt is either withheld or not entered.

(4) Revocation, suspension, limitation, conditioning, or other disciplinary action against
the person's professional or practical nursing license or advanced practice registered nursing
credential, in another state, territory, or country; failure to report to the board that charges
regarding the person's nursing license or other credential are pending in another state,
territory, or country; or having been refused a license or other credential by another state,
territory, or country.

(5) Failure to or inability to perform professional or practical nursing as defined in section
148.171, subdivision 14 or 15, with reasonable skill and safety, including failure of a
registered nurse to supervise or a licensed practical nurse to monitor adequately the
performance of acts by any person working at the nurse's direction.

(6) Engaging in unprofessional conduct, including, but not limited to, a departure from
or failure to conform to board rules of professional or practical nursing practice that interpret
the statutory definition of professional or practical nursing as well as provide criteria for
violations of the statutes, or, if no rule exists, to the minimal standards of acceptable and
prevailing professional or practical nursing practice, or any nursing practice that may create
unnecessary danger to a patient's life, health, or safety. Actual injury to a patient need not
be established under this clause.

(7) Failure of an advanced practice registered nurse to practice with reasonable skill and
safety or departure from or failure to conform to standards of acceptable and prevailing
advanced practice registered nursing.

(8) Delegating or accepting the delegation of a nursing function or a prescribed health
care function when the delegation or acceptance could reasonably be expected to result in
unsafe or ineffective patient care.

(9) Actual or potential inability to practice nursing with reasonable skill and safety to
patients by reason of illness, use of alcohol, drugs, chemicals, or any other material, or as
a result of any mental or physical condition.

(10) Adjudication as mentally incompetent, mentally ill, a chemically dependent person,
or a person dangerous to the public by a court of competent jurisdiction, within or without
this state.

(11) Engaging in any unethical conduct, including, but not limited to, conduct likely to
deceive, defraud, or harm the public, or demonstrating a willful or careless disregard for
the health, welfare, or safety of a patient. Actual injury need not be established under this
clause.

(12) Engaging in conduct with a patient that is sexual or may reasonably be interpreted
by the patient as sexual, or in any verbal behavior that is seductive or sexually demeaning
to a patient, or engaging in sexual exploitation of a patient or former patient.

(13) Obtaining money, property, or services from a patient, other than reasonable fees
for services provided to the patient, through the use of undue influence, harassment, duress,
deception, or fraud.

(14) Revealing a privileged communication from or relating to a patient except when
otherwise required or permitted by law.

(15) Engaging in abusive or fraudulent billing practices, including violations of federal
Medicare and Medicaid laws or state medical assistance laws.

(16) Improper management of patient records, including failure to maintain adequate
patient records, to comply with a patient's request made pursuant to sections 144.291 to
144.298, or to furnish a patient record or report required by law.

(17) Knowingly aiding, assisting, advising, or allowing an unlicensed person to engage
in the unlawful practice of advanced practice, professional, or practical nursing.

(18) Violating a rule adopted by the board, an order of the board, or a state or federal
law relating to the practice of advanced practice, professional, or practical nursing, or a
state or federal narcotics or controlled substance law.

(19) Knowingly providing false or misleading information that is directly related to the
care of that patient unless done for an accepted therapeutic purpose such as the administration
of a placebo.

(20) Aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board shall investigate any complaint of a violation of section 609.215, subdivision 1
or 2.

(21) Practicing outside the scope of practice authorized by section 148.171, subdivision
5, 10, 11, 13, 14, 15, or 21.

(22) Making a false statement or knowingly providing false information to the board,
failing to make reports as required by section 148.263, or failing to cooperate with an
investigation of the board as required by section 148.265.

(23) Engaging in false, fraudulent, deceptive, or misleading advertising.

(24) Failure to inform the board of the person's certification or recertification status as
a certified registered nurse anesthetist, certified nurse-midwife, certified nurse practitioner,
or certified clinical nurse specialist.

(25) Engaging in clinical nurse specialist practice, nurse-midwife practice, nurse
practitioner practice, or registered nurse anesthetist practice without a license and current
certification or recertification by a national nurse certification organization acceptable to
the board.

deleted text begin (26) Engaging in conduct that is prohibited under section 145.412.
deleted text end

deleted text begin (27)deleted text end new text begin (26)new text end Failing to report employment to the board as required by section 148.211,
subdivision 2a, or knowingly aiding, assisting, advising, or allowing a person to fail to report
as required by section 148.211, subdivision 2a.

new text begin EFFECTIVE DATE.new text end

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

Sec. 78.

Minnesota Statutes 2022, section 256B.692, subdivision 2, is amended to read:

Subd. 2.

Duties of commissioner of health.

(a) Notwithstanding chapters 62D and 62N,
a county that elects to purchase medical assistance in return for a fixed sum without regard
to the frequency or extent of services furnished to any particular enrollee is not required to
obtain a certificate of authority under chapter 62D or 62N. The county board of
commissioners is the governing body of a county-based purchasing program. In a multicounty
arrangement, the governing body is a joint powers board established under section 471.59.

(b) A county that elects to purchase medical assistance services under this section must
satisfy the commissioner of health that the requirements for assurance of consumer protection,
provider protection, and fiscal solvency of chapter 62D, applicable to health maintenance
organizations will be met according to the following schedule:

(1) for a county-based purchasing plan approved on or before June 30, 2008, the plan
must have in reserve:

(i) at least 50 percent of the minimum amount required under chapter 62D as of January
1, 2010;

(ii) at least 75 percent of the minimum amount required under chapter 62D as of January
1, 2011;

(iii) at least 87.5 percent of the minimum amount required under chapter 62D as of
January 1, 2012; and

(iv) at least 100 percent of the minimum amount required under chapter 62D as of January
1, 2013; and

(2) for a county-based purchasing plan first approved after June 30, 2008, the plan must
have in reserve:

(i) at least 50 percent of the minimum amount required under chapter 62D at the time
the plan begins enrolling enrollees;

(ii) at least 75 percent of the minimum amount required under chapter 62D after the first
full calendar year;

(iii) at least 87.5 percent of the minimum amount required under chapter 62D after the
second full calendar year; and

(iv) at least 100 percent of the minimum amount required under chapter 62D after the
third full calendar year.

(c) Until a plan is required to have reserves equaling at least 100 percent of the minimum
amount required under chapter 62D, the plan may demonstrate its ability to cover any losses
by satisfying the requirements of chapter 62N. A county-based purchasing plan must also
assure the commissioner of health that the requirements of sections 62J.041; 62J.48; 62J.71
to 62J.73; all applicable provisions of chapter 62Q, including sections 62Q.075; 62Q.1055;
62Q.106; 62Q.12; 62Q.135; 62Q.14; deleted text begin 62Q.145;deleted text end 62Q.19; 62Q.23, paragraph (c); 62Q.43;
62Q.47; 62Q.50; 62Q.52 to 62Q.56; 62Q.58; 62Q.68 to 62Q.72; and 72A.201 will be met.

(d) All enforcement and rulemaking powers available under chapters 62D, 62J, 62N,
and 62Q are hereby granted to the commissioner of health with respect to counties that
purchase medical assistance services under this section.

(e) The commissioner, in consultation with county government, shall develop
administrative and financial reporting requirements for county-based purchasing programs
relating to sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 62N.31,
and other sections as necessary, that are specific to county administrative, accounting, and
reporting systems and consistent with other statutory requirements of counties.

(f) The commissioner shall collect from a county-based purchasing plan under this
section the following fees:

(1) fees attributable to the costs of audits and other examinations of plan financial
operations. These fees are subject to the provisions of Minnesota Rules, part 4685.2800,
subpart 1, item F; and

(2) an annual fee of $21,500, to be paid by June 15 of each calendar year.

All fees collected under this paragraph shall be deposited in the state government special
revenue fund.

new text begin EFFECTIVE DATE.new text end

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

Sec. 79.

Minnesota Statutes 2022, section 259.83, subdivision 1, is amended to read:

Subdivision 1.

Services provided.

new text begin (a) new text end Agencies shall provide assistance and counseling
services upon receiving a request for current information from adoptive parents, birth parents,
or adopted persons aged deleted text begin 19deleted text end new text begin 18new text end yearsnew text begin of agenew text end and deleted text begin overdeleted text end new text begin oldernew text end . The agency shall contact the
other adult persons or the adoptive parents of a minor child in a personal and confidential
manner to determine whether there is a desire to receive or share information or to have
contact. If there is such a desire, the agency shall provide the services requested. The agency
shall provide services to adult genetic siblings if there is no known violation of the
confidentiality of a birth parent or if the birth parent gives written consent.

new text begin (b) Upon a request for assistance or services from an adoptive parent of a minor child,
birth parent, or an adopted person 18 years of age or older, the agency must inform the
person:
new text end

new text begin (1) about the right of an adopted person to request and obtain a copy of the adopted
person's original birth record at the age and circumstances specified in section 144.2253;
and
new text end

new text begin (2) about the right of the birth parent named on the adopted person's original birth record
to file a contact preference form with the state registrar pursuant to section 144.2253.
new text end

new text begin In adoptive placements, the agency must provide in writing to the birth parents listed on
the original birth record the information required under this section.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 80.

Minnesota Statutes 2022, section 259.83, subdivision 1a, is amended to read:

Subd. 1a.

Social and medical history.

(a) If a person aged deleted text begin 19deleted text end new text begin 18new text end years new text begin of age new text end and deleted text begin overdeleted text end new text begin
oldernew text end who was adopted on or after August 1, 1994, or the adoptive parent requests the
detailed nonidentifying social and medical history of the adopted person's birth family that
was provided at the time of the adoption, agencies must provide the information to the
adopted person or adoptive parent on the applicable form required under sections 259.43
and 260C.212, subdivision 15.

(b) If an adopted person aged deleted text begin 19deleted text end new text begin 18new text end years new text begin of age new text end and deleted text begin overdeleted text end new text begin oldernew text end or the adoptive parent
requests the agency to contact the adopted person's birth parents to request current
nonidentifying social and medical history of the adopted person's birth family, agencies
must use the applicable form required under sections 259.43 and 260C.212, subdivision 15,
when obtaining the information for the adopted person or adoptive parent.

new text begin EFFECTIVE DATE.new text end

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

Sec. 81.

Minnesota Statutes 2022, section 259.83, subdivision 1b, is amended to read:

Subd. 1b.

Genetic siblings.

(a) A person who is at least deleted text begin 19deleted text end new text begin 18new text end years deleted text begin olddeleted text end new text begin of agenew text end who was
adopted or, because of a termination of parental rights, was committed to the guardianship
of the commissioner of human services, whether adopted or not, must upon request be
advised of other siblings who were adopted or who were committed to the guardianship of
the commissioner of human services and not adopted.

(b) Assistance must be provided by the county or placing agency of the person requesting
information to the extent that information is available in the existing records at the
Department of Human Services. If the sibling received services from another agency, the
agencies must share necessary information in order to locate the other siblings and to offer
services, as requested. Upon the determination that parental rights with respect to another
sibling were terminated, identifying information and contact must be provided only upon
mutual consent. A reasonable fee may be imposed by the county or placing agency.

new text begin EFFECTIVE DATE.new text end

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

Sec. 82.

Minnesota Statutes 2022, section 259.83, is amended by adding a subdivision to
read:

new text begin Subd. 3a.new text end

new text begin Birth parent identifying information.new text end

new text begin (a) This subdivision applies to adoptive
placements where an adopted person does not have a record of live birth registered in this
state. Upon written request by an adopted person 18 years of age or older, the agency
responsible for or supervising the placement must provide to the requester the following
identifying information related to the birth parents listed on that adopted person's original
birth record:
new text end

new text begin (1) each of the birth parent's names; and
new text end

new text begin (2) each of the birth parent's birthdate and birthplace.
new text end

new text begin (b) The agency may charge a reasonable fee to the requester for providing the required
information under paragraph (a).
new text end

new text begin (c) The agency, acting in good faith and in a lawful manner in disclosing the identifying
information under this subdivision, is not civilly liable for such disclosure.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 83.

Minnesota Statutes 2022, section 260C.317, subdivision 4, is amended to read:

Subd. 4.

Rights of terminated parent.

(a) Upon entry of an order terminating the
parental rights of any person who is identified as a parent on the original birth record of the
child as to whom the parental rights are terminated, the court shall cause written notice to
be made to that person setting forthdeleted text begin :
deleted text end

deleted text begin (1) the right of the person to file at any time with the state registrar of vital records a
consent to disclosure, as defined in section 144.212, subdivision 11;
deleted text end

deleted text begin (2)deleted text end the right of the person to file at any time with the state registrar of vital records deleted text begin an
affidavit stating that the information on the original birth record shall not be disclosed as
provided in section 144.2252; anddeleted text end new text begin a contact preference form under section 144.2253.
new text end

deleted text begin (3) the effect of a failure to file either a consent to disclosure, as defined in section
144.212, subdivision 11, or an affidavit stating that the information on the original birth
record shall not be disclosed.
deleted text end

(b) A parent whose rights are terminated under this section shall retain the ability to
enter into a contact or communication agreement under section 260C.619 if an agreement
is determined by the court to be in the best interests of the child. The agreement shall be
filed with the court at or prior to the time the child is adopted. An order for termination of
parental rights shall not be conditioned on an agreement under section 260C.619.

new text begin EFFECTIVE DATE.new text end

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

Sec. 84.

Minnesota Statutes 2022, section 403.161, subdivision 1, is amended to read:

Subdivision 1.

Fees imposed.

(a) A prepaid wireless E911 fee of 80 cents per retail
transaction is imposed on prepaid wireless telecommunications service until the fee is
adjusted as an amount per retail transaction under subdivision 7.

(b) A prepaid wireless telecommunications access Minnesota fee, in the amount of the
monthly charge provided for in section 237.52, subdivision 2, is imposed on each retail
transaction for prepaid wireless telecommunications service until the fee is adjusted as an
amount per retail transaction under subdivision 7.

new text begin (c) A prepaid wireless 988 fee, in the amount of the monthly charge provided for in
section 145.561, subdivision 4, paragraph (b), is imposed on each retail transaction for
prepaid wireless telecommunications service until the fee is adjusted as an amount per retail
transaction under subdivision 7.
new text end

Sec. 85.

Minnesota Statutes 2022, section 403.161, subdivision 3, is amended to read:

Subd. 3.

Fee collected.

The prepaid wireless E911 deleted text begin anddeleted text end new text begin ,new text end telecommunications access
Minnesotanew text begin , and 988new text end fees must be collected by the seller from the consumer for each retail
transaction occurring in this state. The amount of each fee must be combined into one
amount, which must be separately stated on an invoice, receipt, or other similar document
that is provided to the consumer by the seller.

Sec. 86.

Minnesota Statutes 2022, section 403.161, subdivision 5, is amended to read:

Subd. 5.

Remittance.

The prepaid wireless E911 deleted text begin anddeleted text end new text begin ,new text end telecommunications access
Minnesotanew text begin , and 988new text end fees are the liability of the consumer and not of the seller or of any
provider, except that the seller is liable to remit all fees as provided in section 403.162.

Sec. 87.

Minnesota Statutes 2022, section 403.161, subdivision 6, is amended to read:

Subd. 6.

Exclusion for calculating other charges.

The combined amount of the prepaid
wireless E911 deleted text begin anddeleted text end new text begin ,new text end telecommunications access Minnesotanew text begin , and 988new text end fees collected by a seller
from a consumer must not be included in the base for measuring any tax, fee, surcharge, or
other charge that is imposed by this state, any political subdivision of this state, or any
intergovernmental agency.

Sec. 88.

Minnesota Statutes 2022, section 403.161, subdivision 7, is amended to read:

Subd. 7.

Fee changes.

(a) The prepaid wireless E911 deleted text begin anddeleted text end new text begin ,new text end telecommunications access
Minnesota deleted text begin feedeleted text end new text begin , and 988 feesnew text end must be proportionately increased or reduced upon any change
to the fee imposed under section 403.11, subdivision 1, paragraph (c), after July 1, 2013,
deleted text begin ordeleted text end the fee imposed under section 237.52, subdivision 2, new text begin or the fee imposed under section
145.561, subdivision 4, new text end as applicable.

(b) The department shall post notice of any fee changes on its website at least 30 days
in advance of the effective date of the fee changes. It is the responsibility of sellers to monitor
the department's website for notice of fee changes.

(c) Fee changes are effective 60 days after the first day of the first calendar month after
the commissioner of public safety or the Public Utilities Commission, as applicable, changes
the fee.

Sec. 89.

Minnesota Statutes 2022, section 403.162, subdivision 1, is amended to read:

Subdivision 1.

Remittance.

Prepaid wireless E911 deleted text begin anddeleted text end new text begin ,new text end telecommunications access
Minnesotanew text begin , and 988new text end fees collected by sellers must be remitted to the commissioner of revenue
at the times and in the manner provided by chapter 297A with respect to the general sales
and use tax. The commissioner of revenue shall establish registration and payment procedures
that substantially coincide with the registration and payment procedures that apply in chapter
297A.

Sec. 90.

Minnesota Statutes 2022, section 403.162, subdivision 2, is amended to read:

Subd. 2.

Seller's fee retention.

A seller may deduct and retain three percent of prepaid
wireless E911 deleted text begin anddeleted text end new text begin ,new text end telecommunications access Minnesotanew text begin , and 988new text end fees collected by the
seller from consumers.

Sec. 91.

Minnesota Statutes 2022, section 403.162, subdivision 5, is amended to read:

Subd. 5.

Fees deposited.

(a) The commissioner of revenue shall, based on the relative
proportion of the prepaid wireless E911 fee deleted text begin anddeleted text end new text begin ,new text end the prepaid wireless telecommunications
access Minnesota feenew text begin , and the prepaid wireless 988 feenew text end imposed per retail transaction, divide
the fees collected in corresponding proportions. Within 30 days of receipt of the collected
fees, the commissioner shall:

(1) deposit the proportion of the collected fees attributable to the prepaid wireless E911
fee in the 911 emergency telecommunications service account in the special revenue fund;
deleted text begin and
deleted text end

(2) deposit the proportion of collected fees attributable to the prepaid wireless
telecommunications access Minnesota fee in the telecommunications access fund established
in section 237.52, subdivision 1deleted text begin .deleted text end new text begin ; and
new text end

new text begin (3) deposit the proportion of the collected fees attributable to the prepaid wireless 988
fee in the 988 special revenue account established in section 145.561, subdivision 3.
new text end

(b) The commissioner of revenue may deduct and deposit in a special revenue account
an amount not to exceed two percent of collected fees. Money in the account is annually
appropriated to the commissioner of revenue to reimburse its direct costs of administering
the collection and remittance of prepaid wireless E911 fees deleted text begin anddeleted text end new text begin ,new text end prepaid wireless
telecommunications access Minnesota feesnew text begin , and prepaid wireless 988 feesnew text end .

Sec. 92.

Minnesota Statutes 2022, section 518A.39, subdivision 2, is amended to read:

Subd. 2.

Modification.

(a) The terms of an order respecting maintenance or support
may be modified upon a showing of one or more of the following, any of which makes the
terms unreasonable and unfair: (1) substantially increased or decreased gross income of an
obligor or obligee; (2) substantially increased or decreased need of an obligor or obligee or
the child or children that are the subject of these proceedings; (3) receipt of assistance under
the AFDC program formerly codified under sections 256.72 to 256.87 or 256B.01 to deleted text begin 256B.40deleted text end new text begin
256B.39new text end , or chapter 256J or 256K; (4) a change in the cost of living for either party as
measured by the federal Bureau of Labor Statistics; (5) extraordinary medical expenses of
the child not provided for under section 518A.41; (6) a change in the availability of
appropriate health care coverage or a substantial increase or decrease in health care coverage
costs; (7) the addition of work-related or education-related child care expenses of the obligee
or a substantial increase or decrease in existing work-related or education-related child care
expenses; or (8) upon the emancipation of the child, as provided in subdivision 5.

(b) It is presumed that there has been a substantial change in circumstances under
paragraph (a) and the terms of a current support order shall be rebuttably presumed to be
unreasonable and unfair if:

(1) the application of the child support guidelines in section 518A.35, to the current
circumstances of the parties results in a calculated court order that is at least 20 percent and
at least $75 per month higher or lower than the current support order or, if the current support
order is less than $75, it results in a calculated court order that is at least 20 percent per
month higher or lower;

(2) the medical support provisions of the order established under section 518A.41 are
not enforceable by the public authority or the obligee;

(3) health coverage ordered under section 518A.41 is not available to the child for whom
the order is established by the parent ordered to provide;

(4) the existing support obligation is in the form of a statement of percentage and not a
specific dollar amount;

(5) the gross income of an obligor or obligee has decreased by at least 20 percent through
no fault or choice of the party; or

(6) a deviation was granted based on the factor in section 518A.43, subdivision 1, clause
(4), and the child no longer resides in a foreign country or the factor is otherwise no longer
applicable.

(c) A child support order is not presumptively modifiable solely because an obligor or
obligee becomes responsible for the support of an additional nonjoint child, which is born
after an existing order. Section 518A.33 shall be considered if other grounds are alleged
which allow a modification of support.

(d) If child support was established by applying a parenting expense adjustment or
presumed equal parenting time calculation under previously existing child support guidelines
and there is no parenting plan or order from which overnights or overnight equivalents can
be determined, there is a rebuttable presumption that the established adjustment or calculation
will continue after modification so long as the modification is not based on a change in
parenting time. In determining an obligation under previously existing child support
guidelines, it is presumed that the court shall:

(1) if a 12 percent parenting expense adjustment was applied, multiply the obligor's
share of the combined basic support obligation calculated under section 518A.34, paragraph
(b), clause (5), by 0.88; or

(2) if the parenting time was presumed equal but the parents' parental incomes for
determining child support were not equal:

(i) multiply the combined basic support obligation under section 518A.34, paragraph
(b), clause (5), by 0.75;

(ii) prorate the amount under item (i) between the parents based on each parent's
proportionate share of the combined PICS; and

(iii) subtract the lower amount from the higher amount.

(e) On a motion for modification of maintenance, including a motion for the extension
of the duration of a maintenance award, the court shall apply, in addition to all other relevant
factors, the factors for an award of maintenance under section 518.552 that exist at the time
of the motion. On a motion for modification of support, the court:

(1) shall apply section 518A.35, and shall not consider the financial circumstances of
each party's spouse, if any; and

(2) shall not consider compensation received by a party for employment in excess of a
40-hour work week, provided that the party demonstrates, and the court finds, that:

(i) the excess employment began after entry of the existing support order;

(ii) the excess employment is voluntary and not a condition of employment;

(iii) the excess employment is in the nature of additional, part-time employment, or
overtime employment compensable by the hour or fractions of an hour;

(iv) the party's compensation structure has not been changed for the purpose of affecting
a support or maintenance obligation;

(v) in the case of an obligor, current child support payments are at least equal to the
guidelines amount based on income not excluded under this clause; and

(vi) in the case of an obligor who is in arrears in child support payments to the obligee,
any net income from excess employment must be used to pay the arrearages until the
arrearages are paid in full.

(f) A modification of support or maintenance, including interest that accrued pursuant
to section 548.091, may be made retroactive only with respect to any period during which
the petitioning party has pending a motion for modification but only from the date of service
of notice of the motion on the responding party and on the public authority if public assistance
is being furnished or the county attorney is the attorney of record, unless the court adopts
an alternative effective date under paragraph (l). The court's adoption of an alternative
effective date under paragraph (l) shall not be considered a retroactive modification of
maintenance or support.

(g) Except for an award of the right of occupancy of the homestead, provided in section
518.63, all divisions of real and personal property provided by section 518.58 shall be final,
and may be revoked or modified only where the court finds the existence of conditions that
justify reopening a judgment under the laws of this state, including motions under section
518.145, subdivision 2. The court may impose a lien or charge on the divided property at
any time while the property, or subsequently acquired property, is owned by the parties or
either of them, for the payment of maintenance or support money, or may sequester the
property as is provided by section 518A.71.

(h) The court need not hold an evidentiary hearing on a motion for modification of
maintenance or support.

(i) Sections 518.14 and 518A.735 shall govern the award of attorney fees for motions
brought under this subdivision.

(j) An enactment, amendment, or repeal of law constitutes a substantial change in the
circumstances for purposes of modifying a child support order when it meets the standards
for modification in this section.

(k) On the first modification following implementation of amended child support
guidelines, the modification of basic support may be limited if the amount of the full variance
would create hardship for either the obligor or the obligee. Hardship includes, but is not
limited to, eligibility for assistance under chapter 256J.

(l) The court may select an alternative effective date for a maintenance or support order
if the parties enter into a binding agreement for an alternative effective date.

new text begin EFFECTIVE DATE.new text end

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

Sec. 93.

Laws 2017, First Special Session chapter 6, article 5, section 11, as amended by
Laws 2019, First Special Session chapter 9, article 8, section 20, is amended to read:

Sec. 11. MORATORIUM ON CONVERSION TRANSACTIONS.

(a) Notwithstanding Laws 2017, chapter 2, article 2, a nonprofit health service plan
corporation operating under Minnesota Statutes, chapter 62C, or a nonprofit health
maintenance organization operating under Minnesota Statutes, chapter 62D, as of January
1, 2017, may only merge or consolidate with; convert; or transfer, as part of a single
transaction or a series of transactions within a 24-month period, all or a material amount of
its assets to an entity that is a corporation organized under Minnesota Statutes, chapter
317A; or to a Minnesota nonprofit hospital within the same integrated health system as the
health maintenance organization. For purposes of this section, "material amount" means
the lesser of ten percent of such an entity's total admitted net assets as of December 31 of
the previous year, or $50,000,000.

(b) Paragraph (a) does not apply if the nonprofit service plan corporation or nonprofit
health maintenance organization files an intent to dissolve due to insolvency of the
corporation in accordance with Minnesota Statutes, chapter 317A, or insolvency proceedings
are commenced under Minnesota Statutes, chapter 60B.

(c) Nothing in this section shall be construed to authorize a nonprofit health maintenance
organization or a nonprofit service plan corporation to engage in any transaction or activities
not otherwise permitted under state law.

(d) This section expires July 1, deleted text begin 2023deleted text end new text begin 2026new 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. 94.

Laws 2022, chapter 99, article 1, section 46, is amended to read:

Sec. 46.

MENTAL HEALTH GRANTS FOR HEALTH CARE PROFESSIONALS.

Subdivision 1.

Grants authorized.

(a) The commissioner of health shall develop a grant
program to award grants to health care entities, including but not limited to health care
systems, hospitals, nursing facilities, community health clinics or consortium of clinics,
federally qualified health centers, rural health clinics, or health professional associations
for the purpose of establishing or expanding programs focused on improving the mental
health of health care professionals.

(b) Grants shall be awarded for programs that are evidenced-based or evidenced-informed
and are focused on addressing the mental health of health care professionals by:

(1) identifying and addressing the barriers to and stigma among health care professionals
associated with seeking self-care, including mental health and substance use disorder services;

(2) encouraging health care professionals to seek support and care for mental health and
substance use disorder concerns;

(3) identifying risk factors associated with suicide and other mental health conditions;
deleted text begin or
deleted text end

(4) developing and making available resources to support health care professionals with
self-care and resiliencydeleted text begin .deleted text end new text begin ; or
new text end

new text begin (5) identifying and modifying structural barriers in health care delivery that create
unnecessary stress in the workplace.
new text end

Subd. 2.

Allocation of grants.

(a) To receive a grant, a health care entity must submit
an application to the commissioner by the deadline established by the commissioner. An
application must be on a form and contain information as specified by the commissioner
and at a minimum must contain:

(1) a description of the purpose of the program for which the grant funds will be used;

(2) a description of the achievable objectives of the program and how these objectives
will be met; and

(3) a process for documenting and evaluating the results of the program.

(b) The commissioner shall give priority to programs that involve peer-to-peer support.

new text begin Subd. 2a.new text end

new text begin Grant term.new text end

new text begin Notwithstanding Minnesota Statutes, section 16A.28, subdivision
6, encumbrances for grants under this section issued by June 30 of each year may be certified
for a period of up to three years beyond the year in which the funds were originally
appropriated.
new text end

Subd. 3.

Evaluation.

The commissioner shall evaluate the overall effectiveness of the
grant program by conducting a periodic evaluation of the impact and outcomes of the grant
program on health care professional burnout and retention. The commissioner shall submit
the results of the evaluation and any recommendations for improving the grant program to
the chairs and ranking minority members of the legislative committees with jurisdiction
over health care policy and finance by October 15, 2024.

Sec. 95.

Laws 2022, chapter 99, article 3, section 9, is amended to read:

Sec. 9. APPROPRIATION; MENTAL HEALTH GRANTS FOR HEALTH CARE
PROFESSIONALS.

$1,000,000 in fiscal year 2023 is appropriated from the general fund to the commissioner
of health for the health care professionals mental health grant program. This is a onetime
appropriationnew text begin and is available until June 30, 2027new 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. 96.

new text begin [144.9981] CLIMATE RESILIENCY.
new text end

new text begin The commissioner of health shall implement a climate resiliency program to:
new text end

new text begin (1) increase awareness of climate change;
new text end

new text begin (2) track the public health impacts of climate change and extreme weather events;
new text end

new text begin (3) provide technical assistance and tools that support climate resiliency to local public
health departments, Tribal health departments, soil and water conservation districts, and
other local governmental and nongovernmental organizations; and
new text end

new text begin (4) coordinate with the commissioners of the pollution control agency, natural resources,
and agriculture and other state agencies in climate resiliency related planning and
implementation.
new text end

Sec. 97. new text begin CRITICAL ACCESS DENTAL INFRASTRUCTURE PROGRAM.
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.
new text end

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

new text begin (c) "Critical access dental provider" means a critical access dental provider as defined
in Minnesota Statutes, section 256B.76, subdivision 4.
new text end

new text begin (d) "Dental infrastructure" means:
new text end

new text begin (1) physical infrastructure of a dental setting, including but not limited to the operations
and clinical spaces in a dental clinic; associated heating, ventilation, and air conditioning
infrastructure and other mechanical infrastructure; and dental equipment needed to operate
a dental clinic; or
new text end

new text begin (2) mobile dental equipment or other equipment needed to provide dental services via
a hub-and-spoke service delivery model or via teledentistry.
new text end

new text begin Subd. 2.new text end

new text begin Grant and loan program established.new text end

new text begin The commissioner shall make grants
and forgivable loans to critical access dental providers for eligible dental infrastructure
projects.
new text end

new text begin Subd. 3.new text end

new text begin Eligible projects.new text end

new text begin In order to be eligible for a grant or forgivable loan under
this section, a dental infrastructure project must be proposed by a critical access dental
provider and must allow the provider to maintain or expand the provider's capacity to serve
Minnesota health care program enrollees.
new text end

new text begin Subd. 4.new text end

new text begin Application.new text end

new text begin (a) The commissioner must develop forms and procedures for
soliciting and reviewing applications for grants and forgivable loans under this section and
for awarding grants and forgivable loans. Critical access dental providers seeking a grant
or forgivable loan under this section must apply to the commissioner in a time and manner
specified by the commissioner. In evaluating applications for grants or forgivable loans for
eligible projects, the commissioner must review applications for completeness and must
determine the extent to which the project would increase access to dental care for medical
assistance and MinnesotaCare enrollees. For purposes of this section, "increasing dental
care" means expanding the number of medical assistance and MinnesotaCare enrollees
served by the provider and modernizing the facilities or equipment in a manner necessary
to meet professional standards of care, to expand access, and improve oral health outcomes.
new text end

new text begin (b) The commissioner must award grants and forgivable loans based on the information
provided in the grant application and other information available to the commissioner.
new text end

new text begin Subd. 5.new text end

new text begin Program oversight.new text end

new text begin The commissioner may require and collect from grant and
loan recipients any information needed to evaluate the program.
new text end

Sec. 98. new text begin MEMBERSHIP TERMS; PALLIATIVE CARE ADVISORY COUNCIL.
new text end

new text begin Notwithstanding the terms of office specified to the members upon their appointment,
the terms for members appointed to the Palliative Care Advisory Council under Minnesota
Statutes, section 144.059, on or after February 1, 2022, shall be three years, as provided in
Minnesota Statutes, section 144.059, subdivision 3.
new text end

Sec. 99. new text begin PSYCHEDELIC MEDICINE TASK FORCE.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment; purpose.new text end

new text begin The Psychedelic Medicine Task Force is
established to advise the legislature on the legal, medical, and policy issues associated with
the legalization of psychedelic medicine in the state. For purposes of this section,
"psychedelic medicine" means 3,4-methylenedioxymethamphetamine (MDMA), psilocybin,
and LSD.
new text end

new text begin Subd. 2.new text end

new text begin Membership; compensation.new text end

new text begin (a) The Psychedelic Medicine Task Force shall
consist of:
new text end

new text begin (1) the governor or a designee;
new text end

new text begin (2) two members of the house of representatives, one appointed by the speaker of the
house and one appointed by the minority leader of the house of representatives, and two
members of the senate, one appointed by the senate majority leader and one appointed by
the senate minority leader;
new text end

new text begin (3) the commissioner of health or a designee;
new text end

new text begin (4) the commissioner of public safety or a designee;
new text end

new text begin (5) the commissioner of human services or a designee;
new text end

new text begin (6) the attorney general or a designee;
new text end

new text begin (7) the executive director of the Board of Pharmacy or a designee;
new text end

new text begin (8) the commissioner of commerce or a designee; and
new text end

new text begin (9) members of the public, appointed by the governor, who have relevant knowledge
and expertise, including:
new text end

new text begin (i) two members representing Indian Tribes within the boundaries of Minnesota, one
representing the Ojibwe Tribes and one representing the Dakota Tribes;
new text end

new text begin (ii) one member with expertise in the treatment of substance use disorders;
new text end

new text begin (iii) one member with experience working in public health policy;
new text end

new text begin (iv) two veterans with treatment-resistant mental health conditions;
new text end

new text begin (v) two patients with treatment-resistant mental health conditions;
new text end

new text begin (vi) one psychiatrist with experience treating treatment-resistant mental health conditions,
including post-traumatic stress disorder;
new text end

new text begin (vii) one health care practitioner with experience in integrative medicine;
new text end

new text begin (viii) one psychologist with experience treating treatment-resistant mental health
conditions, including post-traumatic stress disorder; and
new text end

new text begin (ix) one member with demonstrable experience in the medical use of psychedelic
medicine.
new text end

new text begin (b) Members listed in paragraph (a), clauses (1) and (3) to (8), and members appointed
under paragraph (a), clause (9), may be reimbursed for expenses under Minnesota Statutes,
section 15.059, subdivision 6. Members appointed under paragraph (a), clause (2), may
receive per diem compensation from their respective bodies according to the rules of their
respective bodies.
new text end

new text begin (c) Members shall be designated or appointed to the task force by July 15, 2023.
new text end

new text begin Subd. 3.new text end

new text begin Organization.new text end

new text begin (a) The commissioner of health or the commissioner's designee
shall convene the first meeting of the task force.
new text end

new text begin (b) At the first meeting, the members of the task force shall elect a chairperson and other
officers as the members deem necessary.
new text end

new text begin (c) The first meeting of the task force shall occur by August 1, 2023. The task force shall
meet monthly or as determined by the chairperson.
new text end

new text begin Subd. 4.new text end

new text begin Staff.new text end

new text begin The commissioner of health shall provide support staff, office and meeting
space, and administrative services for the task force.
new text end

new text begin Subd. 5.new text end

new text begin Duties.new text end

new text begin The task force shall:
new text end

new text begin (1) survey existing studies in the scientific literature on the therapeutic efficacy of
psychedelic medicine in the treatment of mental health conditions, including depression,
anxiety, post-traumatic stress disorder, bipolar disorder, and any other mental health
conditions and medical conditions for which a psychedelic medicine may provide an effective
treatment option;
new text end

new text begin (2) compare the efficacy of psychedelic medicine in treating the conditions described
in clause (1) with the efficacy of treatments currently used for these conditions; and
new text end

new text begin (3) develop a comprehensive plan that covers:
new text end

new text begin (i) statutory changes necessary for the legalization of psychedelic medicine;
new text end

new text begin (ii) state and local regulation of psychedelic medicine;
new text end

new text begin (iii) federal law, policy, and regulation of psychedelic medicine, with a focus on retaining
state autonomy to act without conflicting with federal law, including methods to resolve
conflicts such as seeking an administrative exemption to the federal Controlled Substances
Act under United States Code, title 21, section 822(d), and Code of Federal Regulations,
title 21, part 1307.03; seeking a judicially created exemption to the federal Controlled
Substances Act; petitioning the United States Attorney General to establish a research
program under United States Code, title 21, section 872(e); using the Food and Drug
Administration's expanded access program; and using authority under the federal Right to
Try Act; and
new text end

new text begin (iv) education of the public on recommendations made to the legislature and others about
necessary and appropriate actions related to the legalization of psychedelic medicine in the
state.
new text end

new text begin Subd. 6.new text end

new text begin Reports.new text end

new text begin The task force shall submit two reports to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services that detail the task force's findings regarding the legalization of psychedelic medicine
in the state, including the comprehensive plan developed under subdivision 5. The first
report must be submitted by February 1, 2024, and the second report must be submitted by
January 1, 2025.
new text end

Sec. 100. new text begin STUDY OF THE DEVELOPMENT OF A STATEWIDE REGISTRY FOR
PROVIDER ORDERS FOR LIFE-SUSTAINING TREATMENT.
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.
new text end

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

new text begin (c) "Life-sustaining treatment" means any medical procedure, pharmaceutical drug,
medical device, or medical intervention that maintains life by sustaining, restoring, or
supplanting a vital function. Life-sustaining treatment does not include routine care necessary
to sustain patient cleanliness and comfort.
new text end

new text begin (d) "POLST" means a provider order for life-sustaining treatment, signed by a physician,
advanced practice registered nurse, or physician assistant, to ensure that the medical treatment
preferences of a patient with an advanced serious illness who is nearing the end of life are
honored.
new text end

new text begin (e) "POLST form" means a portable medical form used to communicate a physician's,
advanced practice registered nurse's, or physician assistant's order to help ensure that a
patient's medical treatment preferences are conveyed to emergency medical service personnel
and other health care providers.
new text end

new text begin Subd. 2.new text end

new text begin Establishment.new text end

new text begin (a) The commissioner, in consultation with the advisory
committee established in paragraph (c), shall develop recommendations for a statewide
registry of POLST forms to ensure that a patient's medical treatment preferences are followed
by all health care providers. The registry must allow for the submission of completed POLST
forms and for the forms to be accessed by health care providers and emergency medical
service personnel in a timely manner for the provision of care or services.
new text end

new text begin (b) The commissioner shall develop recommendations on the following:
new text end

new text begin (1) electronic capture, storage, and security of information in the registry;
new text end

new text begin (2) procedures to protect the accuracy and confidentiality of information submitted to
the registry;
new text end

new text begin (3) limits as to who can access the registry;
new text end

new text begin (4) where the registry should be housed;
new text end

new text begin (5) ongoing funding models for the registry; and
new text end

new text begin (6) any other action needed to ensure that patients' rights are protected and that their
health care decisions are followed.
new text end

new text begin (c) The commissioner shall create an advisory committee with members representing
physicians, physician assistants, advanced practice registered nurses, registered nurses,
nursing homes, emergency medical system providers, hospice and palliative care providers,
the disability community, attorneys, medical ethicists, and the religious community.
new text end

new text begin Subd. 3.new text end

new text begin Report.new text end

new text begin The commissioner shall submit recommendations on establishing a
statewide registry of POLST forms to the chairs and ranking minority members of the
legislative committees with jurisdiction over health and human services policy and finance
by February 1, 2024.
new text end

Sec. 101.

new text begin DIRECTION TO THE COMMISSIONER; ALZHEIMER'S PUBLIC
INFORMATION PROGRAM.
new text end

new text begin (a) The commissioner of health shall design and make publicly available materials for
a statewide public information program that:
new text end

new text begin (1) promotes the benefits of early detection and the importance of discussing cognition
with a health care provider;
new text end

new text begin (2) outlines the benefits of cognitive testing, the early warning signs of cognitive
impairment, and the difference between normal cognitive aging and dementia; and
new text end

new text begin (3) provides awareness of Alzheimer's disease and other dementias.
new text end

new text begin (b) The commissioner shall include in the program materials messages directed at the
general population, as well as messages designed to reach underserved communities including
but not limited to rural populations, Native and Indigenous communities, and communities
of color. The program materials shall include culturally specific messages developed in
consultation with leaders of targeted cultural communities who have experience with
Alzheimer's disease and other dementias. The commissioner shall develop the materials for
the program by June 30, 2024, and make them available online to local and county public
health agencies and other interested parties.
new text end

new text begin (c) To the extent funds remain available for this purpose, the commissioner shall
implement an initial statewide public information campaign using the developed program
materials. The campaign must include culturally specific messages and the development of
a community digital public forum. These messages may be disseminated by television and
radio public service announcements, social media and digital advertising, print materials,
or other means.
new text end

new text begin (d) The commissioner may contract with one or more third parties to initially implement
some or all of the public information campaign, provided the contracted third party has
prior experience promoting Alzheimer's awareness and the contract is awarded through a
competitive process. The public information campaign must be implemented by July 1,
2025.
new text end

new text begin (e) By June 30, 2026, the commissioner shall report to the chairs and ranking minority
members of the legislative committees and divisions with jurisdiction over public health or
aging on the development of the program materials and initial implementation of the public
information campaign, including how and where the funds appropriated for this purpose
were spent.
new text end

Sec. 102. new text begin MORATORIUM ON GREEN BURIALS; STUDY.
new text end

new text begin Subdivision 1.new text end

new text begin Definition.new text end

new text begin For purposes of this section, "green burial" means a burial
of a dead human body in a manner that minimizes environmental impact and does not inhibit
decomposition of the body by using practices that include at least the following:
new text end

new text begin (1) the human body is not embalmed prior to burial or is embalmed only with nontoxic
chemicals;
new text end

new text begin (2) a biodegradable casket or shroud is used for burial; and
new text end

new text begin (3) the casket or shroud holding the human body is not placed in an outer burial container
when buried.
new text end

new text begin Subd. 2.new text end

new text begin Moratorium.new text end

new text begin Between July 1, 2023, and July 1, 2025, a green burial shall not
be performed in this state unless the green burial is performed in a cemetery that permits
green burials and at which green burials are permitted by any applicable ordinances or
regulations.
new text end

new text begin Subd. 3.new text end

new text begin Study and report.new text end

new text begin (a) The commissioner of health shall study the environmental
and health impacts of green burials and natural organic reduction and develop
recommendations for the performance of green burials and natural organic reduction to
prevent environmental harm, including contamination of groundwater and surface water,
and to protect the health of workers performing green burials and natural organic reduction,
mourners, and the public. The study and recommendations may address topics that include:
new text end

new text begin (1) the siting of locations where green burials are permitted;
new text end

new text begin (2) the minimum distance a green burial location must have from groundwater, surface
water, and drinking water;
new text end

new text begin (3) the minimum depth at which a body buried via green burial must be buried, the
minimum soil depth below the body, and the minimum soil depth covering the body;
new text end

new text begin (4) the maximum density of green burial interments in a green burial location;
new text end

new text begin (5) procedures used by individuals who come in direct contact with a body awaiting
green burial to minimize the risk of infectious disease transmission from the body;
new text end

new text begin (6) methods to temporarily inhibit decomposition of an unembalmed body awaiting
green burial;
new text end

new text begin (7) the time period within which an unembalmed body awaiting green burial must be
buried or held in a manner that delays decomposition; and
new text end

new text begin (8) use of natural organic reduction of a human body.
new text end

new text begin (b) The commissioner shall submit the study and recommendations, including any
statutory changes needed to implement the recommendations, to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and the
environment by February 1, 2025.
new text end

Sec. 103. new text begin ADOPTION LAW CHANGES; PUBLIC AWARENESS CAMPAIGN.
new text end

new text begin (a) The commissioner of human services must, in consultation with licensed child-placing
agencies and the commissioner of health, provide information and educational materials to
adopted persons and birth parents about the changes in law made by this article affecting
access to birth records.
new text end

new text begin (b) The commissioner of human services and the commissioner of health must provide
notice on the department website about the changes in the law. The commissioners or the
commissioners' designee, in consultation with licensed child-placement agencies, must
coordinate a public awareness campaign to advise the public about the changes in law made
by this article.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 104. new text begin EMMETT LOUIS TILL VICTIMS RECOVERY PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Short title.new text end

new text begin This section shall be known as the Emmett Louis Till Victims
Recovery Program.
new text end

new text begin Subd. 2.new text end

new text begin Program established; grants.new text end

new text begin (a) The commissioner of health shall establish
the Emmett Louis Till Victims Recovery Program to address the health and wellness needs
of:
new text end

new text begin (1) victims who experienced trauma, including historical trauma, resulting from events
such as assault or another violent physical act, intimidation, false accusations, wrongful
conviction, a hate crime, the violent death of a family member, or experiences of
discrimination or oppression based on the victim's race, ethnicity, or national origin; and
new text end

new text begin (2) the families and heirs of victims described in clause (1), who experienced trauma,
including historical trauma, because of their proximity or connection to the victim.
new text end

new text begin (b) The commissioner, in consultation with victims, families, and heirs described in
paragraph (a), shall award competitive grants to applicants for projects to provide the
following services to victims, families, and heirs described in paragraph (a):
new text end

new text begin (1) health and wellness services, which may include services and support to address
physical health, mental health, cultural needs, and spiritual or faith-based needs;
new text end

new text begin (2) remembrance and legacy preservation activities;
new text end

new text begin (3) cultural awareness services; and
new text end

new text begin (4) community resources and services to promote healing for victims, families, and heirs
described in paragraph (a).
new text end

new text begin (c) In awarding grants under this section, the commissioner must prioritize grant awards
to community-based organizations experienced in providing support and services to victims,
families, and heirs described in paragraph (a).
new text end

new text begin Subd. 3.new text end

new text begin Evaluation.new text end

new text begin Grant recipients must provide the commissioner with information
required by the commissioner to evaluate the grant program, in a time and manner specified
by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Reports.new text end

new text begin The commissioner must submit a status report by January 15, 2024,
and an additional report by January 15, 2025, on the operation and results of the grant
program, to the extent available. These reports must be submitted to the chairs and ranking
minority members of the legislative committees with jurisdiction over health care. The
report due January 15, 2024, must include information on grant program activities to date
and an assessment of the need to continue to offer services provided by grant recipients to
victims, families, and heirs who experienced trauma as described in subdivision 2, paragraph
(a). The report due January 15, 2025, must include a summary of the services offered by
grant recipients; an assessment of the need to continue to offer services provided by grant
recipients to victims, families, and heirs described in subdivision 2, paragraph (a); and an
evaluation of the grant program's goals and outcomes.
new text end

Sec. 105. new text begin EQUITABLE HEALTH CARE TASK FORCE.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment; composition of task force.new text end

new text begin The equitable health care
task force consists of up to 20 members appointed by the commissioner of health from both
metropolitan and greater Minnesota. Members must include representatives of:
new text end

new text begin (1) African American and African heritage communities;
new text end

new text begin (2) Asian American and Pacific Islander communities;
new text end

new text begin (3) Latina/o/x/ communities;
new text end

new text begin (4) American Indian communities and Tribal Nations;
new text end

new text begin (5) disability communities;
new text end

new text begin (6) lesbian, gay, bisexual, transgender, queer, intergender, and asexual (LGBTQIA+)
communities;
new text end

new text begin (7) organizations that advocate for the rights of individuals using the health care system;
new text end

new text begin (8) health care providers of primary care and specialty care; and
new text end

new text begin (9) organizations that provide health coverage in Minnesota.
new text end

new text begin Subd. 2.new text end

new text begin Organization and meetings.new text end

new text begin The task force shall be organized and administered
under Minnesota Statutes, section 15.059. The commissioner of health must convene meetings
of the task force at least quarterly. Subcommittees or work groups may be established as
necessary. Task force meetings are subject to Minnesota Statutes, chapter 13D. The task
force shall expire on June 30, 2025.
new text end

new text begin Subd. 3.new text end

new text begin Duties of task force.new text end

new text begin The task force shall examine inequities in how people
access and receive health care based on race or ethnicity, religion, culture, sexual orientation,
gender identity, age, or disability and identify strategies to ensure that all Minnesotans can
receive care and coverage that is respectful and ensures optimal health outcomes, to include:
new text end

new text begin (1) identifying inequities experienced by Minnesotans in interacting with the health care
system that originate from or can be attributed to their race, religion, culture, sexual
orientation, gender identity, age, or disability status;
new text end

new text begin (2) conducting community engagement across multiple systems, sectors, and communities
to identify barriers for these population groups that result in diminished standards of care
and foregone care;
new text end

new text begin (3) identifying promising practices to improve the experience of care and health outcomes
for individuals in these population groups; and
new text end

new text begin (4) making recommendations to the commissioner of health and to the chairs and ranking
minority members of the legislative with primary jurisdiction over health policy and finance
for changes in health care system practices or health insurance regulations that would address
identified issues.
new text end

Sec. 106. new text begin TRANSITION.
new text end

new text begin A person with a permit issued pursuant to Minnesota Statutes, section 103I.210, must
comply with Minnesota Statutes, sections 103I.209 and 103I.210, until permanent rules
governing submerged closed loop heat exchangers adopted by the commissioner are published
in the State Register.
new text end

Sec. 107. new text begin CLOSED LOOP HEAT EXCHANGER SYSTEM MONITORING AND
REPORTING.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

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

new text begin (b) "Accredited laboratory" means a laboratory that is certified under Minnesota Rules,
chapter 4740.
new text end

new text begin (c) "Permit holder" means persons who receive a permit under this section and includes
the property owner and licensed well contractor.
new text end

new text begin Subd. 2.new text end

new text begin Monitoring and reporting requirements.new text end

new text begin (a) The system owner is responsible
for monitoring and reporting to the commissioner for permitted submerged closed loop heat
exchanger systems installed under the provisional program. The commissioner must identify
projects subject to reporting by including a permit condition.
new text end

new text begin (b) The closed loop heat exchanger owner must implement a closed loop water monitoring
plan.
new text end

new text begin (c) The system owner must analyze the closed loop water for:
new text end

new text begin (1) aluminum;
new text end

new text begin (2) arsenic;
new text end

new text begin (3) copper;
new text end

new text begin (4) iron;
new text end

new text begin (5) lead;
new text end

new text begin (6) manganese;
new text end

new text begin (7) zinc;
new text end

new text begin (8) total coliform;
new text end

new text begin (9) escherichia coli (E. coli);
new text end

new text begin (10) heterotrophic plate count;
new text end

new text begin (11) legionella;
new text end

new text begin (12) pH;
new text end

new text begin (13) electrical conductivity;
new text end

new text begin (14) dissolved oxygen; and
new text end

new text begin (15) temperature.
new text end

new text begin (d) The system owner must provide the results for the sampling event, including the
parameters in paragraph (c), clauses (1) to (11), to the commissioner within 30 days of the
date of the report provided by an accredited laboratory. Paragraph (c), clauses (12) to (15),
may be measured in the field and reported along with the laboratory results.
new text end

new text begin Subd. 3.new text end

new text begin Evaluation of permit conditions.new text end

new text begin (a) In order to determine whether additional
permit conditions are necessary and appropriate to ensure that the construction and operation
of a submerged closed loop heat exchanger does not create the risk of material adverse
impacts on the state's groundwater, the commissioner shall require semiannual sampling of
the circulating fluids in accordance with subdivision 2 to determine whether there have been
any material changes in the chemical or biological composition of the circulating fluids.
new text end

new text begin (b) The information required by this section shall be collected from each submerged
closed loop heat exchanger system installed after June 30, 2023, under this provisional
program. The information shall be provided to the commissioner on a semiannual basis and
the final semiannual submission shall include information from the period from July 1,
2023, through December 31, 2024.
new text end

new text begin Subd. 4.new text end

new text begin Report requirements.new text end

new text begin (a) Every closed loop heat exchanger owner that holds
a permit issued under this section must provide a report to the commissioner for each permit
by July 31, 2025. The report must describe the status, operation, and performance of each
submerged closed loop heat exchanger system. The report may be in a format determined
by the system owner and must include:
new text end

new text begin (1) the date of the report;
new text end

new text begin (2) the name of the individual who prepared the report and permit number;
new text end

new text begin (3) a narrative description of system installation, operation, and status, including dates;
new text end

new text begin (4) the mean monthly temperature of the water entering the building;
new text end

new text begin (5) the mean monthly temperature of the water leaving the building;
new text end

new text begin (6) maintenance performed on the system, including dates, identification of heat
exchangers or components that were addressed, and descriptions of actions that occurred;
and
new text end

new text begin (7) any maintenance issues, material failures, leaks, and repairs, including dates and
descriptions of the heat exchangers or components involved, issues, failures, leaks, and
repairs.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective the day following final enactment and
expires on December 31, 2025.
new text end

Sec. 108.

new text begin VACCINES FOR UNINSURED AND UNDERINSURED ADULTS.
new text end

new text begin The commissioner of health shall administer a program to provide vaccines to uninsured
and underinsured adults. The commissioner shall determine adult eligibility for free or
low-cost vaccines under this program and shall enroll clinics to participate in the program
and administer vaccines recommended by the Centers for Disease Control and Prevention.
In administering the program, the commissioner shall address racial and ethnic disparities
in vaccine coverage rates. State money appropriated for purposes of this section shall be
used to supplement, but not supplant, available federal funding for purposes of this section.
new text end

Sec. 109. new text begin WORKPLACE SAFETY GRANTS; HEALTH CARE ENTITIES.
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 health shall administer
a program to award workplace safety grants to increase safety measures in health care
settings and establish or expand programs to train staff in health care settings on de-escalation
and positive support services.
new text end

new text begin Subd. 2.new text end

new text begin Eligible applicants; application.new text end

new text begin (a) Entities eligible for a grant under this
section shall include long-term care facilities, acute care hospitals that are staffed for 49
beds or less and located in a rural area, critical access hospitals, medical clinics, dental
clinics, and community health clinics.
new text end

new text begin (b) An entity seeking a grant under this section must submit an application to the
commissioner in a form and manner prescribed by the commissioner. An application must
include information about:
new text end

new text begin (1) the type of entity or organization seeking grant funding;
new text end

new text begin (2) the specific safety measures or activities for which the applicant will use the grant
funding;
new text end

new text begin (3) a proposed budget for each of the specific activities for which the applicant will use
the grant funding;
new text end

new text begin (4) how the grant-funded measures will lead to long-term improvements in safety and
stability for staff and for patients accessing health care from the applicant; and
new text end

new text begin (5) methods the applicant will use to evaluate the effectiveness of the safety measures
and changes that will be made if the measures are deemed ineffective.
new text end

new text begin Subd. 3.new text end

new text begin Grant awards.new text end

new text begin The commissioner shall evaluate applications and award grants
according to a process established by the commissioner. A grant award shall not exceed
$50,000.
new text end

Sec. 110. new text begin TASK FORCE ON PREGNANCY HEALTH AND SUBSTANCE USE
DISORDERS.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The Task Force on Pregnancy Health and Substance Use
Disorders is established to recommend protocols for when physicians, advanced practice
registered nurses, and physician assistants should administer a toxicology test and
requirements for reporting for prenatal exposure to a controlled substance.
new text end

new text begin Subd. 2.new text end

new text begin Membership.new text end

new text begin (a) The task force shall consist of the following members:
new text end

new text begin (1) a physician licensed in Minnesota to practice obstetrics and gynecology who provides
care primarily to medical assistance enrollees during pregnancy appointed by the American
College of Obstetricians and Gynecologists;
new text end

new text begin (2) a physician licensed in Minnesota to practice pediatrics or family medicine who
provides care primarily to medical assistance enrollees with substance use disorders or who
provides addiction medicine care during pregnancy appointed by the Minnesota Medical
Association;
new text end

new text begin (3) a certified nurse-midwife licensed as an advanced practice registered nurse in
Minnesota who provides care primarily to medical assistance enrollees with substance use
disorders or provides addiction medicine care during pregnancy appointed by the Minnesota
Advanced Practice Registered Nurses Coalition;
new text end

new text begin (4) two representatives of county social services agencies, one from a county outside
the seven-county metropolitan area and one from a county within the seven-county
metropolitan area, appointed by the Minnesota Association of County Social Service
Administrators;
new text end

new text begin (5) one representative from the Board of Social Work;
new text end

new text begin (6) two Tribal representatives appointed by the Minnesota Indian Affairs Council;
new text end

new text begin (7) two members who identify as Black or African American and who have lived
experience with the child welfare system and substance use disorders appointed by the
Cultural and Ethnic Communities Leadership Council;
new text end

new text begin (8) two members who are licensed substance use disorder treatment providers appointed
by the Minnesota Association of Resources for Recovery and Chemical Health;
new text end

new text begin (9) one member representing hospitals appointed by the Minnesota Hospital Association;
new text end

new text begin (10) one designee of the commissioner of health with expertise in substance use disorders
and treatment;
new text end

new text begin (11) two members who identify as Native American or American Indian and who have
lived experience with the child welfare system and substance use disorders appointed by
the Minnesota Indian Affairs Council;
new text end

new text begin (12) two members from the Council for Minnesotans of African Heritage;
new text end

new text begin (13) one member of the Minnesota Perinatal Quality Collaborative; and
new text end

new text begin (14) one designee of the commissioner of human services with expertise in child welfare.
new text end

new text begin (b) Appointments to the task force must be made by October 1, 2023.
new text end

new text begin Subd. 3.new text end

new text begin Chairs; meetings.new text end

new text begin (a) The task force shall elect a chair and cochair at the first
meeting, which shall be convened no later than October 15, 2023.
new text end

new text begin (b) Task force meetings are subject to the Minnesota Open Meeting Law under Minnesota
Statutes, chapter 13D.
new text end

new text begin Subd. 4.new text end

new text begin Administrative support.new text end

new text begin The Department of Health must provide administrative
support and meeting space for the task force.
new text end

new text begin Subd. 5.new text end

new text begin Duties; reports.new text end

new text begin (a) The task force shall develop recommended protocols for
when a toxicology test for prenatal exposure to a controlled substance should be administered
to a birthing parent and a newborn infant. The task force must also recommend protocols
for providing notice or reporting of prenatal exposure to a controlled substance to local
welfare agencies under Minnesota Statutes, chapter 260E.
new text end

new text begin (b) No later than December 1, 2024, the task force must submit a written report to the
chairs and ranking minority members of the legislative committees and divisions with
jurisdiction over health and human services on the task force's activities and recommendations
on the protocols developed under paragraph (a).
new text end

new text begin Subd. 6.new text end

new text begin Expiration.new text end

new text begin The task force shall expire upon submission of the report required
under subdivision 5, paragraph (b), or December 1, 2024, whichever is later.
new text end

Sec. 111. new text begin SKIN-LIGHTENING PRODUCTS PUBLIC AWARENESS AND
EDUCATION GRANT.
new text end

new text begin An organization receiving a grant from the commissioner of health for public awareness
and education activities to address issues of colorism, skin-lightening products, and chemical
exposure from skin-lightening products must use the grant funds for activities that are
culturally specific and community-based and that focus on:
new text end

new text begin (1) increasing public awareness and providing education on the health dangers associated
with using skin-lightening creams and products that contain mercury and hydroquinone and
are manufactured in other countries, brought into this country, and sold illegally online or
in stores; the dangers of exposure to mercury through dermal absorption, inhalation,
hand-to-mouth contact, and contact with individuals who have used skin-lightening products;
the health effects of mercury poisoning, including the permanent effects on the central
nervous system and kidneys; and the dangers to mothers and infants of using these products
or being exposed to these products during pregnancy and while breastfeeding;
new text end

new text begin (2) identifying products that contain mercury and hydroquinone by testing skin-lightening
products;
new text end

new text begin (3) developing a train the trainer curriculum to increase community knowledge and
influence behavior changes by training community leaders, cultural brokers, community
health workers, and educators;
new text end

new text begin (4) continuing to build the self-esteem and overall wellness of young people who are
using skin-lightening products or are at risk of starting the practice of skin lightening; and
new text end

new text begin (5) building the capacity of community-based organizations to continue to combat
skin-lightening practices and chemical exposures from skin-lightening products.
new text end

Sec. 112. new text begin REVISOR INSTRUCTION.
new text end

new text begin (a) The revisor of statutes shall change the term "cancer surveillance system" to "cancer
reporting system" wherever it appears in the next edition of Minnesota Statutes and Minnesota
Rules and in the online publication.
new text end

new text begin (b) The revisor of statutes shall amend the headnote for Minnesota Statutes, section
145.423, to read "RECOGNITION OF INFANT WHO IS BORN ALIVE."
new text end

Sec. 113. new text begin REPEALER.
new text end

new text begin (a)new text end new text begin Minnesota Statutes 2022, sections 144.212, subdivision 11; 259.83, subdivision 3;
259.89; and 260C.637,new text end new text begin are repealed effective July 1, 2024.
new text end

new text begin (b)new text end new text begin Minnesota Statutes 2022, sections 62U.10, subdivisions 6, 7, and 8; 144.059,
subdivision 10; and 145.4235,new text end new text begin are repealed.
new text end

new text begin (c)new text end new text begin Minnesota Statutes 2022, sections 62Q.145; 145.411, subdivisions 2 and 4; 145.412;
145.413, subdivisions 2 and 3; 145.4132; 145.4133; 145.4135; 145.4136; 145.415; 145.416;
145.423, subdivisions 2, 3, 4, 5, 6, 7, 8, and 9; 145.4241; 145.4242; 145.4243; 145.4244;
145.4245; 145.4246; 145.4247; 145.4248; 145.4249; 256B.011; 256B.40; 261.28; and
393.07, subdivision 11,new text end new text begin are repealed effective the day following final enactment.
new text end

new text begin (d)new text end new text begin Minnesota Rules, part 4615.3600,new text end new text begin is repealed effective the day following final
enactment.
new text end

new text begin (e)new text end new text begin Minnesota Rules, parts 4700.1900; 4700.2000; 4700.2100; 4700.2210; 4700.2300,
subparts 1, 3, 4, 4a, and 5; 4700.2410; 4700.2420; and 4700.2500,new text end new text begin are repealed.
new text end

ARTICLE 5

MEDICAL EDUCATION AND RESEARCH COSTS AND HEALTH CARE
WORKFORCE

Section 1.

Minnesota Statutes 2022, section 62J.692, subdivision 1, is amended to read:

Subdivision 1.

Definitions.

(a) For purposes of this section, the following definitions
apply:

(b) "Accredited clinical training" means the clinical training provided by a medical
education program that is accredited through an organization recognized by the Department
of Education, the Centers for Medicare and Medicaid Services, or another national body
who reviews the accrediting organizations for multiple disciplines and whose standards for
recognizing accrediting organizations are reviewed and approved by the commissioner of
health.

(d) "Clinical medical education program" means the accredited clinical training of
physicians (medical students and residents), doctor of pharmacy practitionersnew text begin (pharmacy
students and residents)new text end , doctors of chiropractic, dentistsnew text begin (dental students and residents)new text end ,
advanced practice registered nurses (clinical nurse specialists, certified registered nurse
anesthetists, nurse practitioners, and certified nurse midwives), physician assistants, dental
therapists and advanced dental therapists, psychologists, clinical social workers, community
paramedics, and community health workers.

(e) "Sponsoring institution" means a hospital, school, or consortium located in Minnesota
that sponsors and maintains primary organizational and financial responsibility for a clinical
medical education program in Minnesota and which is accountable to the accrediting body.

(f) "Teaching institution" means a hospital, medical center, clinic, or other organization
that conducts a clinical medical education program in Minnesota.

(g) "Trainee" means a student or resident involved in a clinical medical education
program.

(h) "Eligible trainee FTE's" means the number of trainees, as measured by full-time
equivalent counts, that are at training sites located in Minnesota with currently active medical
assistance enrollment status and a National Provider Identification (NPI) number where
training occurs deleted text begin indeleted text end new text begin as part of or under the scope ofnew text end either an inpatient or ambulatory patient
care setting and where the training is funded, in part, by patient care revenues. Training that
occurs in nursing facility settingsnew text begin , rural health clinics, or federally qualified health centersnew text end
is not eligible for funding under this section.

Sec. 2.

Minnesota Statutes 2022, section 62J.692, subdivision 3, is amended to read:

Subd. 3.

Application process.

(a) A clinical medical education program conducted in
Minnesota by a teaching institution to train physicians, doctor of pharmacy practitioners,
dentists, chiropractors, physician assistants, dental therapists and advanced dental therapists,
psychologists, clinical social workers, community paramedics, or community health workers
is eligible for funds under subdivision 4 if the program:

(1) is funded, in part, by patient care revenues;

(2) occurs in patient care settings that face increased financial pressure as a result of
competition with nonteaching patient care entitiesnew text begin , including training hours in settings
outside of the hospital or clinic site, as applicable, including but not limited to school, home,
and community settingsnew text end ; and

(3) emphasizes primary care or specialties that are in undersupply in Minnesota.

(b) A clinical medical education program for advanced practice nursing is eligible for
funds under subdivision 4 if the program meets the eligibility requirements in paragraph
(a), clauses (1) to (3), and is sponsored by the University of Minnesota Academic Health
Center, the Mayo Foundation, or institutions that are part of the Minnesota State Colleges
and Universities system or members of the Minnesota Private College Council.

(c) Applications must be submitted to the commissioner by a sponsoring institution on
behalf of an eligible clinical medical education program deleted text begin and must be received by October
31 of each year for distribution in the following yeardeleted text end new text begin on a timeline determined by the
commissionernew text end . An application for funds must contain deleted text begin the following information:deleted text end new text begin information
the commissioner deems necessary to determine program eligibility based on the criteria
in paragraphs (a) and (b) and to ensure the equitable distribution of funds.
new text end

deleted text begin (1) the official name and address of the sponsoring institution and the official name and
site address of the clinical medical education programs on whose behalf the sponsoring
institution is applying;
deleted text end

deleted text begin (2) the name, title, and business address of those persons responsible for administering
the funds;
deleted text end

deleted text begin (3) for each clinical medical education program for which funds are being sought; the
type and specialty orientation of trainees in the program; the name, site address, and medical
assistance provider number and national provider identification number of each training
site used in the program; the federal tax identification number of each training site used in
the program, where available; the total number of trainees at each training site; and the total
number of eligible trainee FTEs at each site; and
deleted text end

deleted text begin (4) other supporting information the commissioner deems necessary to determine program
eligibility based on the criteria in paragraphs (a) and (b) and to ensure the equitable
distribution of funds.
deleted text end

deleted text begin (d) An application must include the information specified in clauses (1) to (3) for each
clinical medical education program on an annual basis for three consecutive years. After
that time, an application must include the information specified in clauses (1) to (3) when
requested, at the discretion of the commissioner:
deleted text end

deleted text begin (1) audited clinical training costs per trainee for each clinical medical education program
when available or estimates of clinical training costs based on audited financial data;
deleted text end

deleted text begin (2) a description of current sources of funding for clinical medical education costs,
including a description and dollar amount of all state and federal financial support, including
Medicare direct and indirect payments; and
deleted text end

deleted text begin (3) other revenue received for the purposes of clinical training.
deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end An applicant that does not provide information requested by the commissioner
shall not be eligible for funds for the deleted text begin currentdeleted text end new text begin applicablenew text end funding cycle.

Sec. 3.

Minnesota Statutes 2022, section 62J.692, subdivision 4, is amended to read:

Subd. 4.

Distribution of funds.

(a) The commissioner shall annually distribute deleted text begin the
available medical education fundsdeleted text end new text begin revenue credited or money transferred to the medical
education and research costs account under subdivision 8 and section 297F.10, subdivision
1, clause (2), new text end to all qualifying applicants based on a public program volume factor, which
is determined by the total volume of public program revenue received by each training site
as a percentage of all public program revenue received by all training sites in the fund pool.

Public program revenue for the distribution formula includes revenue from medical
assistance and prepaid medical assistance. Training sites that receive no public program
revenue are ineligible for funds available under this subdivision. deleted text begin For purposes of determining
training-site level grants to be distributed under this paragraph, total statewide average costs
per trainee for medical residents is based on audited clinical training costs per trainee in
primary care clinical medical education programs for medical residents. Total statewide
average costs per trainee for dental residents is based on audited clinical training costs per
trainee in clinical medical education programs for dental students. Total statewide average
costs per trainee for pharmacy residents is based on audited clinical training costs per trainee
in clinical medical education programs for pharmacy students.
deleted text end

Training sites whose training site level grant is less than $5,000, based on the deleted text begin formuladeleted text end new text begin
formulasnew text end described in this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end , or that train fewer than 0.1 FTE eligible
trainees, are ineligible for funds available under this subdivision. No training sites shall
receive a grant per FTE trainee that is in excess of the 95th percentile grant per FTE across
all eligible training sites; grants in excess of this amount will be redistributed to other eligible
sites based on the deleted text begin formuladeleted text end new text begin formulasnew text end described in this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end .

(b) deleted text begin For funds distributed in fiscal years 2014 and 2015, the distribution formula shall
include a supplemental public program volume factor, which is determined by providing a
supplemental payment to training sites whose public program revenue accounted for at least
0.98 percent of the total public program revenue received by all eligible training sites. The
supplemental public program volume factor shall be equal to ten percent of each training
site's grant for funds distributed in fiscal year 2014 and for funds distributed in fiscal year
2015. Grants to training sites whose public program revenue accounted for less than 0.98
percent of the total public program revenue received by all eligible training sites shall be
reduced by an amount equal to the total value of the supplemental payment. For fiscal year
2016 and beyond, the distribution of funds shall be based solely on the public program
volume factor as described in paragraph (a).deleted text end new text begin Money appropriated through the state general
fund, the health care access fund, and any additional fund for the purpose of funding medical
education and research costs and that does not require federal approval must be awarded
only to eligible training sites that do not qualify for a medical education and research cost
rate factor under sections 256.969, subdivision 2b, paragraph (k), or 256B.75, paragraph
(b). The commissioner shall distribute the available medical education money appropriated
to eligible training sites that do not qualify for a medical education and research cost rate
factor based on a distribution formula determined by the commissioner. The distribution
formula under this paragraph must consider clinical training costs, public program revenues,
and other factors identified by the commissioner that address the objective of supporting
clinical training.
new text end

(d) Funds shall be distributed to the sponsoring institutions indicating the amount to be
distributed to each of the sponsor's clinical medical education programs based on the criteria
in this subdivision and in accordance with the commissioner's approval letter. Each clinical
medical education program must distribute funds allocated under paragraphs (a) and (b) to
the training sites as specified in the commissioner's approval letter. Sponsoring institutions,
which are accredited through an organization recognized by the Department of Education
or the Centers for Medicare and Medicaid Services, may contract directly with training sites
to provide clinical training. To ensure the quality of clinical training, those accredited
sponsoring institutions must:

(1) develop contracts specifying the terms, expectations, and outcomes of the clinical
training conducted at sites; and

(2) take necessary action if the contract requirements are not met. Action may include
deleted text begin the withholding of paymentsdeleted text end new text begin disqualifying the training sitenew text end under this section or the removal
of students from the site.

(e) Use of funds is limited to expenses related to new text begin eligible new text end clinical training deleted text begin programdeleted text end costs
deleted text begin for eligible programsdeleted text end new text begin . The commissioner shall develop a methodology for determining
eligible costsnew text end .

(f) Any funds deleted text begin notdeleted text end new text begin that cannot benew text end distributed in accordance with the commissioner's
approval letter must be returned to the medical education and research fund within 30 days
of receiving notice from the commissioner. deleted text begin The commissioner shall distribute returned
funds to the appropriate training sites in accordance with the commissioner's approval letter.deleted text end new text begin
When appropriate, the commissioner shall include the undistributed money in the subsequent
distribution cycle using the applicable methodology described in this subdivision.
new text end

deleted text begin (g) A maximum of $150,000 of the funds dedicated to the commissioner under section
297F.10, subdivision 1, clause (2), may be used by the commissioner for administrative
expenses associated with implementing this section.
deleted text end

Sec. 4.

Minnesota Statutes 2022, section 62J.692, subdivision 5, is amended to read:

Subd. 5.

Report.

(a) Sponsoring institutions receiving funds under this section must
deleted text begin sign anddeleted text end submit a medical education grant verification report (GVR) to verify that the correct
grant amount was forwarded to each eligible training site. deleted text begin If the sponsoring institution fails
to submit the GVR by the stated deadline, or to request and meet the deadline for an
extension, the sponsoring institution is required to return the full amount of funds received
to the commissioner within 30 days of receiving notice from the commissioner. The
commissioner shall distribute returned funds to the appropriate training sites in accordance
with the commissioner's approval letter.
deleted text end

(b) The reports must provide verification of the distribution of the funds and must include:

deleted text begin (1) the total number of eligible trainee FTEs in each clinical medical education program;
deleted text end

deleted text begin (2) the name of each funded program and, for each program, the dollar amount distributed
to each training site and a training site expenditure report;
deleted text end

deleted text begin (3)deleted text end new text begin (1)new text end documentation of any discrepancies between the deleted text begin initialdeleted text end grant distribution notice
included in the commissioner's approval letter and the actual distribution;

deleted text begin (4)deleted text end new text begin (2)new text end a statement by the sponsoring institution stating that the completed grant
verification report is valid and accurate; and

deleted text begin (5)deleted text end new text begin (3)new text end other information the commissioner deems appropriate to evaluate the effectiveness
of the use of funds for medical education.

deleted text begin (c) Each year, the commissioner shall provide an annual summary report to the legislature
on the implementation of this section. This report is exempt from section 144.05, subdivision
7.
deleted text end

Sec. 5.

Minnesota Statutes 2022, section 62J.692, subdivision 8, is amended to read:

Subd. 8.

Federal financial participation.

The commissioner of human services shall
seek deleted text begin to maximizedeleted text end federal financial participation deleted text begin in paymentsdeleted text end new text begin for the dedicated revenuenew text end for
medical education and research costsnew text begin provided under section 297F.10, subdivision 1, clause
(2)new text end .

deleted text begin The commissioner shall use physician clinic rates where possible to maximize federal
financial participation. Any additional funds that become available must be distributed under
subdivision 4, paragraph (a).
deleted text end

Sec. 6.

Minnesota Statutes 2022, section 144.1501, subdivision 2, is amended to read:

Subd. 2.

Creation of account.

(a) A health professional education loan forgiveness
program account is established. The commissioner of health shall use money from the
account to establish a loan forgiveness program:

(1) for medical residents, mental health professionals, and alcohol and drug counselors
agreeing to practice in designated rural areas or underserved urban communities or
specializing in the area of pediatric psychiatry;

(2) for midlevel practitioners agreeing to practice in designated rural areas or to teach
at least 12 credit hours, or 720 hours per year in the nursing field in a postsecondary program
at the undergraduate level or the equivalent at the graduate level;

(3) for nurses who agree to practice in a Minnesota nursing home; new text begin in new text end an intermediate
care facility for persons with developmental disability; new text begin in new text end a hospital if the hospital owns
and operates a Minnesota nursing home and a minimum of 50 percent of the hours worked
by the nurse is in the nursing home; deleted text begin a housing with services establishmentdeleted text end new text begin in an assisted
living facility new text end as defined in section deleted text begin 144D.01deleted text end new text begin 144G.08new text end , subdivision deleted text begin 4deleted text end new text begin 7new text end ; or for a home care
provider as defined in section 144A.43, subdivision 4; or agree to teach at least 12 credit
hours, or 720 hours per year in the nursing field in a postsecondary program at the
undergraduate level or the equivalent at the graduate level;

(4) for other health care technicians agreeing to teach at least 12 credit hours, or 720
hours per year in their designated field in a postsecondary program at the undergraduate
level or the equivalent at the graduate level. The commissioner, in consultation with the
Healthcare Education-Industry Partnership, shall determine the health care fields where the
need is the greatest, including, but not limited to, respiratory therapy, clinical laboratory
technology, radiologic technology, and surgical technology;

(5) for pharmacists, advanced dental therapists, dental therapists, and public health nurses
who agree to practice in designated rural areas; and

(6) for dentists agreeing to deliver at least 25 percent of the dentist's yearly patient
encounters to state public program enrollees or patients receiving sliding fee schedule
discounts through a formal sliding fee schedule meeting the standards established by the
United States Department of Health and Human Services under Code of Federal Regulations,
title 42, section 51, chapter 303.

(b) Appropriations made to the account do not cancel and are available until expended,
except that at the end of each biennium, any remaining balance in the account that is not
committed by contract and not needed to fulfill existing commitments shall cancel to the
fund.

Sec. 7.

Minnesota Statutes 2022, section 144.1506, subdivision 4, is amended to read:

Subd. 4.

Consideration of expansion grant applications.

The commissioner shall
review each application to determine whether or not the residency program application is
complete and whether the proposed new residency program and any new residency slots
are eligible for a grant. The commissioner shall award grants to support up to six family
medicine, general internal medicine, or general pediatrics residents; deleted text begin fourdeleted text end new text begin fivenew text end psychiatry
residents; two geriatrics residents; and two general surgery residents. If insufficient
applications are received from any eligible specialty, funds may be redistributed to
applications from other eligible specialties.

Sec. 8.

new text begin [144.1509] PEDIATRIC PRIMARY CARE MENTAL HEALTH TRAINING
GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish a pediatric
primary care mental health training grant program. The commissioner shall award grants
for the development of child mental health training programs that are located in outpatient
primary care clinics. To be eligible for a grant, a training program must:
new text end

new text begin (1) focus on the training of pediatric primary care providers working with
multidisciplinary mental health teams;
new text end

new text begin (2) provide training on conducting comprehensive clinical mental health assessments
and potential pharmacological therapy;
new text end

new text begin (3) provide psychiatric consultation to pediatric primary care providers during their
outpatient pediatric primary care experiences;
new text end

new text begin (4) emphasize longitudinal care for patients with behavioral health needs; and
new text end

new text begin (5) develop partnerships with community resources.
new text end

new text begin Subd. 2.new text end

new text begin Child mental health training grant program.new text end

new text begin (a) Child mental health training
grants may be awarded to eligible primary care training programs to plan and implement
new programs or expand existing programs in child mental health training.
new text end

new text begin (b) Money may be spent to cover the costs of:
new text end

new text begin (1) planning related to implementing or expanding child mental health training in an
outpatient primary care clinic setting;
new text end

new text begin (2) training site improvements, fees, equipment, and supplies required for implementation
of the training programs; and
new text end

new text begin (3) supporting clinical training in the outpatient primary clinic sites.
new text end

new text begin Subd. 3.new text end

new text begin Applications for child mental health training grants.new text end

new text begin Eligible primary care
training programs seeking a grant must apply to the commissioner. Applications must include
the location of the training; a description of the training program, including all costs
associated with the training program; all sources of money for the training program; detailed
uses of all money for the training program; the results expected; and a plan to maintain the
training program after the grant period. The applicant must describe achievable objectives
and a timetable for the training program.
new text end

new text begin Subd. 4.new text end

new text begin Consideration of child mental health training grant applications.new text end

new text begin The
commissioner shall review each application to determine whether the application meets the
stated goals of the grant and shall award grants to support up to four training program
proposals.
new text end

new text begin Subd. 5.new text end

new text begin Program oversight.new text end

new text begin During the grant period, the commissioner may require
and collect from grantees any information necessary to evaluate the training program.
new text end

Sec. 9.

new text begin [144.1511] MENTAL HEALTH CULTURAL COMMUNITY CONTINUING
EDUCATION GRANT PROGRAM.
new text end

new text begin The mental health cultural community continuing education grant program is established
in the Department of Health to provide grants for the continuing education necessary for
social workers, marriage and family therapists, psychologists, and professional clinical
counselors to become supervisors for individuals pursuing licensure in mental health
professions. The commissioner must consult with the relevant mental health licensing boards
in creating the program. To be eligible for a grant under this section, a social worker, marriage
and family therapist, psychologist, or professional clinical counselor must:
new text end

new text begin (1) be a member of a community of color or an underrepresented community as defined
in section 148E.010, subdivision 20; and
new text end

new text begin (2) work for a community mental health provider and agree to deliver at least 25 percent
of their yearly patient encounters to state public program enrollees or patients receiving
sliding fee schedule discounts through a formal sliding fee schedule meeting the standards
established by the United States Department of Health and Human Services under Code of
Federal Regulations, title 42, section 51c.303.
new text end

Sec. 10.

new text begin [144.1913] CLINICAL DENTAL EDUCATION INNOVATION GRANTS.
new text end

new text begin (a) The commissioner of health shall award clinical dental education innovation grants
to teaching institutions and clinical training sites for projects that increase dental access for
underserved populations and promote innovative clinical training of dental professionals.
In awarding the grants, the commissioner shall consider the following:
new text end

new text begin (1) potential to successfully increase access to dental services for an underserved
population;
new text end

new text begin (2) the long-term viability of the project to improve access to dental services beyond
the period of initial funding;
new text end

new text begin (3) evidence of collaboration between the applicant and local communities;
new text end

new text begin (4) efficiency in the use of grant money; and
new text end

new text begin (5) the priority level of the project in relation to state clinical education, access, and
workforce goals.
new text end

new text begin (b) The commissioner shall periodically evaluate the priorities in awarding innovation
grants under this section to ensure that the priorities meet the changing workforce needs of
the state.
new text end

Sec. 11.

new text begin [145.9272] FEDERALLY QUALIFIED HEALTH CENTERS REGISTERED
APPRENTICESHIP GRANT PROGRAM.
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.
new text end

new text begin (b) "Apprentice" means an employee participating in a registered apprenticeship program.
new text end

new text begin (c) "Federally qualified health center" has the meaning given in section 145.9269,
subdivision 1.
new text end

new text begin (d) "Nonprofit organization of community health centers" means a nonprofit organization,
the membership of which consists of federally qualified health centers operating service
delivery sites in Minnesota and that provides services to federally qualified health centers
in Minnesota to promote the delivery of affordable, quality primary care services in the
state.
new text end

new text begin (e) "Registered apprenticeship program" means an employer or organization registered
with the Department of Labor and Industry under chapter 178.
new text end

new text begin Subd. 2.new text end

new text begin Registered apprenticeship grant program.new text end

new text begin The commissioner of health shall
distribute a grant to a nonprofit organization of community health centers for registered
apprenticeship programs in federally qualified health centers operating in Minnesota. Grant
money must be used to establish new registered apprenticeship programs and fund ongoing
costs for existing registered apprenticeship programs for medical assistants, dental assistants,
and other health care occupations at federally qualified health center service delivery sites
in Minnesota. Apprentices must be recruited from federally qualified health center staff and
from the population in the geographic area served by the federally qualified health center.
new text end

Sec. 12.

Minnesota Statutes 2022, section 245.4663, subdivision 4, is amended to read:

Subd. 4.

Allowable uses of grant funds.

A mental health provider must use grant funds
received under this section for one or more of the following:

(1) to pay for direct supervision hours new text begin or preceptorships new text end for new text begin students, new text end internsnew text begin ,new text end and clinical
trainees, in an amount up to $7,500 per new text begin student, new text end internnew text begin ,new text end or clinical trainee;

(2) to establish a program to provide supervision to multiple new text begin students, new text end internsnew text begin ,new text end or clinical
trainees; deleted text begin or
deleted text end

(3) to pay licensing application and examination fees for clinical traineesdeleted text begin .deleted text end new text begin ; or
new text end

new text begin (4) to provide a weekend training program for workers to become supervisors.
new text end

Sec. 13.

Minnesota Statutes 2022, section 256.969, subdivision 2b, is amended to read:

Subd. 2b.

Hospital payment rates.

(a) For discharges occurring on or after November
1, 2014, hospital inpatient services for hospitals located in Minnesota shall be paid according
to the following:

(1) critical access hospitals as defined by Medicare shall be paid using a cost-based
methodology;

(2) long-term hospitals as defined by Medicare shall be paid on a per diem methodology
under subdivision 25;

(3) rehabilitation hospitals or units of hospitals that are recognized as rehabilitation
distinct parts as defined by Medicare shall be paid according to the methodology under
subdivision 12; and

(4) all other hospitals shall be paid on a diagnosis-related group (DRG) methodology.

(1) pediatric services;

(2) behavioral health services;

(3) trauma services as defined by the National Uniform Billing Committee;

(4) transplant services;

(5) obstetric services, newborn services, and behavioral health services provided by
hospitals outside the seven-county metropolitan area;

(6) outlier admissions;

(7) low-volume providers; and

(8) services provided by small rural hospitals that are not critical access hospitals.

(f) Hospital payment rates established under paragraph (c) must incorporate the following:

(2) for critical access hospitals, payment rates for discharges between November 1, 2014,
and June 30, 2015, shall be set to the same rate of payment that applied for discharges on
October 31, 2014;

(3) the cost and charge data used to establish hospital payment rates must only reflect
inpatient services covered by medical assistance; and

(h) Effective for discharges occurring on or after July 1, 2017, and every two years
thereafter, payment rates under this section shall be rebased to reflect only those changes
in hospital costs between the existing base year or years and the next base year or years. In
any year that inpatient claims volume falls below the threshold required to ensure a
statistically valid sample of claims, the commissioner may combine claims data from two
consecutive years to serve as the base year. Years in which inpatient claims volume is
reduced or altered due to a pandemic or other public health emergency shall not be used as
a base year or part of a base year if the base year includes more than one year. Changes in
costs between base years shall be measured using the lower of the hospital cost index defined
in subdivision 1, paragraph (a), or the percentage change in the case mix adjusted cost per
claim. The commissioner shall establish the base year for each rebasing period considering
the most recent year or years for which filed Medicare cost reports are available. The
estimated change in the average payment per hospital discharge resulting from a scheduled
rebasing must be calculated and made available to the legislature by January 15 of each
year in which rebasing is scheduled to occur, and must include by hospital the differential
in payment rates compared to the individual hospital's costs.

(1) hospitals that had payments at or below 80 percent of their costs in the base year
shall have a rate set that equals 85 percent of their base year costs;

(2) hospitals that had payments that were above 80 percent, up to and including 90
percent of their costs in the base year shall have a rate set that equals 95 percent of their
base year costs; and

(3) hospitals that had payments that were above 90 percent of their costs in the base year
shall have a rate set that equals 100 percent of their base year costs.

(1) the ratio between the hospital's costs for treating medical assistance patients and the
hospital's charges to the medical assistance program;

(3) the ratio between the hospital's charges to the medical assistance program and the
hospital's payments received from the medical assistance program for the care of medical
assistance patients;

(4) the statewide average increases in the ratios identified in clauses (1), (2), and (3);

(5) the proportion of that hospital's costs that are administrative and trends in
administrative costs; and

(6) geographic location.

new text begin (k) Effective for discharges occurring on or after January 1, 2024, the rates paid to
hospitals described in paragraph (a), clauses (2) to (4), must include a rate factor specific
to each hospital that qualifies for a medical education and research cost distribution under
section 62J.692, subdivision 4, paragraph (a).
new text end

Sec. 14.

Minnesota Statutes 2022, section 256B.75, is amended to read:

256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.

(a) For outpatient hospital facility fee payments for services rendered on or after October
1, 1992, the commissioner of human services shall pay the lower of (1) submitted charge,
or (2) 32 percent above the rate in effect on June 30, 1992, except for those services for
which there is a federal maximum allowable payment. Effective for services rendered on
or after January 1, 2000, payment rates for nonsurgical outpatient hospital facility fees and
emergency room facility fees shall be increased by eight percent over the rates in effect on
December 31, 1999, except for those services for which there is a federal maximum allowable
payment. Services for which there is a federal maximum allowable payment shall be paid
at the lower of (1) submitted charge, or (2) the federal maximum allowable payment. Total
aggregate payment for outpatient hospital facility fee services shall not exceed the Medicare
upper limit. If it is determined that a provision of this section conflicts with existing or
future requirements of the United States government with respect to federal financial
participation in medical assistance, the federal requirements prevail. The commissioner
may, in the aggregate, prospectively reduce payment rates to avoid reduced federal financial
participation resulting from rates that are in excess of the Medicare upper limitations.

(b) Notwithstanding paragraph (a), payment for outpatient, emergency, and ambulatory
surgery hospital facility fee services for critical access hospitals designated under section
144.1483, clause (9), shall be paid on a cost-based payment system that is based on the
cost-finding methods and allowable costs of the Medicare program. Effective for services
provided on or after July 1, 2015, rates established for critical access hospitals under this
paragraph for the applicable payment year shall be the final payment and shall not be settled
to actual costs. Effective for services delivered on or after the first day of the hospital's fiscal
year ending in 2017, the rate for outpatient hospital services shall be computed using
information from each hospital's Medicare cost report as filed with Medicare for the year
that is two years before the year that the rate is being computed. Rates shall be computed
using information from Worksheet C series until the department finalizes the medical
assistance cost reporting process for critical access hospitals. After the cost reporting process
is finalized, rates shall be computed using information from Title XIX Worksheet D series.
The outpatient rate shall be equal to ancillary cost plus outpatient cost, excluding costs
related to rural health clinics and federally qualified health clinics, divided by ancillary
charges plus outpatient charges, excluding charges related to rural health clinics and federally
qualified health clinics.new text begin Effective for services delivered on or after January 1, 2024, the
rates paid to critical access hospitals under this section must be adjusted to include the
amount of any distributions under section 62J.692, subdivision 4, paragraph (a), that were
not included in the rate adjustment described under section 256.969, subdivision 2b,
paragraph (k).
new text end

(c) Effective for services provided on or after July 1, 2003, rates that are based on the
Medicare outpatient prospective payment system shall be replaced by a budget neutral
prospective payment system that is derived using medical assistance data. The commissioner
shall provide a proposal to the 2003 legislature to define and implement this provision.
When implementing prospective payment methodologies, the commissioner shall use general
methods and rate calculation parameters similar to the applicable Medicare prospective
payment systems for services delivered in outpatient hospital and ambulatory surgical center
settings unless other payment methodologies for these services are specified in this chapter.

(d) For fee-for-service services provided on or after July 1, 2002, the total payment,
before third-party liability and spenddown, made to hospitals for outpatient hospital facility
services is reduced by .5 percent from the current statutory rate.

(e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
services provided on or after July 1, 2003, made to hospitals for outpatient hospital facility
services before third-party liability and spenddown, is reduced five percent from the current
statutory rates. Facilities defined under section 256.969, subdivision 16, are excluded from
this paragraph.

(f) In addition to the reductions in paragraphs (d) and (e), the total payment for
fee-for-service services provided on or after July 1, 2008, made to hospitals for outpatient
hospital facility services before third-party liability and spenddown, is reduced three percent
from the current statutory rates. Mental health services and facilities defined under section
256.969, subdivision 16, are excluded from this paragraph.

Sec. 15.

Minnesota Statutes 2022, section 297F.10, subdivision 1, is amended to read:

Subdivision 1.

Tax and use tax on cigarettes.

Revenue received from cigarette taxes,
as well as related penalties, interest, license fees, and miscellaneous sources of revenue
shall be deposited by the commissioner in the state treasury and credited as follows:

(1) $22,250,000 each year must be credited to the Academic Health Center special
revenue fund hereby created and is annually appropriated to the Board of Regents at the
University of Minnesota for Academic Health Center funding at the University of Minnesota;
and

(2) deleted text begin $3,937,000deleted text end new text begin $3,788,000new text end each year must be credited to the medical education and
research costs account hereby created in the special revenue fund and is annually appropriated
to the commissioner of health for distribution under section 62J.692, subdivision 4new text begin , paragraph
(a)new text end ; and

(3) the balance of the revenues derived from taxes, penalties, and interest (under this
chapter) and from license fees and miscellaneous sources of revenue shall be credited to
the general fund.

Sec. 16. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2022, sections 62J.692, subdivisions 4a, 7, and 7a; 137.38, subdivision
1; and 256B.69, subdivision 5c,new text end new text begin are repealed.
new text end

ARTICLE 6

HEALTH-RELATED LICENSING BOARDS

Section 1.

Minnesota Statutes 2022, section 144E.001, subdivision 1, is amended to read:

Subdivision 1.

Scope.

For the purposes of deleted text begin sections 144E.001 to 144E.52deleted text end new text begin this chapternew text end ,
the terms defined in this section have the meanings given them.

Sec. 2.

Minnesota Statutes 2022, section 144E.001, is amended by adding a subdivision
to read:

new text begin Subd. 8b.new text end

new text begin Medical resource communication center.new text end

new text begin "Medical resource communication
center" means an entity that:
new text end

new text begin (1) facilitates hospital-to-ambulance communications for ambulance services, the regional
emergency medical services systems, and the board by coordinating patient care and
transportation for ground and air operations;
new text end

new text begin (2) is integrated with the state's Allied Radio Matrix for Emergency Response (ARMER)
radio system; and
new text end

new text begin (3) is the point of contact and a communication resource for statewide public safety
entities, hospitals, and communities.
new text end

Sec. 3.

Minnesota Statutes 2022, section 144E.101, subdivision 6, is amended to read:

Subd. 6.

Basic life support.

(a) Except as provided in paragraph deleted text begin (e)deleted text end new text begin (f)new text end , a basic
life-support ambulance shall be staffed by at least two EMTs, one of whom must accompany
the patient and provide a level of care so as to ensure that:

(1) life-threatening situations and potentially serious injuries are recognized;

(2) patients are protected from additional hazards;

(3) basic treatment to reduce the seriousness of emergency situations is administered;
and

(4) patients are transported to an appropriate medical facility for treatment.

(b) A basic life-support service shall provide basic airway management.

new text begin (d) A basic life-support service shall administer opiate antagonists consistent with
protocols established by the service's medical director.
new text end

deleted text begin (d)deleted text end new text begin (e)new text end A basic life-support service licensee's medical director may authorize ambulance
service personnel to perform intravenous infusion and use equipment that is within the
licensure level of the ambulance servicedeleted text begin , including administration of an opiate antagonistdeleted text end .
Ambulance service personnel must be properly trained. Documentation of authorization for
use, guidelines for use, continuing education, and skill verification must be maintained in
the licensee's files.

deleted text begin (e)deleted text end new text begin (f)new text end For emergency ambulance calls and interfacility transfers, an ambulance service
may staff its basic life-support ambulances with one EMT, who must accompany the patient,
and one registered emergency medical responder driver. For purposes of this paragraph,
"ambulance service" means either an ambulance service whose primary service area is
mainly located outside the metropolitan counties listed in section 473.121, subdivision 4,
and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud; or an
ambulance service based in a community with a population of less than 2,500.

Sec. 4.

Minnesota Statutes 2022, section 144E.101, subdivision 7, is amended to read:

Subd. 7.

Advanced life support.

(a) Except as provided in paragraphs (f) and (g), an
advanced life-support ambulance shall be staffed by at least:

(1) one EMT or one AEMT and one paramedic;

(2) one EMT or one AEMT and one registered nurse who is an EMT or an AEMT, is
currently practicing nursing, and has passed a paramedic practical skills test approved by
the board and administered by an education program; or

(3) one EMT or one AEMT and one physician assistant who is an EMT or an AEMT,
is currently practicing as a physician assistant, and has passed a paramedic practical skills
test approved by the board and administered by an education program.

(b) An advanced life-support service shall provide basic life support, as specified under
subdivision 6, paragraph (a), advanced airway management, manual defibrillation, deleted text begin anddeleted text end
administration of intravenous fluids and pharmaceuticalsnew text begin , and administration of opiate
antagonistsnew text end .

(c) In addition to providing advanced life support, an advanced life-support service may
staff additional ambulances to provide basic life support according to subdivision 6 and
section 144E.103, subdivision 1.

(d) An ambulance service providing advanced life support shall have a written agreement
with its medical director to ensure medical control for patient care 24 hours a day, seven
days a week. The terms of the agreement shall include a written policy on the administration
of medical control for the service. The policy shall address the following issues:

(1) two-way communication for physician direction of ambulance service personnel;

(2) patient triage, treatment, and transport;

(3) use of standing orders; and

(4) the means by which medical control will be provided 24 hours a day.

The agreement shall be signed by the licensee's medical director and the licensee or the
licensee's designee and maintained in the files of the licensee.

(e) When an ambulance service provides advanced life support, the authority of a
paramedic, Minnesota registered nurse-EMT, or Minnesota registered physician
assistant-EMT to determine the delivery of patient care prevails over the authority of an
EMT.

(f) Upon application from an ambulance service that includes evidence demonstrating
hardship, the board may grant a variance from the staff requirements in paragraph (a), clause
(1), and may authorize an advanced life-support ambulance to be staffed by a registered
emergency medical responder driver with a paramedic for all emergency calls and interfacility
transfers. The variance shall apply to advanced life-support ambulance services until the
ambulance service renews its license. When the variance expires, an ambulance service
may apply for a new variance under this paragraph. This paragraph applies only to an
ambulance service whose primary service area is mainly located outside the metropolitan
counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato,
Moorhead, Rochester, and St. Cloud, or an ambulance based in a community with a
population of less than 1,000 persons.

(g) After an initial emergency ambulance call, each subsequent emergency ambulance
response, until the initial ambulance is again available, and interfacility transfers, may be
staffed by one registered emergency medical responder driver and an EMT or paramedic.
This paragraph applies only to an ambulance service whose primary service area is mainly
located outside the metropolitan counties listed in section 473.121, subdivision 4, and outside
the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud, or an ambulance based
in a community with a population of less than 1,000 persons.

Sec. 5.

Minnesota Statutes 2022, section 144E.101, subdivision 12, is amended to read:

Subd. 12.

Mutual aid agreement.

(a) A licensee shall have a written agreement with
at least one neighboring licensed ambulance service for the preplanned and organized
response of emergency medical services, and other emergency personnel and equipment,
to a request for assistance in an emergency when local ambulance transport resources have
been expended. The response is predicated upon formal agreements among participating
ambulance services. A copy of each mutual aid agreement shall be maintained in the files
of the licenseenew text begin and shall be filed with the board for informational purposes onlynew text end .

(b) A licensee may have a written agreement with a neighboring licensed ambulance
service, including a licensed ambulance service from a neighboring state if that service is
currently and remains in compliance with its home state licensing requirements, to provide
deleted text begin part-timedeleted text end support to the primary service area of the licensee upon the licensee's request. The
agreement may allow the licensee to suspend ambulance services in its primary service area
during the times the neighboring licensed ambulance service has agreed to provide all
emergency services to the licensee's primary service area. The agreement may deleted text begin notdeleted text end permit
the neighboring licensed ambulance service to serve the licensee's primary service area fordeleted text begin
more than 12deleted text end new text begin up to 24new text end hours per daynew text begin , provided service by the neighboring licensed ambulance
service does not exceed 108 hours per calendar weeknew text end . This paragraph applies only to an
ambulance service whose primary service area is mainly located outside the metropolitan
counties listed in section 473.121, subdivision 4, and outside the cities of Duluth, Mankato,
Moorhead, Rochester, and St. Cloud, or an ambulance based in a community with a
population of less than 2,500 persons.

Sec. 6.

Minnesota Statutes 2022, section 144E.103, subdivision 1, is amended to read:

Subdivision 1.

General requirements.

Every ambulance in service for patient care shall
carry, at a minimum:

(1) oxygen;

(2) airway maintenance equipment in various sizes to accommodate all age groups;

(3) splinting equipment in various sizes to accommodate all age groups;

(4) dressings, bandages, commercially manufactured tourniquets, and bandaging
equipment;

(5) an emergency obstetric kit;

(6) equipment to determine vital signs in various sizes to accommodate all age groups;

(7) a stretcher;

(8) a defibrillator; deleted text begin and
deleted text end

(9) a fire extinguisherdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (10) opiate antagonists.
new text end

Sec. 7.

Minnesota Statutes 2022, section 144E.35, is amended to read:

144E.35 REIMBURSEMENT TO deleted text begin NONPROFITdeleted text end AMBULANCE SERVICESnew text begin FOR
VOLUNTEER EDUCATION COSTSnew text end .

Subdivision 1.

Repayment for volunteer education.

A licensed ambulance service
shall be reimbursed by the board for the necessary expense of the initial education of a
volunteer ambulance attendant upon successful completion by the attendant of an EMT
education course, or a continuing education course for EMT care, or both, which has been
approved by the board, pursuant to section 144E.285. Reimbursement may include tuition,
transportation, food, lodging, hourly payment for the time spent in the education course,
and other necessary expenditures, except that in no instance shall a volunteer ambulance
attendant be reimbursed more than deleted text begin $600deleted text end new text begin $900new text end for successful completion of an initial
education course, and deleted text begin $275deleted text end new text begin $375new text end for successful completion of a continuing education course.

Subd. 2.

Reimbursement provisions.

Reimbursement deleted text begin willdeleted text end new text begin mustnew text end be paid under provisions
of this section when documentation is provided new text begin to new text end the board that the individual has served
for one year from the date of the final certification exam as an active member of a Minnesota
licensed ambulance service.

Sec. 8.

new text begin [144E.53] MEDICAL RESOURCE COMMUNICATION CENTER GRANTS.
new text end

new text begin The board shall distribute medical resource communication center grants annually to
the two medical resource communication centers that were in operation in the state prior to
January 1, 2000.
new text end

Sec. 9.

Minnesota Statutes 2022, section 147.02, subdivision 1, is amended to read:

Subdivision 1.

United States or Canadian medical school graduates.

The board shall
issue a license to practice medicine to a person not currently licensed in another state or
Canada and who meets the requirements in paragraphs (a) to (i).

(a) An applicant for a license shall file a written application on forms provided by the
board, showing to the board's satisfaction that the applicant is of good moral character and
satisfies the requirements of this section.

(b) The applicant shall present evidence satisfactory to the board of being a graduate of
a medical or osteopathic medical school located in the United States, its territories or Canada,
and approved by the board based upon its faculty, curriculum, facilities, accreditation by a
recognized national accrediting organization approved by the board, and other relevant data,
or is currently enrolled in the final year of study at the school.

(1) The applicant must have passed a comprehensive examination for initial licensure
prepared and graded by the National Board of Medical Examiners, the Federation of State
Medical Boards, the Medical Council of Canada, the National Board of Osteopathic
Examiners, or the appropriate state board that the board determines acceptable. The board
shall by rule determine what constitutes a passing score in the examination.

(2) The applicant taking the United States Medical Licensing Examination (USMLE)
or Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) must
have passed steps or levels one, two, and three. Step or level three must be passed within
five years of passing step or level two, or before the end of residency training. The applicant
must pass each of steps or levels one, two, and three with passing scores as recommended
by the USMLE program or National Board of Osteopathic Medical Examiners within three
attempts. The applicant taking combinations of Federation of State Medical Boards, National
Board of Medical Examiners, and USMLE may be accepted only if the combination is
approved by the board as comparable to existing comparable examination sequences and
all examinations are completed prior to the year 2000.

(d) The applicant shall present evidence satisfactory to the board of the completion of
one year of graduate, clinical medical training in a program accredited by a national
accrediting organization approved by the board deleted text begin or other graduate training approved in
advance by the board as meeting standards similar to those of a national accrediting
organizationdeleted text end .

(e) The applicant may make arrangements with the executive director to appear in person
before the board or its designated representative to show that the applicant satisfies the
requirements of this section. The board may establish as internal operating procedures the
procedures or requirements for the applicant's personal presentation.

(f) The applicant shall pay a nonrefundable fee established by the board. Upon application
or notice of license renewal, the board must provide notice to the applicant and to the person
whose license is scheduled to be issued or renewed of any additional fees, surcharges, or
other costs which the person is obligated to pay as a condition of licensure. The notice must:

(1) state the dollar amount of the additional costs; and

(2) clearly identify to the applicant the payment schedule of additional costs.

(g) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(h) The applicant must not have engaged in conduct warranting disciplinary action
against a licensee, or have been subject to disciplinary action other than as specified in
paragraph (g). If the applicant does not satisfy the requirements stated in this paragraph,
the board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions and limitations the board considers appropriate.

(i) If the examination in paragraph (c) was passed more than ten years ago, the applicant
must either:

(1) pass the special purpose examination of the Federation of State Medical Boards with
a score of 75 or better within three attempts; or

(2) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada.

Sec. 10.

Minnesota Statutes 2022, section 147.03, subdivision 1, is amended to read:

Subdivision 1.

Endorsement; reciprocity.

(a) The board may issue a license to practice
medicine to any person who satisfies the requirements in paragraphs (b) to (e).

(b) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1, paragraphs (a), (b), (d), (e), and (f), or section 147.037, subdivision 1,
paragraphs (a) to (e).

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the National Board of Medical Examiners, or the United States Medical Licensing
Examination (USMLE) program in accordance with section 147.02, subdivision 1, paragraph
(c), clause (2); the National Board of Osteopathic Medical Examiners; or the Medical Council
of Canada; and

(2) have a current license from the equivalent licensing agency in another state or Canada
and, if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards deleted text begin with
a score of 75 or betterdeleted text end new text begin (SPEX) new text end within three attempts; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, of the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or of the College of Family Physicians of Canada; or

(3) if the applicant fails to meet the requirement established in section 147.02, subdivision
1, paragraph (c), clause (2), because the applicant failed to pass new text begin within the permitted three
attempts new text end each of steps new text begin or levels new text end one, two, and three of the USMLE deleted text begin within the required three
attemptsdeleted text end new text begin or the Comprehensive Osteopathic Medical Licensing Examination
(COMLEX-USA)new text end , the applicant may be granted a license provided the applicant:

(i) has passed each of steps new text begin or levels new text end one, two, and three new text begin within no more than four attempts
for any of the three steps or levels new text end with passing scores as recommended by the USMLE new text begin or
COMLEX-USA new text end program deleted text begin within no more than four attempts for any of the three stepsdeleted text end ;

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association deleted text begin Bureau of Professional Educationdeleted text end , the
Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians
of Canada.

(d) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(e) The applicant must not have engaged in conduct warranting disciplinary action against
a licensee, or have been subject to disciplinary action other than as specified in paragraph
(d). If an applicant does not satisfy the requirements stated in this paragraph, the board may
issue a license only on the applicant's showing that the public will be protected through
issuance of a license with conditions or limitations the board considers appropriate.

(f) Upon the request of an applicant, the board may conduct the final interview of the
applicant by teleconference.

Sec. 11.

Minnesota Statutes 2022, section 147.037, subdivision 1, is amended to read:

Subdivision 1.

Requirements.

The board shall issue a license to practice medicine to
any person who satisfies the requirements in paragraphs (a) to (g).

(a) The applicant shall satisfy all the requirements established in section 147.02,
subdivision 1, paragraphs (a), (e), (f), (g), and (h).

(b) The applicant shall present evidence satisfactory to the board that the applicant is a
graduate of a medical or osteopathic school approved by the board as equivalent to accredited
United States or Canadian schools based upon its faculty, curriculum, facilities, accreditation,
or other relevant data. If the applicant is a graduate of a medical or osteopathic program
that is not accredited by the Liaison Committee for Medical Education or the American
Osteopathic Association, the applicant may use the Federation of State Medical Boards'
Federation Credentials Verification Service (FCVS) or its successor. If the applicant uses
this service as allowed under this paragraph, the physician application fee may be less than
$200 but must not exceed the cost of administering this paragraph.

(c) The applicant shall present evidence satisfactory to the board that the applicant has
been awarded a certificate by the Educational Council for Foreign Medical Graduates, and
the applicant has a working ability in the English language sufficient to communicate with
patients and physicians and to engage in the practice of medicine.

(1) deleted text begin to an applicantdeleted text end who deleted text begin isdeleted text end new text begin wasnew text end admitted as a permanent immigrant to the United States
on or before October 1, 1991, as a person of exceptional ability in the sciences according
to Code of Federal Regulations, title 20, section 656.22(d); or

(2) deleted text begin to an applicant holdingdeleted text end new text begin who holdsnew text end a valid license to practice medicine in another
country and new text begin was new text end issued a permanent immigrant visa after October 1, 1991, as a person of
extraordinary ability in the field of science or as an outstanding professor or researcher
according to Code of Federal Regulations, title 8, section 204.5(h) and (i), or a temporary
nonimmigrant visa as a person of extraordinary ability in the field of science according to
Code of Federal Regulations, title 8, section 214.2(o)deleted text begin ,deleted text end new text begin .
new text end

deleted text begin provided that a person under clause (1) or (2) is admitted pursuant to rules of the United
States Department of Labor.
deleted text end

(e) The applicant must:

(1) have passed an examination prepared and graded by the Federation of State Medical
Boards, the United States Medical Licensing Examinationnew text begin (USMLE)new text end program in accordance
with section 147.02, subdivision 1, paragraph (c), clause (2), or the Medical Council of
Canada; and

(2) if the examination in clause (1) was passed more than ten years ago, either:

(i) pass the Special Purpose Examination of the Federation of State Medical Boards deleted text begin with
a score of 75 or better within three attemptsdeleted text end new text begin (SPEX) or the Comprehensive Osteopathic
Medical Variable-Purpose Examination of the National Board of Osteopathic Medical
Examiners (COMVEX). The applicant must pass the SPEX or COMVEX within no more
than three attempts of taking the SPEX, COMVEX, or a combination of the SPEX and
COMVEXnew text end ; or

(ii) have a current certification by a specialty board of the American Board of Medical
Specialties, deleted text begin ofdeleted text end the American Osteopathic Association, deleted text begin ofdeleted text end the Royal College of Physicians
and Surgeons of Canada, or deleted text begin ofdeleted text end the College of Family Physicians of Canada; or

(ii) is currently licensed in another state; and

(iii) has current certification by a specialty board of the American Board of Medical
Specialties, the American Osteopathic Association, the Royal College of Physicians and
Surgeons of Canada, or the College of Family Physicians of Canada.

(f) The applicant must not be under license suspension or revocation by the licensing
board of the state or jurisdiction in which the conduct that caused the suspension or revocation
occurred.

(g) The applicant must not have engaged in conduct warranting disciplinary action
against a licenseedeleted text begin ,deleted text end or have been subject to disciplinary action other than as specified in
paragraph (f). If an applicant does not satisfy the requirements stated in this paragraph, the
board may issue a license only on the applicant's showing that the public will be protected
through issuance of a license with conditions or limitations the board considers appropriate.

Sec. 12.

Minnesota Statutes 2022, section 147.141, is amended to read:

147.141 FORMS OF DISCIPLINARY ACTION.

When the board finds that a licensed physician or a physician registered under section
147.032 has violated a provision or provisions of sections 147.01 to 147.22, it may do one
or more of the following:

(1) revoke the license;

(2) suspend the license;

(3) revoke or suspend registration to perform interstate telehealth;

(4) impose limitations or conditions on the physician's practice of medicine, including
new text begin limiting new text end the deleted text begin limitation ofdeleted text end scope of practice to designated field specialties; deleted text begin the imposition ofdeleted text end new text begin
imposingnew text end retraining or rehabilitation requirements; deleted text begin the requirement ofdeleted text end new text begin requiringnew text end practice
under supervision; or deleted text begin thedeleted text end conditioning deleted text begin ofdeleted text end continued practice on demonstration of knowledge
or skills by appropriate examination or other review of skill and competence;

(5) impose a civil penalty not exceeding $10,000 for each separate violation, the amount
of the civil penalty to be fixed deleted text begin so asdeleted text end to deprive the physician of any economic advantage
gained by reason of the violation charged or to reimburse the board for the cost of the
investigation and proceeding;

(6) order the physician to provide unremunerated professional service under supervision
at a designated public hospital, clinic, or other health care institution; or

(7) censure or reprimand the licensed physician.

Sec. 13.

Minnesota Statutes 2022, section 147A.16, is amended to read:

147A.16 FORMS OF DISCIPLINARY ACTION.

new text begin (a) new text end When the board finds that a licensed physician assistant has violated a provision of
this chapter, it may do one or more of the following:

(1) revoke the license;

(2) suspend the license;

(3) impose limitations or conditions on the physician assistant's practice, including
limiting the scope of practice to designated field specialties; imposing retraining or
rehabilitation requirements; or limiting practice until demonstration of knowledge or skills
by appropriate examination or other review of skill and competence;

(4) impose a civil penalty not exceeding $10,000 for each separate violation, the amount
of the civil penalty to be fixed deleted text begin so asdeleted text end to deprive the physician assistant of any economic
advantage gained by reason of the violation charged or to reimburse the board for the cost
of the investigation and proceeding; or

(5) censure or reprimand the licensed physician assistant.

new text begin (b) new text end Upon judicial review of any board disciplinary action taken under this chapter, the
reviewing court shall seal the administrative record, except for the board's final decision,
and shall not make the administrative record available to the public.

Sec. 14.

Minnesota Statutes 2022, section 147B.02, subdivision 4, is amended to read:

Subd. 4.

Exceptions.

(a) The following persons may practice acupuncture within the
scope of their practice without an acupuncture license:

(1) a physician licensed under chapter 147;

(2) an osteopathic physician licensed under chapter 147;

(3) a chiropractor licensed under chapter 148;

deleted text begin (4) a person who is studying in a formal course of study or tutorial intern program
approved by the acupuncture advisory council established in section 147B.05 so long as
the person's acupuncture practice is supervised by a licensed acupuncturist or a person who
is exempt under clause (5);
deleted text end

new text begin (4) a person who is studying in a formal course of study so long as the person's
acupuncture practice is supervised by a licensed acupuncturist or a person who is exempt
under clause (5);
new text end

(5) a visiting acupuncturist practicing acupuncture within an instructional setting for the
sole purpose of teaching at a school registered with the Minnesota Office of Higher
Education, who may practice without a license for a period of one year, with two one-year
extensions permitted; and

(6) a visiting acupuncturist who is in the state for the sole purpose of providing a tutorial
or workshop not to exceed 30 days in one calendar year.

(b) This chapter does not prohibit a person who does not have an acupuncturist license
from practicing specific noninvasive techniques, such as acupressure, that are within the
scope of practice as set forth in section 147B.06, subdivision 4.

Sec. 15.

Minnesota Statutes 2022, section 147B.02, subdivision 7, is amended to read:

Subd. 7.

Licensure requirements.

(a) deleted text begin After June 30, 1997,deleted text end An applicant for licensure
must:

(1) submit a completed application for licensure on forms provided by the board, which
must include the applicant's name and address of record, which shall be public;

(2) unless licensed under subdivision 5 or 6, submit deleted text begin a notarized copy of adeleted text end new text begin evidence
satisfactory to the board ofnew text end current NCCAOM certification;

(3) sign a statement that the information in the application is true and correct to the best
of the applicant's knowledge and belief;

(4) submit with the application all fees required; and

(5) sign a waiver authorizing the board to obtain access to the applicant's records in this
state or any state in which the applicant has engaged in the practice of acupuncture.

(b) The board may ask the applicant to provide any additional information necessary to
ensure that the applicant is able to practice with reasonable skill and safety to the public.

(c) The board may investigate information provided by an applicant to determine whether
the information is accurate and complete. The board shall notify an applicant of action taken
on the application and the reasons for denying licensure if licensure is denied.

Sec. 16.

new text begin [148.635] FEE.
new text end

new text begin The fee for verification of licensure is $20. The fee is nonrefundable.
new text end

Sec. 17.

Minnesota Statutes 2022, section 148B.392, subdivision 2, is amended to read:

Subd. 2.

Licensure and application fees.

Licensure and application fees established
by the board shall not exceed the following amounts:

(1) application fee for national examination is deleted text begin $110deleted text end new text begin $150new text end ;

(2) application fee for Licensed Marriage and Family Therapist (LMFT) state examination
is deleted text begin $110deleted text end new text begin $150new text end ;

(3) initial LMFT license fee is prorated, but cannot exceed deleted text begin $125deleted text end new text begin $225new text end ;

(4) annual renewal fee for LMFT license is deleted text begin $125deleted text end new text begin $225new text end ;

(5) late fee for LMFT license renewal is deleted text begin $50deleted text end new text begin $100new text end ;

(6) application fee for LMFT licensure by reciprocity is deleted text begin $220deleted text end new text begin $300new text end ;

(7) fee for initial Licensed Associate Marriage and Family Therapist (LAMFT) license
is deleted text begin $75deleted text end new text begin $100new text end ;

(8) annual renewal fee for LAMFT license is deleted text begin $75deleted text end new text begin $100new text end ;

(9) late fee for LAMFT renewal is deleted text begin $25deleted text end new text begin $50new text end ;

(10) fee for reinstatement of license is $150;

(11) fee for emeritus status is deleted text begin $125deleted text end new text begin $225new text end ; and

(12) fee for temporary license for members of the military is $100.

Sec. 18.

Minnesota Statutes 2022, section 150A.08, subdivision 1, is amended to read:

Subdivision 1.

Grounds.

The board may refuse or by order suspend or revoke, limit or
modify by imposing conditions it deems necessary, the license of a dentist, dental therapist,
dental hygienist, or dental deleted text begin assistingdeleted text end new text begin assistantnew text end upon any of the following grounds:

(1) fraud or deception in connection with the practice of dentistry or the securing of a
license certificate;

(2) conviction, including a finding or verdict of guilt, an admission of guilt, or a no
contest plea, in any court of a felony or gross misdemeanor reasonably related to the practice
of dentistry as evidenced by a certified copy of the conviction;

(3) conviction, including a finding or verdict of guilt, an admission of guilt, or a no
contest plea, in any court of an offense involving moral turpitude as evidenced by a certified
copy of the conviction;

(4) habitual overindulgence in the use of intoxicating liquors;

(5) improper or unauthorized prescription, dispensing, administering, or personal or
other use of any legend drug as defined in chapter 151, of any chemical as defined in chapter
151, or of any controlled substance as defined in chapter 152;

(6) conduct unbecoming a person licensed to practice dentistry, dental therapy, dental
hygiene, or dental assisting, or conduct contrary to the best interest of the public, as such
conduct is defined by the rules of the board;

(7) gross immorality;

(8) any physical, mental, emotional, or other disability which adversely affects a dentist's,
dental therapist's, dental hygienist's, or dental assistant's ability to perform the service for
which the person is licensed;

(9) revocation or suspension of a license or equivalent authority to practice, or other
disciplinary action or denial of a license application taken by a licensing or credentialing
authority of another state, territory, or country as evidenced by a certified copy of the
licensing authority's order, if the disciplinary action or application denial was based on facts
that would provide a basis for disciplinary action under this chapter and if the action was
taken only after affording the credentialed person or applicant notice and opportunity to
refute the allegations or pursuant to stipulation or other agreement;

(10) failure to maintain adequate safety and sanitary conditions for a dental office in
accordance with the standards established by the rules of the board;

(11) employing, assisting, or enabling in any manner an unlicensed person to practice
dentistry;

(12) failure or refusal to attend, testify, and produce records as directed by the board
under subdivision 7;

(13) violation of, or failure to comply with, any other provisions of sections 150A.01 to
150A.12, the rules of the Board of Dentistry, or any disciplinary order issued by the board,
sections 144.291 to 144.298 or 595.02, subdivision 1, paragraph (d), or for any other just
cause related to the practice of dentistry. Suspension, revocation, modification or limitation
of any license shall not be based upon any judgment as to therapeutic or monetary value of
any individual drug prescribed or any individual treatment rendered, but only upon a repeated
pattern of conduct;

(14) knowingly providing false or misleading information that is directly related to the
care of that patient unless done for an accepted therapeutic purpose such as the administration
of a placebo; or

(15) aiding suicide or aiding attempted suicide in violation of section 609.215 as
established by any of the following:

(i) a copy of the record of criminal conviction or plea of guilty for a felony in violation
of section 609.215, subdivision 1 or 2;

(ii) a copy of the record of a judgment of contempt of court for violating an injunction
issued under section 609.215, subdivision 4;

(iii) a copy of the record of a judgment assessing damages under section 609.215,
subdivision 5; or

(iv) a finding by the board that the person violated section 609.215, subdivision 1 or 2.
The board shall investigate any complaint of a violation of section 609.215, subdivision 1
or 2.

Sec. 19.

Minnesota Statutes 2022, section 150A.08, subdivision 5, is amended to read:

Subd. 5.

Medical examinations.

If the board has probable cause to believe that a dentist,
dental therapist, dental hygienist, dental assistant, or applicant engages in acts described in
subdivision 1, clause (4) or (5), or has a condition described in subdivision 1, clause (8), it
shall direct the dentist, dental therapist, dental hygienist, new text begin dental new text end assistant, or applicant to
submit to a mental or physical examination or a substance use disorder assessment. For the
purpose of this subdivision, every dentist, dental therapist, dental hygienist, or dental assistant
licensed under this chapter or person submitting an application for a license is deemed to
have given consent to submit to a mental or physical examination when directed in writing
by the board and to have waived all objections in any proceeding under this section to the
admissibility of the examining physician's testimony or examination reports on the ground
that they constitute a privileged communication. Failure to submit to an examination without
just cause may result in an application being denied or a default and final order being entered
without the taking of testimony or presentation of evidence, other than evidence which may
be submitted by affidavit, that the licensee or applicant did not submit to the examination.
A dentist, dental therapist, dental hygienist, dental assistant, or applicant affected under this
section shall at reasonable intervals be afforded an opportunity to demonstrate ability to
start or resume the competent practice of dentistry or perform the duties of a dental therapist,
dental hygienist, or dental assistant with reasonable skill and safety to patients. In any
proceeding under this subdivision, neither the record of proceedings nor the orders entered
by the board is admissible, is subject to subpoena, or may be used against the dentist, dental
therapist, dental hygienist, dental assistant, or applicant in any proceeding not commenced
by the board. Information obtained under this subdivision shall be classified as private
pursuant to the Minnesota Government Data Practices Act.

Sec. 20.

Minnesota Statutes 2022, section 150A.091, is amended by adding a subdivision
to read:

new text begin Subd. 23.new text end

new text begin Mailing list services.new text end

new text begin Each licensee must submit a nonrefundable $5 fee to
request a mailing address list.
new text end

Sec. 21.

Minnesota Statutes 2022, section 150A.13, subdivision 10, is amended to read:

Subd. 10.

Failure to report.

deleted text begin On or after August 1, 2012,deleted text end Any person, institution, insurer,
or organization that fails to report as required under subdivisions 2 to 6 shall be subject to
civil penalties for failing to report as required by law.

Sec. 22.

Minnesota Statutes 2022, section 151.065, subdivision 1, is amended to read:

Subdivision 1.

Application fees.

Application fees for licensure and registration are as
follows:

(1) pharmacist licensed by examination, deleted text begin $175deleted text end new text begin $225new text end ;

(2) pharmacist licensed by reciprocity, deleted text begin $275deleted text end new text begin $300new text end ;

(3) pharmacy intern, deleted text begin $50deleted text end new text begin $75new text end ;

(4) pharmacy technician, deleted text begin $50deleted text end new text begin $60new text end ;

(5) pharmacy, deleted text begin $260deleted text end new text begin $450new text end ;

(6) drug wholesaler, legend drugs only, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(7) drug wholesaler, legend and nonlegend drugs, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(8) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(9) drug wholesaler, medical gases, deleted text begin $5,260deleted text end new text begin $5,500new text end for the first facility and deleted text begin $260deleted text end new text begin $500new text end
for each additional facility;

(10) third-party logistics provider, deleted text begin $260deleted text end new text begin $300new text end ;

(11) drug manufacturer, nonopiate legend drugs only, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(12) drug manufacturer, nonopiate legend and nonlegend drugs, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(13) drug manufacturer, nonlegend or veterinary legend drugs, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(14) drug manufacturer, medical gases, deleted text begin $5,260deleted text end new text begin $5,500new text end for the first facility and deleted text begin $260deleted text end new text begin
$500new text end for each additional facility;

(15) drug manufacturer, also licensed as a pharmacy in Minnesota, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(16) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, deleted text begin $55,260deleted text end new text begin $55,500new text end ;

(17) medical gas dispenser, deleted text begin $260deleted text end new text begin $400new text end ;

(18) controlled substance researcher, deleted text begin $75deleted text end new text begin $150new text end ; and

(19) pharmacy professional corporation, $150.

Sec. 23.

Minnesota Statutes 2022, section 151.065, subdivision 2, is amended to read:

Subd. 2.

Original license fee.

The pharmacist original licensure fee, deleted text begin $175deleted text end new text begin $225new text end .

Sec. 24.

Minnesota Statutes 2022, section 151.065, subdivision 3, is amended to read:

Subd. 3.

Annual renewal fees.

Annual licensure and registration renewal fees are as
follows:

(1) pharmacist, deleted text begin $175deleted text end new text begin $225new text end ;

(2) pharmacy technician, deleted text begin $50deleted text end new text begin $60new text end ;

(3) pharmacy, deleted text begin $260deleted text end new text begin $450new text end ;

(4) drug wholesaler, legend drugs only, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(5) drug wholesaler, legend and nonlegend drugs, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(6) drug wholesaler, nonlegend drugs, veterinary legend drugs, or both, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(7) drug wholesaler, medical gases, deleted text begin $5,260deleted text end new text begin $5,500new text end for the first facility and deleted text begin $260deleted text end new text begin $500new text end
for each additional facility;

(8) third-party logistics provider, deleted text begin $260deleted text end new text begin $300new text end ;

(9) drug manufacturer, nonopiate legend drugs only, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(10) drug manufacturer, nonopiate legend and nonlegend drugs, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(11) drug manufacturer, nonlegend, veterinary legend drugs, or both, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(12) drug manufacturer, medical gases, deleted text begin $5,260deleted text end new text begin $5,500new text end for the first facility and deleted text begin $260deleted text end new text begin
$500new text end for each additional facility;

(13) drug manufacturer, also licensed as a pharmacy in Minnesota, deleted text begin $5,260deleted text end new text begin $5,500new text end ;

(14) drug manufacturer of opiate-containing controlled substances listed in section
152.02, subdivisions 3 to 5, deleted text begin $55,260deleted text end new text begin $55,500new text end ;

(15) medical gas dispenser, deleted text begin $260deleted text end new text begin $400new text end ;

(16) controlled substance researcher, deleted text begin $75deleted text end new text begin $150new text end ; and

(17) pharmacy professional corporation, deleted text begin $100deleted text end new text begin $150new text end .

Sec. 25.

Minnesota Statutes 2022, section 151.065, subdivision 4, is amended to read:

Subd. 4.

Miscellaneous fees.

Fees for issuance of affidavits and duplicate licenses and
certificates are as follows:

(1) intern affidavit, deleted text begin $20deleted text end new text begin $30new text end ;

(2) duplicate small license, deleted text begin $20deleted text end new text begin $30new text end ; and

(3) duplicate large certificate, $30.

Sec. 26.

Minnesota Statutes 2022, section 151.065, subdivision 6, is amended to read:

Subd. 6.

Reinstatement fees.

(a) A pharmacist who has allowed the pharmacist's license
to lapse may reinstate the license with board approval and upon payment of any fees and
late fees in arrears, up to a maximum of $1,000.

(b) A pharmacy technician who has allowed the technician's registration to lapse may
reinstate the registration with board approval and upon payment of any fees and late fees
in arrears, up to a maximum of deleted text begin $90deleted text end new text begin $250new text end .

(c) An owner of a pharmacy, a drug wholesaler, a drug manufacturer, third-party logistics
provider, or a medical gas dispenser who has allowed the license of the establishment to
lapse may reinstate the license with board approval and upon payment of any fees and late
fees in arrears.

(d) A controlled substance researcher who has allowed the researcher's registration to
lapse may reinstate the registration with board approval and upon payment of any fees and
late fees in arrears.

(e) A pharmacist owner of a professional corporation who has allowed the corporation's
registration to lapse may reinstate the registration with board approval and upon payment
of any fees and late fees in arrears.

Sec. 27.

Minnesota Statutes 2022, section 151.555, is amended to read:

151.555 deleted text begin PRESCRIPTION DRUGdeleted text end new text begin MEDICATIONnew text end REPOSITORY PROGRAM.

Subdivision 1.

Definitions.

(a) For the purposes of this section, the terms defined in this
subdivision have the meanings given.

(b) "Central repository" means a wholesale distributor that meets the requirements under
subdivision 3 and enters into a contract with the Board of Pharmacy in accordance with this
section.

(d) "Donor" means:

(1) a health care facility as defined in this subdivision;

(2) a skilled nursing facility licensed under chapter 144A;

(3) an assisted living facility licensed under chapter 144G;

(4) a pharmacy licensed under section 151.19, and located either in the state or outside
the state;

(5) a drug wholesaler licensed under section 151.47;

(6) a drug manufacturer licensed under section 151.252; or

(7) an individual at least 18 years of age, provided that the drug or medical supply that
is donated was obtained legally and meets the requirements of this section for donation.

(e) "Drug" means any prescription drug that has been approved for medical use in the
United States, is listed in the United States Pharmacopoeia or National Formulary, and
meets the criteria established under this section for donation; or any over-the-counter
medication that meets the criteria established under this section for donation. This definition
includes cancer drugs and antirejection drugs, but does not include controlled substances,
as defined in section 152.01, subdivision 4, or a prescription drug that can only be dispensed
to a patient registered with the drug's manufacturer in accordance with federal Food and
Drug Administration requirements.

(f) "Health care facility" means:

(1) a physician's office or health care clinic where licensed practitioners provide health
care to patients;

(2) a hospital licensed under section 144.50;

(3) a pharmacy licensed under section 151.19 and located in Minnesota; or

(4) a nonprofit community clinic, including a federally qualified health center; a rural
health clinic; public health clinic; or other community clinic that provides health care utilizing
a sliding fee scale to patients who are low-income, uninsured, or underinsured.

(g) "Local repository" means a health care facility that elects to accept donated drugs
and medical supplies and meets the requirements of subdivision 4.

(h) "Medical supplies" or "supplies" means any prescription deleted text begin anddeleted text end new text begin ornew text end nonprescription
medical supplies needed to administer a deleted text begin prescriptiondeleted text end drug.

(i) "Original, sealed, unopened, tamper-evident packaging" means packaging that is
sealed, unopened, and tamper-evident, including a manufacturer's original unit dose or
unit-of-use container, a repackager's original unit dose or unit-of-use container, or unit-dose
packaging prepared by a licensed pharmacy according to the standards of Minnesota Rules,
part 6800.3750.

(j) "Practitioner" has the meaning given in section 151.01, subdivision 23, except that
it does not include a veterinarian.

Subd. 2.

Establishmentnew text begin ; contract and oversightnew text end .

deleted text begin By January 1, 2020,deleted text end new text begin (a) new text end The Board
of Pharmacy shall establish a deleted text begin drugdeleted text end new text begin medicationnew text end repository program, through which donors
may donate a drug or medical supply for use by an individual who meets the eligibility
criteria specified under subdivision 5.

new text begin (b)new text end The board shall contract with a central repository that meets the requirements of
subdivision 3 to implement and administer the deleted text begin prescription drugdeleted text end new text begin medicationnew text end repository
program.new text begin The contract must:
new text end

new text begin (1) require payment by the board to the central repository any amount appropriated by
the legislature for the operation and administration of the medication repository program;
new text end

new text begin (2) require the central repository to report the following performance measures to the
board:
new text end

new text begin (i) the number of individuals served and the types of medications these individuals
received;
new text end

new text begin (ii) the number of clinics, pharmacies, and long-term care facilities with which the central
repository partnered;
new text end

new text begin (iii) the number and cost of medications accepted for inventory, disposed of, and
dispensed to individuals in need; and
new text end

new text begin (iv) locations within the state to which medications were shipped or delivered; and
new text end

new text begin (3) require the board to annually audit the expenditure by the central repository of any
money appropriated by the legislature and paid under a contract by the board to ensure that
the amount appropriated is used only for purposes specified in the contract.
new text end

Subd. 3.

Central repository requirements.

(a) The board may publish a request for
proposal for participants who meet the requirements of this subdivision and are interested
in acting as the central repository for the deleted text begin drugdeleted text end new text begin medicationnew text end repository program. If the board
publishes a request for proposal, it shall follow all applicable state procurement procedures
in the selection process. The board may also work directly with the University of Minnesota
to establish a central repository.

(b) To be eligible to act as the central repository, the participant must be a wholesale
drug distributor located in Minnesota, licensed pursuant to section 151.47, and in compliance
with all applicable federal and state statutes, rules, and regulations.

(d) The central repository shall comply with all applicable federal and state laws, rules,
and regulations pertaining to the deleted text begin drugdeleted text end new text begin medicationnew text end repository program, drug storage, and
dispensing. The facility must maintain in good standing any state license or registration that
applies to the facility.

Subd. 4.

Local repository requirements.

(a) To be eligible for participation in the deleted text begin drugdeleted text end new text begin
medicationnew text end repository program, a health care facility must agree to comply with all applicable
federal and state laws, rules, and regulations pertaining to the deleted text begin drugdeleted text end new text begin medicationnew text end repository
program, drug storage, and dispensing. The facility must also agree to maintain in good
standing any required state license or registration that may apply to the facility.

(b) A local repository may elect to participate in the program by submitting the following
information to the central repository on a form developed by the board and made available
on the board's website:

(1) the name, street address, and telephone number of the health care facility and any
state-issued license or registration number issued to the facility, including the issuing state
agency;

(2) the name and telephone number of a responsible pharmacist or practitioner who is
employed by or under contract with the health care facility; and

(3) a statement signed and dated by the responsible pharmacist or practitioner indicating
that the health care facility meets the eligibility requirements under this section and agrees
to comply with this section.

(c) Participation in the deleted text begin drugdeleted text end new text begin medicationnew text end repository program is voluntary. A local
repository may withdraw from participation in the deleted text begin drugdeleted text end new text begin medicationnew text end repository program at
any time by providing written notice to the central repository on a form developed by the
board and made available on the board's website. The central repository shall provide the
board with a copy of the withdrawal notice within ten business days from the date of receipt
of the withdrawal notice.

Subd. 5.

Individual eligibility and application requirements.

(a) To be eligible for
the deleted text begin drugdeleted text end new text begin medicationnew text end repository program, an individual must submit to a local repository an
intake application form that is signed by the individual and attests that the individual:

(1) is a resident of Minnesota;

(2) is uninsured and is not enrolled in the medical assistance program under chapter
256B or the MinnesotaCare program under chapter 256L, has no prescription drug coverage,
or is underinsured;

(3) acknowledges that the drugs or medical supplies to be received through the program
may have been donated; and

(4) consents to a waiver of the child-resistant packaging requirements of the federal
Poison Prevention Packaging Act.

(b) Upon determining that an individual is eligible for the program, the local repository
shall furnish the individual with an identification card. The card shall be valid for one year
from the date of issuance and may be used at any local repository. A new identification card
may be issued upon expiration once the individual submits a new application form.

(c) The local repository shall send a copy of the intake application form to the central
repository by regular mail, facsimile, or secured email within ten days from the date the
application is approved by the local repository.

(d) The board shall develop and make available on the board's website an application
form and the format for the identification card.

Subd. 6.

Standards and procedures for accepting donations of drugs and supplies.

(a)
A donor may donate deleted text begin prescriptiondeleted text end drugs or medical supplies to the central repository or a
local repository if the drug or supply meets the requirements of this section as determined
by a pharmacist or practitioner who is employed by or under contract with the central
repository or a local repository.

(b) A deleted text begin prescriptiondeleted text end drug is eligible for donation under the deleted text begin drugdeleted text end new text begin medicationnew text end repository
program if the following requirements are met:

(1) the donation is accompanied by a deleted text begin drugdeleted text end new text begin medicationnew text end repository donor form described
under paragraph (d) that is signed by an individual who is authorized by the donor to attest
to the donor's knowledge in accordance with paragraph (d);

(2) the drug's expiration date is at least six months after the date the drug was donated.
If a donated drug bears an expiration date that is less than six months from the donation
date, the drug may be accepted and distributed if the drug is in high demand and can be
dispensed for use by a patient before the drug's expiration date;

(3) the drug is in its original, sealed, unopened, tamper-evident packaging that includes
the expiration date. Single-unit-dose drugs may be accepted if the single-unit-dose packaging
is unopened;

(4) the drug or the packaging does not have any physical signs of tampering, misbranding,
deterioration, compromised integrity, or adulteration;

(5) the drug does not require storage temperatures other than normal room temperature
as specified by the manufacturer or United States Pharmacopoeia, unless the drug is being
donated directly by its manufacturer, a wholesale drug distributor, or a pharmacy located
in Minnesota; and

(6) the deleted text begin prescriptiondeleted text end drug is not a controlled substance.

(c) A medical supply is eligible for donation under the deleted text begin drugdeleted text end new text begin medicationnew text end repository
program if the following requirements are met:

(1) the supply has no physical signs of tampering, misbranding, or alteration and there
is no reason to believe it has been adulterated, tampered with, or misbranded;

(2) the supply is in its original, unopened, sealed packaging;

(3) the donation is accompanied by a deleted text begin drugdeleted text end new text begin medicationnew text end repository donor form described
under paragraph (d) that is signed by an individual who is authorized by the donor to attest
to the donor's knowledge in accordance with paragraph (d); and

(4) if the supply bears an expiration date, the date is at least six months later than the
date the supply was donated. If the donated supply bears an expiration date that is less than
six months from the date the supply was donated, the supply may be accepted and distributed
if the supply is in high demand and can be dispensed for use by a patient before the supply's
expiration date.

(d) The board shall develop the deleted text begin drugdeleted text end new text begin medicationnew text end repository donor form and make it
available on the board's website. The form must state that to the best of the donor's knowledge
the donated drug or supply has been properly stored under appropriate temperature and
humidity conditions and that the drug or supply has never been opened, used, tampered
with, adulterated, or misbranded.

(e) Donated drugs and supplies may be shipped or delivered to the premises of the central
repository or a local repository, and shall be inspected by a pharmacist or an authorized
practitioner who is employed by or under contract with the repository and who has been
designated by the repository to accept donations. A drop box must not be used to deliver
or accept donations.

(f) The central repository and local repository shall inventory all drugs and supplies
donated to the repository. For each drug, the inventory must include the drug's name, strength,
quantity, manufacturer, expiration date, and the date the drug was donated. For each medical
supply, the inventory must include a description of the supply, its manufacturer, the date
the supply was donated, and, if applicable, the supply's brand name and expiration date.

Subd. 7.

Standards and procedures for inspecting and storing donated deleted text begin prescriptiondeleted text end
drugs and supplies.

(a) A pharmacist or authorized practitioner who is employed by or
under contract with the central repository or a local repository shall inspect all donated
deleted text begin prescriptiondeleted text end drugs and supplies before the drug or supply is dispensed to determine, to the
extent reasonably possible in the professional judgment of the pharmacist or practitioner,
that the drug or supply is not adulterated or misbranded, has not been tampered with, is safe
and suitable for dispensing, has not been subject to a recall, and meets the requirements for
donation. The pharmacist or practitioner who inspects the drugs or supplies shall sign an
inspection record stating that the requirements for donation have been met. If a local
repository receives drugs and supplies from the central repository, the local repository does
not need to reinspect the drugs and supplies.

(b) The central repository and local repositories shall store donated drugs and supplies
in a secure storage area under environmental conditions appropriate for the drug or supply
being stored. Donated drugs and supplies may not be stored with nondonated inventory.

(c) The central repository and local repositories shall dispose of all deleted text begin prescriptiondeleted text end drugs
and medical supplies that are not suitable for donation in compliance with applicable federal
and state statutes, regulations, and rules concerning hazardous waste.

(d) In the event that controlled substances or deleted text begin prescriptiondeleted text end drugs that can only be dispensed
to a patient registered with the drug's manufacturer are shipped or delivered to a central or
local repository for donation, the shipment delivery must be documented by the repository
and returned immediately to the donor or the donor's representative that provided the drugs.

(e) Each repository must develop drug and medical supply recall policies and procedures.
If a repository receives a recall notification, the repository shall destroy all of the drug or
medical supply in its inventory that is the subject of the recall and complete a record of
destruction form in accordance with paragraph (f). If a drug or medical supply that is the
subject of a Class I or Class II recall has been dispensed, the repository shall immediately
notify the recipient of the recalled drug or medical supply. A drug that potentially is subject
to a recall need not be destroyed if its packaging bears a lot number and that lot of the drug
is not subject to the recall. If no lot number is on the drug's packaging, it must be destroyed.

(f) A record of destruction of donated drugs and supplies that are not dispensed under
subdivision 8, are subject to a recall under paragraph (e), or are not suitable for donation
shall be maintained by the repository for at least two years. For each drug or supply destroyed,
the record shall include the following information:

(1) the date of destruction;

(2) the name, strength, and quantity of the drug destroyed; and

(3) the name of the person or firm that destroyed the drug.

Subd. 8.

Dispensing requirements.

(a) Donated drugs and supplies may be dispensed
if the drugs or supplies are prescribed by a practitioner for use by an eligible individual and
are dispensed by a pharmacist or practitioner. A repository shall dispense drugs and supplies
to eligible individuals in the following priority order: (1) individuals who are uninsured;
(2) individuals with no prescription drug coverage; and (3) individuals who are underinsured.
A repository shall dispense donated deleted text begin prescriptiondeleted text end drugs in compliance with applicable federal
and state laws and regulations for dispensing deleted text begin prescriptiondeleted text end drugs, including all requirements
relating to packaging, labeling, record keeping, drug utilization review, and patient
counseling.

(b) Before dispensing or administering a drug or supply, the pharmacist or practitioner
shall visually inspect the drug or supply for adulteration, misbranding, tampering, and date
of expiration. Drugs or supplies that have expired or appear upon visual inspection to be
adulterated, misbranded, or tampered with in any way must not be dispensed or administered.

(c) Before a drug or supply is dispensed or administered to an individual, the individual
must sign a drug repository recipient form acknowledging that the individual understands
the information stated on the form. The board shall develop the form and make it available
on the board's website. The form must include the following information:

(1) that the drug or supply being dispensed or administered has been donated and may
have been previously dispensed;

(2) that a visual inspection has been conducted by the pharmacist or practitioner to ensure
that the drug or supply has not expired, has not been adulterated or misbranded, and is in
its original, unopened packaging; and

(3) that the dispensing pharmacist, the dispensing or administering practitioner, the
central repository or local repository, the Board of Pharmacy, and any other participant of
the deleted text begin drugdeleted text end new text begin medicationnew text end repository program cannot guarantee the safety of the drug or medical
supply being dispensed or administered and that the pharmacist or practitioner has determined
that the drug or supply is safe to dispense or administer based on the accuracy of the donor's
form submitted with the donated drug or medical supply and the visual inspection required
to be performed by the pharmacist or practitioner before dispensing or administering.

Subd. 9.

Handling fees.

(a) The central or local repository may charge the individual
receiving a drug or supply a handling fee of no more than 250 percent of the medical
assistance program dispensing fee for each drug or medical supply dispensed or administered
by that repository.

(b) A repository that dispenses or administers a drug or medical supply through the deleted text begin drugdeleted text end new text begin
medicationnew text end repository program shall not receive reimbursement under the medical assistance
program or the MinnesotaCare program for that dispensed or administered drug or supply.

Subd. 10.

Distribution of donated drugs and supplies.

(a) The central repository and
local repositories may distribute drugs and supplies donated under the deleted text begin drugdeleted text end new text begin medicationnew text end
repository program to other participating repositories for use pursuant to this program.

(b) A local repository that elects not to dispense donated drugs or supplies must transfer
all donated drugs and supplies to the central repository. A copy of the donor form that was
completed by the original donor under subdivision 6 must be provided to the central
repository at the time of transfer.

Subd. 11.

Forms and record-keeping requirements.

(a) The following forms developed
for the administration of this program shall be utilized by the participants of the program
and shall be available on the board's website:

(1) intake application form described under subdivision 5;

(2) local repository participation form described under subdivision 4;

(3) local repository withdrawal form described under subdivision 4;

(4) deleted text begin drugdeleted text end new text begin medicationnew text end repository donor form described under subdivision 6;

(5) record of destruction form described under subdivision 7; and

(6) deleted text begin drugdeleted text end new text begin medicationnew text end repository recipient form described under subdivision 8.

(b) All records, including drug inventory, inspection, and disposal of donated deleted text begin prescriptiondeleted text end
drugs and medical supplies, must be maintained by a repository for a minimum of two years.
Records required as part of this program must be maintained pursuant to all applicable
practice acts.

(c) Data collected by the deleted text begin drugdeleted text end new text begin medicationnew text end repository program from all local repositories
shall be submitted quarterly or upon request to the central repository. Data collected may
consist of the information, records, and forms required to be collected under this section.

(d) The central repository shall submit reports to the board as required by the contract
or upon request of the board.

Subd. 12.

Liability.

(a) The manufacturer of a drug or supply is not subject to criminal
or civil liability for injury, death, or loss to a person or to property for causes of action
described in clauses (1) and (2). A manufacturer is not liable for:

(1) the intentional or unintentional alteration of the drug or supply by a party not under
the control of the manufacturer; or

(2) the failure of a party not under the control of the manufacturer to transfer or
communicate product or consumer information or the expiration date of the donated drug
or supply.

(b) A health care facility participating in the program, a pharmacist dispensing a drug
or supply pursuant to the program, a practitioner dispensing or administering a drug or
supply pursuant to the program, or a donor of a drug or medical supply is immune from
civil liability for an act or omission that causes injury to or the death of an individual to
whom the drug or supply is dispensed and no disciplinary action by a health-related licensing
board shall be taken against a pharmacist or practitioner so long as the drug or supply is
donated, accepted, distributed, and dispensed according to the requirements of this section.
This immunity does not apply if the act or omission involves reckless, wanton, or intentional
misconduct, or malpractice unrelated to the quality of the drug or medical supply.

Subd. 13.

Drug returned for credit.

Nothing in this section allows a long-term care
facility to donate a drug to a central or local repository when federal or state law requires
the drug to be returned to the pharmacy that initially dispensed it, so that the pharmacy can
credit the payer for the amount of the drug returned.

Subd. 14.

Cooperation.

The central repository, as approved by the Board of Pharmacy,
may enter into an agreement with another state that has an established drug repository or
drug donation program if the other state's program includes regulations to ensure the purity,
integrity, and safety of the drugs and supplies donated, to permit the central repository to
offer to another state program inventory that is not needed by a Minnesota resident and to
accept inventory from another state program to be distributed to local repositories and
dispensed to Minnesota residents in accordance with this program.

new text begin Subd. 15.new text end

new text begin Funding.new text end

new text begin The central repository may seek grants and other money from
nonprofit charitable organizations, the federal government, and other sources to fund the
ongoing operations of the medication repository program.
new text end

Sec. 28.

Minnesota Statutes 2022, section 151.74, subdivision 3, is amended to read:

Subd. 3.

Access to urgent-need insulin.

(a) MNsure shall develop an application form
to be used by an individual who is in urgent need of insulin. The application must ask the
individual to attest to the eligibility requirements described in subdivision 2. The form shall
be accessible through MNsure's website. MNsure shall also make the form available to
pharmacies and health care providers who prescribe or dispense insulin, hospital emergency
departments, urgent care clinics, and community health clinics. By submitting a completed,
signed, and dated application to a pharmacy, the individual attests that the information
contained in the application is correct.

(b) If the individual is in urgent need of insulin, the individual may present a completed,
signed, and dated application form to a pharmacy. The individual must also:

(1) have a valid insulin prescription; and

(2) present the pharmacist with identification indicating Minnesota residency in the form
of a valid Minnesota identification card, driver's license or permit, new text begin individual taxpayer
identification number, new text end or Tribal identification card as defined in section 171.072, paragraph
(b). If the individual in urgent need of insulin is under the age of 18, the individual's parent
or legal guardian must provide the pharmacist with proof of residency.

(c) Upon receipt of a completed and signed application, the pharmacist shall dispense
the prescribed insulin in an amount that will provide the individual with a 30-day supply.
The pharmacy must notify the health care practitioner who issued the prescription order no
later than 72 hours after the insulin is dispensed.

(d) The pharmacy may submit to the manufacturer of the dispensed insulin product or
to the manufacturer's vendor a claim for payment that is in accordance with the National
Council for Prescription Drug Program standards for electronic claims processing, unless
the manufacturer agrees to send to the pharmacy a replacement supply of the same insulin
as dispensed in the amount dispensed. If the pharmacy submits an electronic claim to the
manufacturer or the manufacturer's vendor, the manufacturer or vendor shall reimburse the
pharmacy in an amount that covers the pharmacy's acquisition cost.

(e) The pharmacy may collect an insulin co-payment from the individual to cover the
pharmacy's costs of processing and dispensing in an amount not to exceed $35 for the 30-day
supply of insulin dispensed.

(f) The pharmacy shall also provide each eligible individual with the information sheet
described in subdivision 7 and a list of trained navigators provided by the Board of Pharmacy
for the individual to contact if the individual is in need of accessing ongoing insulin coverage
options, including assistance in:

(1) applying for medical assistance or MinnesotaCare;

(2) applying for a qualified health plan offered through MNsure, subject to open and
special enrollment periods;

(3) accessing information on providers who participate in prescription drug discount
programs, including providers who are authorized to participate in the 340B program under
section 340b of the federal Public Health Services Act, United States Code, title 42, section
256b; and

(4) accessing insulin manufacturers' patient assistance programs, co-payment assistance
programs, and other foundation-based programs.

(g) The pharmacist shall retain a copy of the application form submitted by the individual
to the pharmacy for reporting and auditing purposes.

Sec. 29.

Minnesota Statutes 2022, section 151.74, subdivision 4, is amended to read:

Subd. 4.

Continuing safety net program; general.

(a) Each manufacturer shall make
a patient assistance program available to any individual who meets the requirements of this
subdivision. Each manufacturer's patient assistance programs must meet the requirements
of this section. Each manufacturer shall provide the Board of Pharmacy with information
regarding the manufacturer's patient assistance program, including contact information for
individuals to call for assistance in accessing their patient assistance program.

(b) To be eligible to participate in a manufacturer's patient assistance program, the
individual must:

(1) be a Minnesota resident with a valid Minnesota identification card that indicates
Minnesota residency in the form of a Minnesota identification card, driver's license or
permit, new text begin individual taxpayer identification number, new text end or Tribal identification card as defined
in section 171.072, paragraph (b). If the individual is under the age of 18, the individual's
parent or legal guardian must provide proof of residency;

(2) have a family income that is equal to or less than 400 percent of the federal poverty
guidelines;

(3) not be enrolled in medical assistance or MinnesotaCare;

(4) not be eligible to receive health care through a federally funded program or receive
prescription drug benefits through the Department of Veterans Affairs; and

(5) not be enrolled in prescription drug coverage through an individual or group health
plan that limits the total amount of cost-sharing that an enrollee is required to pay for a
30-day supply of insulin, including co-payments, deductibles, or coinsurance to $75 or less,
regardless of the type or amount of insulin needed.

(c) Notwithstanding the requirement in paragraph (b), clause (4), an individual who is
enrolled in Medicare Part D is eligible for a manufacturer's patient assistance program if
the individual has spent $1,000 on prescription drugs in the current calendar year and meets
the eligibility requirements in paragraph (b), clauses (1) to (3).

(d) An individual who is interested in participating in a manufacturer's patient assistance
program may apply directly to the manufacturer; apply through the individual's health care
practitioner, if the practitioner participates; or contact a trained navigator for assistance in
finding a long-term insulin supply solution, including assistance in applying to a
manufacturer's patient assistance program.

Sec. 30.

Minnesota Statutes 2022, section 152.126, subdivision 4, is amended to read:

Subd. 4.

Reporting requirements; notice.

(a) Each dispenser must submit the following
data to the board or its designated vendor:

(1) name of the prescriber;

(2) national provider identifier of the prescriber;

(3) name of the dispenser;

(4) national provider identifier of the dispenser;

(5) prescription number;

(6) name of the patient for whom the prescription was written;

(7) address of the patient for whom the prescription was written;

(8) date of birth of the patient for whom the prescription was written;

(9) date the prescription was written;

(10) date the prescription was filled;

(11) name and strength of the controlled substance;

(12) quantity of controlled substance prescribed;

(13) quantity of controlled substance dispensed; and

(14) number of days supply.

(b) The dispenser must submit the required information by a procedure and in a format
established by the board. The board may allow dispensers to omit data listed in this
subdivision or may require the submission of data not listed in this subdivision provided
the omission or submission is necessary for the purpose of complying with the electronic
reporting or data transmission standards of the American Society for Automation in
Pharmacy, the National Council on Prescription Drug Programs, or other relevant national
standard-setting body.

(1) individuals residing in a health care facility as defined in section 151.58, subdivision
2, paragraph (b), when a drug is distributed through the use of an automated drug distribution
system according to section 151.58; deleted text begin and
deleted text end

(2) individuals receiving a drug sample that was packaged by a manufacturer and provided
to the dispenser for dispensing as a professional sample pursuant to Code of Federal
Regulations, title 21, part 203, subpart Ddeleted text begin .deleted text end new text begin ; and
new text end

new text begin (3) individuals whose prescriptions are being mailed, shipped, or delivered from
Minnesota to another state, so long as the data are reported to the prescription drug monitoring
program of that state.
new text end

(d) A dispenser must provide new text begin notice new text end to the patient for whom the prescription was written
deleted text begin a conspicuous noticedeleted text end new text begin , or to that patient's authorized representative,new text end of the reporting
requirements of this section and notice that the information may be used for program
administration purposes.

new text begin (e) The dispenser must submit the required information within the time frame specified
by the board; if no reportable prescriptions are dispensed or sold on any day, a report
indicating that fact must be filed with the board.
new text end

new text begin (f) The dispenser must submit accurate information to the database and must correct
errors identified during the submission process within seven calendar days.
new text end

new text begin (g) For the purposes of this paragraph, the term "subject of the data" means the individual
reported as being the patient, the practitioner reported as being the prescriber, the client
when an animal is reported as being the patient, or an authorized agent of these individuals.
The dispenser must correct errors brought to its attention by the subject of the data within
seven calendar days, unless the dispenser verifies that an error did not occur and the data
were correctly submitted. The dispenser must notify the subject of the data that either the
error was corrected or that no error occurred.
new text end

Sec. 31.

Minnesota Statutes 2022, section 152.126, subdivision 5, is amended to read:

Subd. 5.

Use of data by board.

(a) The board shall develop and maintain a database of
the data reported under subdivision 4. The board shall maintain data that could identify an
individual prescriber or dispenser in encrypted form. Except as otherwise allowed under
subdivision 6, the database may be used by permissible users identified under subdivision
6 for the identification of:

(1) individuals receiving prescriptions for controlled substances from prescribers who
subsequently obtain controlled substances from dispensers in quantities or with a frequency
inconsistent with generally recognized standards of use for those controlled substances,
including standards accepted by national and international pain management associations;
and

(2) individuals presenting forged or otherwise false or altered prescriptions for controlled
substances to dispensers.

(b) No permissible user identified under subdivision 6 may access the database for the
sole purpose of identifying prescribers of controlled substances for unusual or excessive
prescribing patterns without a valid search warrant or court order.

(c) No personnel of a state or federal occupational licensing board or agency may access
the database for the purpose of obtaining information to be used to initiate a disciplinary
action against a prescriber.

(d) Data reported under subdivision 4 shall be made available to permissible users for
a 12-month period beginning the day the data was received and ending 12 months from the
last day of the month in which the data was received, except that permissible users defined
in subdivision 6, paragraph (b), clauses deleted text begin (6)deleted text end new text begin (7)new text end and deleted text begin (7)deleted text end new text begin (8)new text end , may use all data collected under
this section for the purposes of administering, operating, and maintaining the prescription
monitoring program and conducting trend analyses and other studies necessary to evaluate
the effectiveness of the program.

(e) Data reported during the period January 1, 2015, through December 31, 2018, may
be retained through December 31, 2019, in an identifiable manner. Effective January 1,
2020, data older than 24 months must be destroyed. Data reported new text begin for prescriptions dispensed
new text end on or after January 1, 2020, must be destroyed no later than 12 months from the date the
deleted text begin datadeleted text end new text begin prescriptionnew text end was deleted text begin receiveddeleted text end new text begin reported as dispensednew text end .

Sec. 32.

Minnesota Statutes 2022, section 152.126, subdivision 6, is amended to read:

Subd. 6.

Access to reporting system data.

(a) Except as indicated in this subdivision,
the data submitted to the board under subdivision 4 is private data on individuals as defined
in section 13.02, subdivision 12, and not subject to public disclosure.

(b) Except as specified in subdivision 5, the following persons shall be considered
permissible users and may access the data submitted under subdivision 4 in the same or
similar manner, and for the same or similar purposes, as those persons who are authorized
to access similar private data on individuals under federal and state law:

(1) a prescriber or an agent or employee of the prescriber to whom the prescriber has
delegated the task of accessing the data, to the extent the information relates specifically to
a current patient, to whom the prescriber is:

(i) prescribing or considering prescribing any controlled substance;

(ii) providing emergency medical treatment for which access to the data may be necessary;

(iii) providing care, and the prescriber has reason to believe, based on clinically valid
indications, that the patient is potentially abusing a controlled substance; or

(iv) providing other medical treatment for which access to the data may be necessary
for a clinically valid purpose and the patient has consented to access to the submitted data,
and with the provision that the prescriber remains responsible for the use or misuse of data
accessed by a delegated agent or employee;

(2) a dispenser or an agent or employee of the dispenser to whom the dispenser has
delegated the task of accessing the data, to the extent the information relates specifically to
a current patient to whom that dispenser is dispensing or considering dispensing any
controlled substance and with the provision that the dispenser remains responsible for the
use or misuse of data accessed by a delegated agent or employee;

(3) new text begin a licensed dispensing practitioner or licensed pharmacist to the extent necessary to
determine whether corrections made to the data reported under subdivision 4 are accurate;
new text end

new text begin (4) new text end a licensed pharmacist who is providing pharmaceutical care for which access to the
data may be necessary to the extent that the information relates specifically to a current
patient for whom the pharmacist is providing pharmaceutical care: (i) if the patient has
consented to access to the submitted data; or (ii) if the pharmacist is consulted by a prescriber
who is requesting data in accordance with clause (1);

deleted text begin (4)deleted text end new text begin (5)new text end an individual who is the recipient of a controlled substance prescription for which
data was submitted under subdivision 4, or a guardian of the individual, parent or guardian
of a minor, or health care agent of the individual acting under a health care directive under
chapter 145C. For purposes of this clause, access by individuals includes persons in the
definition of an individual under section 13.02;

deleted text begin (5)deleted text end new text begin (6)new text end personnel or designees of a health-related licensing board listed in section 214.01,
subdivision 2, or of the Emergency Medical Services Regulatory Board, assigned to conduct
a bona fide investigation of a complaint received by that board that alleges that a specific
licensee is impaired by use of a drug for which data is collected under subdivision 4, has
engaged in activity that would constitute a crime as defined in section 152.025, or has
engaged in the behavior specified in subdivision 5, paragraph (a);

deleted text begin (6)deleted text end new text begin (7)new text end personnel of the board engaged in the collection, review, and analysis of controlled
substance prescription information as part of the assigned duties and responsibilities under
this section;

deleted text begin (7)deleted text end new text begin (8)new text end authorized personnel deleted text begin of a vendordeleted text end under contract with the new text begin board, or under contract
with the new text end state of Minnesota new text begin and approved by the board, new text end who are engaged in the design,
new text begin evaluation, new text end implementation, operation, deleted text begin anddeleted text end new text begin ornew text end maintenance of the prescription monitoring
program as part of the assigned duties and responsibilities of their employment, provided
that access to data is limited to the minimum amount necessary to carry out such duties and
responsibilities, and subject to the requirement of de-identification and time limit on retention
of data specified in subdivision 5, paragraphs (d) and (e);

deleted text begin (8)deleted text end new text begin (9)new text end federal, state, and local law enforcement authorities acting pursuant to a valid
search warrant;

deleted text begin (9)deleted text end new text begin (10)new text end personnel of the Minnesota health care programs assigned to use the data
collected under this section to identify and manage recipients whose usage of controlled
substances may warrant restriction to a single primary care provider, a single outpatient
pharmacy, and a single hospital;

deleted text begin (10)deleted text end new text begin (11)new text end personnel of the Department of Human Services assigned to access the data
pursuant to paragraph (k);

deleted text begin (11)deleted text end new text begin (12)new text end personnel of the health professionals services program established under section
214.31, to the extent that the information relates specifically to an individual who is currently
enrolled in and being monitored by the program, and the individual consents to access to
that information. The health professionals services program personnel shall not provide this
data to a health-related licensing board or the Emergency Medical Services Regulatory
Board, except as permitted under section 214.33, subdivision 3; deleted text begin and
deleted text end

deleted text begin (12)deleted text end new text begin (13)new text end personnel or designees of a health-related licensing board new text begin other than the Board
of Pharmacy new text end listed in section 214.01, subdivision 2, assigned to conduct a bona fide
investigation of a complaint received by that board that alleges that a specific licensee is
inappropriately prescribing controlled substances as defined in this section.new text begin For the purposes
of this clause, the health-related licensing board may also obtain utilization data; and
new text end

new text begin (14) personnel of the board specifically assigned to conduct a bona fide investigation
of a specific licensee or registrant. For the purposes of this clause, the board may also obtain
utilization data.
new text end

(c) By July 1, 2017, every prescriber licensed by a health-related licensing board listed
in section 214.01, subdivision 2, practicing within this state who is authorized to prescribe
controlled substances for humans and who holds a current registration issued by the federal
Drug Enforcement Administration, and every pharmacist licensed by the board and practicing
within the state, shall register and maintain a user account with the prescription monitoring
program. Data submitted by a prescriber, pharmacist, or their delegate during the registration
application process, other than their name, license number, and license type, is classified
as private pursuant to section 13.02, subdivision 12.

(d) Notwithstanding paragraph (b), beginning January 1, 2021, a prescriber or an agent
or employee of the prescriber to whom the prescriber has delegated the task of accessing
the data, must access the data submitted under subdivision 4 to the extent the information
relates specifically to the patient:

(1) before the prescriber issues an initial prescription order for a Schedules II through
IV opiate controlled substance to the patient; and

(2) at least once every three months for patients receiving an opiate for treatment of
chronic pain or participating in medically assisted treatment for an opioid addiction.

(e) Paragraph (d) does not apply if:

(1) the patient is receiving palliative care, or hospice or other end-of-life care;

(2) the patient is being treated for pain due to cancer or the treatment of cancer;

(3) the prescription order is for a number of doses that is intended to last the patient five
days or less and is not subject to a refill;

(4) the prescriber and patient have a current or ongoing provider/patient relationship of
a duration longer than one year;

(5) the prescription order is issued within 14 days following surgery or three days
following oral surgery or follows the prescribing protocols established under the opioid
prescribing improvement program under section 256B.0638;

(6) the controlled substance is prescribed or administered to a patient who is admitted
to an inpatient hospital;

(7) the controlled substance is lawfully administered by injection, ingestion, or any other
means to the patient by the prescriber, a pharmacist, or by the patient at the direction of a
prescriber and in the presence of the prescriber or pharmacist;

(8) due to a medical emergency, it is not possible for the prescriber to review the data
before the prescriber issues the prescription order for the patient; or

(9) the prescriber is unable to access the data due to operational or other technological
failure of the program so long as the prescriber reports the failure to the board.

(f) Only permissible users identified in paragraph (b), clauses (1), (2), (3), deleted text begin (6)deleted text end new text begin (4)new text end , (7),
deleted text begin (9), anddeleted text end new text begin (8),new text end (10), new text begin and (11), new text end may directly access the data electronically. No other permissible
users may directly access the data electronically. If the data is directly accessed electronically,
the permissible user shall implement and maintain a comprehensive information security
program that contains administrative, technical, and physical safeguards that are appropriate
to the user's size and complexity, and the sensitivity of the personal information obtained.
The permissible user shall identify reasonably foreseeable internal and external risks to the
security, confidentiality, and integrity of personal information that could result in the
unauthorized disclosure, misuse, or other compromise of the information and assess the
sufficiency of any safeguards in place to control the risks.

(g) The board shall not release data submitted under subdivision 4 unless it is provided
with evidence, satisfactory to the board, that the person requesting the information is entitled
to receive the data.

(h) The board shall maintain a log of all persons who access the data for a period of at
least three years and shall ensure that any permissible user complies with paragraph (c)
prior to attaining direct access to the data.

(i) Section 13.05, subdivision 6, shall apply to any contract the board enters into pursuant
to subdivision 2. A vendor shall not use data collected under this section for any purpose
not specified in this section.

(j) The board may participate in an interstate prescription monitoring program data
exchange system provided that permissible users in other states have access to the data only
as allowed under this section, and that section 13.05, subdivision 6, applies to any contract
or memorandum of understanding that the board enters into under this paragraph.

(k) With available appropriations, the commissioner of human services shall establish
and implement a system through which the Department of Human Services shall routinely
access the data for the purpose of determining whether any client enrolled in an opioid
treatment program licensed according to chapter 245A has been prescribed or dispensed a
controlled substance in addition to that administered or dispensed by the opioid treatment
program. When the commissioner determines there have been multiple prescribers or multiple
prescriptions of controlled substances, the commissioner shall:

(1) inform the medical director of the opioid treatment program only that the
commissioner determined the existence of multiple prescribers or multiple prescriptions of
controlled substances; and

(2) direct the medical director of the opioid treatment program to access the data directly,
review the effect of the multiple prescribers or multiple prescriptions, and document the
review.

If determined necessary, the commissioner of human services shall seek a federal waiver
of, or exception to, any applicable provision of Code of Federal Regulations, title 42, section
2.34, paragraph (c), prior to implementing this paragraph.

(l) The board shall review the data submitted under subdivision 4 on at least a quarterly
basis and shall establish criteria, in consultation with the advisory task force, for referring
information about a patient to prescribers and dispensers who prescribed or dispensed the
prescriptions in question if the criteria are met.

(m) The board shall conduct random audits, on at least a quarterly basis, of electronic
access by permissible users, as identified in paragraph (b), clauses (1), (2), (3), deleted text begin (6)deleted text end new text begin (4)new text end , (7),
deleted text begin (9), anddeleted text end new text begin (8),new text end (10)new text begin , and (11)new text end , to the data in subdivision 4, to ensure compliance with permissible
use as defined in this section. A permissible user whose account has been selected for a
random audit shall respond to an inquiry by the board, no later than 30 days after receipt of
notice that an audit is being conducted. Failure to respond may result in deactivation of
access to the electronic system and referral to the appropriate health licensing board, or the
commissioner of human services, for further action. The board shall report the results of
random audits to the chairs and ranking minority members of the legislative committees
with jurisdiction over health and human services policy and finance and government data
practices.

(n) A permissible user who has delegated the task of accessing the data in subdivision
4 to an agent or employee shall audit the use of the electronic system by delegated agents
or employees on at least a quarterly basis to ensure compliance with permissible use as
defined in this section. When a delegated agent or employee has been identified as
inappropriately accessing data, the permissible user must immediately remove access for
that individual and notify the board within seven days. The board shall notify all permissible
users associated with the delegated agent or employee of the alleged violation.

(o) A permissible user who delegates access to the data submitted under subdivision 4
to an agent or employee shall terminate that individual's access to the data within three
business days of the agent or employee leaving employment with the permissible user. The
board may conduct random audits to determine compliance with this requirement.

Sec. 33.

new text begin [245A.245] CHILDREN'S RESIDENTIAL FACILITY SUBSTANCE USE
DISORDER TREATMENT PROGRAMS.
new text end

new text begin Subdivision 1.new text end

new text begin Applicability.new text end

new text begin A license holder of a children's residential facility substance
use disorder treatment program license issued under this chapter and Minnesota Rules, parts
2960.0010 to 2960.0220 and 2960.0430 to 2960.0490, must comply with this section.
new text end

new text begin Subd. 2.new text end

new text begin Former students.new text end

new text begin (a) "Alcohol and drug counselor" means an individual
qualified according to Minnesota Rules, part 2960.0460, subpart 5.
new text end

new text begin (b) "Former student" means an individual that meets the requirements in section 148F.11,
subdivision 2a, to practice as a former student.
new text end

new text begin (c) An alcohol and drug counselor must supervise and be responsible for a treatment
service performed by a former student and must review and sign each assessment, individual
treatment plan, progress note, and treatment plan review prepared by a former student.
new text end

new text begin (d) A former student must receive the orientation and training required for permanent
staff members.
new text end

Sec. 34.

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

new text begin Subd. 13c.new text end

new text begin Former student.new text end

new text begin "Former student" means a staff person that meets the
requirements in section 148F.11, subdivision 2a, to practice as a former student.
new text end

Sec. 35.

Minnesota Statutes 2022, section 245G.11, subdivision 10, is amended to read:

Subd. 10.

Student internsnew text begin and former studentsnew text end .

new text begin (a) new text end A qualified staff member must
supervise and be responsible for a treatment service performed by a student intern and must
review and sign each assessment, individual treatment plan, and treatment plan review
prepared by a student intern.

new text begin (b) An alcohol and drug counselor must supervise and be responsible for a treatment
service performed by a former student and must review and sign each assessment, individual
treatment plan, and treatment plan review prepared by the former student.
new text end

new text begin (c)new text end A student intern new text begin or former student new text end must receive the orientation and training required
in section 245G.13, subdivisions 1, clause (7), and 2. No more than 50 percent of the
treatment staff may be studentsnew text begin , former students,new text end or licensing candidates with time
documented to be directly related to the provision of treatment services for which the staff
are authorized.

Sec. 36. new text begin REPEALER.
new text end

new text begin Minnesota Rules, parts 5610.0100; 5610.0200; and 5610.0300,new text end new text begin are repealed.
new text end

ARTICLE 7

BACKGROUND STUDIES

Section 1.

Minnesota Statutes 2022, section 13.46, subdivision 4, is amended to read:

Subd. 4.

Licensing data.

(a) As used in this subdivision:

(1) "licensing data" are all data collected, maintained, used, or disseminated by the
welfare system pertaining to persons licensed or registered or who apply for licensure or
registration or who formerly were licensed or registered under the authority of the
commissioner of human services;

(2) "client" means a person who is receiving services from a licensee or from an applicant
for licensure; and

(3) "personal and personal financial data" are Social Security numbers, identity of and
letters of reference, insurance information, reports from the Bureau of Criminal
Apprehension, health examination reports, and social/home studies.

(b)(1)(i) Except as provided in paragraph (c), the following data on applicants, license
holders, and former licensees are public: name, address, telephone number of licensees,
date of receipt of a completed application, dates of licensure, licensed capacity, type of
client preferred, variances granted, record of training and education in child care and child
development, type of dwelling, name and relationship of other family members, previous
license history, class of license, the existence and status of complaints, and the number of
serious injuries to or deaths of individuals in the licensed program as reported to the
commissioner of human services, the local social services agency, or any other county
welfare agency. For purposes of this clause, a serious injury is one that is treated by a
physician.

(ii) Except as provided in item (v), when a correction order, an order to forfeit a fine,
an order of license suspension, an order of temporary immediate suspension, an order of
license revocation, an order of license denial, or an order of conditional license has been
issued, or a complaint is resolved, the following data on current and former licensees and
applicants are public: the general nature of the complaint or allegations leading to the
temporary immediate suspension; the substance and investigative findings of the licensing
or maltreatment complaint, licensing violation, or substantiated maltreatment; the existence
of settlement negotiations; the record of informal resolution of a licensing violation; orders
of hearing; findings of fact; conclusions of law; specifications of the final correction order,
fine, suspension, temporary immediate suspension, revocation, denial, or conditional license
contained in the record of licensing action; whether a fine has been paid; and the status of
any appeal of these actions.

(iii) When a license denial under section 245A.05 or a sanction under section 245A.07
is based on a determination that a license holder, applicant, or controlling individual is
responsible for maltreatment under section 626.557 or chapter 260E, the identity of the
applicant, license holder, or controlling individual as the individual responsible for
maltreatment is public data at the time of the issuance of the license denial or sanction.

(iv) When a license denial under section 245A.05 or a sanction under section 245A.07
is based on a determination that a license holder, applicant, or controlling individual is
disqualified under chapter 245C, the identity of the license holder, applicant, or controlling
individual as the disqualified individual deleted text begin and the reason for the disqualification aredeleted text end new text begin isnew text end public
data at the time of the issuance of the licensing sanction or denial. If the applicant, license
holder, or controlling individual requests reconsideration of the disqualification and the
disqualification is affirmed, the reason for the disqualification and the reason to not set aside
the disqualification are deleted text begin publicdeleted text end new text begin privatenew text end data.

(v) A correction order or fine issued to a child care provider for a licensing violation is
private data on individuals under section 13.02, subdivision 12, or nonpublic data under
section 13.02, subdivision 9, if the correction order or fine is seven years old or older.

(2) For applicants who withdraw their application prior to licensure or denial of a license,
the following data are public: the name of the applicant, the city and county in which the
applicant was seeking licensure, the dates of the commissioner's receipt of the initial
application and completed application, the type of license sought, and the date of withdrawal
of the application.

(3) For applicants who are denied a license, the following data are public: the name and
address of the applicant, the city and county in which the applicant was seeking licensure,
the dates of the commissioner's receipt of the initial application and completed application,
the type of license sought, the date of denial of the application, the nature of the basis for
the denial, the existence of settlement negotiations, the record of informal resolution of a
denial, orders of hearings, findings of fact, conclusions of law, specifications of the final
order of denial, and the status of any appeal of the denial.

(4) When maltreatment is substantiated under section 626.557 or chapter 260E and the
victim and the substantiated perpetrator are affiliated with a program licensed under chapter
245A, the commissioner of human services, local social services agency, or county welfare
agency may inform the license holder where the maltreatment occurred of the identity of
the substantiated perpetrator and the victim.

(5) Notwithstanding clause (1), for child foster care, only the name of the license holder
and the status of the license are public if the county attorney has requested that data otherwise
classified as public data under clause (1) be considered private data based on the best interests
of a child in placement in a licensed program.

(c) The following are private data on individuals under section 13.02, subdivision 12,
or nonpublic data under section 13.02, subdivision 9: personal and personal financial data
on family day care program and family foster care program applicants and licensees and
their family members who provide services under the license.

(d) The following are private data on individuals: the identity of persons who have made
reports concerning licensees or applicants that appear in inactive investigative data, and the
records of clients or employees of the licensee or applicant for licensure whose records are
received by the licensing agency for purposes of review or in anticipation of a contested
matter. The names of reporters of complaints or alleged violations of licensing standards
under chapters 245A, 245B, 245C, and 245D, and applicable rules and alleged maltreatment
under section 626.557 and chapter 260E, are confidential data and may be disclosed only
as provided in section 260E.21, subdivision 4; 260E.35; or 626.557, subdivision 12b.

(e) Data classified as private, confidential, nonpublic, or protected nonpublic under this
subdivision become public data if submitted to a court or administrative law judge as part
of a disciplinary proceeding in which there is a public hearing concerning a license which
has been suspended, immediately suspended, revoked, or denied.

(f) Data generated in the course of licensing investigations that relate to an alleged
violation of law are investigative data under subdivision 3.

(g) Data that are not public data collected, maintained, used, or disseminated under this
subdivision that relate to or are derived from a report as defined in section 260E.03, or
626.5572, subdivision 18, are subject to the destruction provisions of sections 260E.35,
subdivision 6, and 626.557, subdivision 12b.

(h) Upon request, not public data collected, maintained, used, or disseminated under
this subdivision that relate to or are derived from a report of substantiated maltreatment as
defined in section 626.557 or chapter 260E may be exchanged with the Department of
Health for purposes of completing background studies pursuant to section 144.057 and with
the Department of Corrections for purposes of completing background studies pursuant to
section 241.021.

(i) Data on individuals collected according to licensing activities under chapters 245A
and 245C, data on individuals collected by the commissioner of human services according
to investigations under section 626.557 and chapters 245A, 245B, 245C, 245D, and 260E
may be shared with the Department of Human Rights, the Department of Health, the
Department of Corrections, the ombudsman for mental health and developmental disabilities,
and the individual's professional regulatory board when there is reason to believe that laws
or standards under the jurisdiction of those agencies may have been violated or the
information may otherwise be relevant to the board's regulatory jurisdiction. Background
study data on an individual who is the subject of a background study under chapter 245C
for a licensed service for which the commissioner of human services is the license holder
may be shared with the commissioner and the commissioner's delegate by the licensing
division. Unless otherwise specified in this chapter, the identity of a reporter of alleged
maltreatment or licensing violations may not be disclosed.

(j) In addition to the notice of determinations required under sections 260E.24,
subdivisions 5 and 7, and 260E.30, subdivision 6, paragraphs (b), (c), (d), (e), and (f), if the
commissioner or the local social services agency has determined that an individual is a
substantiated perpetrator of maltreatment of a child based on sexual abuse, as defined in
section 260E.03, and the commissioner or local social services agency knows that the
individual is a person responsible for a child's care in another facility, the commissioner or
local social services agency shall notify the head of that facility of this determination. The
notification must include an explanation of the individual's available appeal rights and the
status of any appeal. If a notice is given under this paragraph, the government entity making
the notification shall provide a copy of the notice to the individual who is the subject of the
notice.

(k) All not public data collected, maintained, used, or disseminated under this subdivision
and subdivision 3 may be exchanged between the Department of Human Services, Licensing
Division, and the Department of Corrections for purposes of regulating services for which
the Department of Human Services and the Department of Corrections have regulatory
authority.

Sec. 2.

Minnesota Statutes 2022, section 245C.02, is amended by adding a subdivision to
read:

new text begin Subd. 7a.new text end

new text begin Conservator.new text end

new text begin "Conservator" has the meaning given in section 524.1-201,
clause (10), and includes proposed and current conservators.
new text end

Sec. 3.

Minnesota Statutes 2022, section 245C.02, is amended by adding a subdivision to
read:

new text begin Subd. 11g.new text end

new text begin Guardian.new text end

new text begin "Guardian" has the meaning given in section 524.1-201, clause
(27), and includes proposed and current guardians.
new text end

Sec. 4.

Minnesota Statutes 2022, section 245C.02, subdivision 13e, is amended to read:

Subd. 13e.

NETStudy 2.0.

"NETStudy 2.0" means the commissioner's system that
replaces both NETStudy and the department's internal background study processing system.
NETStudy 2.0 is designed to enhance protection of children and vulnerable adults by
improving the accuracy of background studies through fingerprint-based criminal record
checks and expanding the background studies to include a review of information from the
Minnesota Court Information System and the national crime information database. NETStudy
2.0 is also designed to increase efficiencies in and the speed of the hiring process by:

(1) providing access to and updates from public web-based data related to employment
eligibility;

(2) decreasing the need for repeat studies through electronic updates of background
study subjects' criminal records;

(3) supporting identity verification using subjects' Social Security numbers and
photographs;

(4) using electronic employer notifications; deleted text begin and
deleted text end

(5) issuing immediate verification of subjects' eligibility to provide services as more
studies are completed under the NETStudy 2.0 systemdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (6) providing electronic access to certain notices for entities and background study
subjects.
new text end

Sec. 5.

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

Subdivision 1.

Licensed programs.

(a) The commissioner shall conduct a background
study on:

(1) the person or persons applying for a license;

(2) an individual age 13 and over living in the household where the licensed program
will be provided who is not receiving licensed services from the program;

(3) current or prospective employees deleted text begin or contractorsdeleted text end of the applicant new text begin or license holder
new text end who will have direct contact with persons served by the facility, agency, or program;

(4) volunteers or student volunteers who will have direct contact with persons served
by the program to provide program services if the contact is not under the continuous, direct
supervision by an individual listed in clause (1) or (3);

(5) an individual age ten to 12 living in the household where the licensed services will
be provided when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;

(6) an individual who, without providing direct contact services at a licensed program,
may have unsupervised access to children or vulnerable adults receiving services from a
program, when the commissioner has reasonable cause as defined in section 245C.02,
subdivision 15;

(7) all controlling individuals as defined in section 245A.02, subdivision 5a;

(8) notwithstanding the other requirements in this subdivision, child care background
study subjects as defined in section 245C.02, subdivision 6a; and

(9) notwithstanding clause (3), for children's residential facilities and foster residence
settings, any adult working in the facility, whether or not the individual will have direct
contact with persons served by the facility.

(b) For child foster care when the license holder resides in the home where foster care
services are provided, a short-term substitute caregiver providing direct contact services for
a child for less than 72 hours of continuous care is not required to receive a background
study under this chapter.

(1) adult foster care;

(2) child foster care;

(3) children's residential facilities;

(4) family child care;

(5) licensed child care centers;

(6) licensed home and community-based services under chapter 245D;

(7) residential mental health programs for adults;

(8) substance use disorder treatment programs under chapter 245G;

(9) withdrawal management programs under chapter 245F;

(10) adult day care centers;

(11) family adult day services;

deleted text begin (12) independent living assistance for youth;
deleted text end

deleted text begin (13)deleted text end new text begin (12)new text end detoxification programs;

deleted text begin (14)deleted text end new text begin (13)new text end community residential settings; deleted text begin and
deleted text end

deleted text begin (15)deleted text end new text begin (14)new text end intensive residential treatment services and residential crisis stabilization under
chapter 245Ideleted text begin .deleted text end new text begin ; and
new text end

new text begin (15) treatment programs for persons with sexual psychopathic personality or sexually
dangerous persons, licensed under chapter 245A and according to Minnesota Rules, parts
9515.3000 to 9515.3110.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin The changes to paragraph (a) are effective July 1, 2023; the
change to paragraph (c), clause (12), is effective the day following final enactment; and the
new paragraph (c), clause (15), is effective January 1, 2024.
new text end

Sec. 6.

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

Subd. 1a.

Procedure.

(a) Individuals and organizations that are required under this
section to have or initiate background studies shall comply with the requirements of this
chapter.

(b) All studies conducted under this section shall be conducted according to sections
299C.60 to 299C.64. This requirement does not apply to subdivisions 1, paragraph (c),
clauses (2) to (5), and 6a.

new text begin (c) All data obtained by the commissioner for a background study completed under this
section is classified as private data on individuals, as defined in section 13.02, subdivision
12.
new text end

Sec. 7.

Minnesota Statutes 2022, section 245C.031, subdivision 1, is amended to read:

Subdivision 1.

Alternative background studies.

(a) The commissioner shall conduct
an alternative background study of individuals listed in this section.

(b) Notwithstanding other sections of this chapter, all alternative background studies
except subdivision 12 shall be conducted according to this section and with sections 299C.60
to 299C.64.

(d) The entity that submits an alternative background study request under this section
shall submit the request to the commissioner according to section 245C.05.

(e) The commissioner shall comply with the destruction requirements in section 245C.051.

(f) Background studies conducted under this section are subject to the provisions of
section 245C.32.

(g) The commissioner shall forward all information that the commissioner receives under
section 245C.08 to the entity that submitted the alternative background study request under
subdivision 2. The commissioner shall not make any eligibility determinations regarding
background studies conducted under this section.

new text begin (h) All data obtained by the commissioner for a background study completed under this
section is classified as private data on individuals, as defined in section 13.02, subdivision
12.
new text end

Sec. 8.

new text begin [245C.033] GUARDIANS AND CONSERVATORS; MALTREATMENT
AND STATE LICENSING AGENCY CHECKS.
new text end

new text begin Subdivision 1.new text end

new text begin Maltreatment data.new text end

new text begin Requests for maltreatment data submitted pursuant
to section 524.5-118 must include information regarding whether the guardian or conservator
has been a perpetrator of substantiated maltreatment of a vulnerable adult under section
626.557 or a minor under chapter 260E. If the guardian or conservator has been the
perpetrator of substantiated maltreatment of a vulnerable adult or a minor, the commissioner
must include a copy of any available public portion of the investigation memorandum under
section 626.557, subdivision 12b, or any available public portion of the investigation
memorandum under section 260E.30.
new text end

new text begin Subd. 2.new text end

new text begin State licensing agency data.new text end

new text begin (a) Requests for state licensing agency data
submitted pursuant to section 524.5-118 must include information from a check of state
licensing agency records.
new text end

new text begin (b) The commissioner shall provide the court with licensing agency data for licenses
directly related to the responsibilities of a guardian or conservator if the guardian or
conservator has a current or prior affiliation with the:
new text end

new text begin (1) Lawyers Responsibility Board;
new text end

new text begin (2) State Board of Accountancy;
new text end

new text begin (3) Board of Social Work;
new text end

new text begin (4) Board of Psychology;
new text end

new text begin (5) Board of Nursing;
new text end

new text begin (6) Board of Medical Practice;
new text end

new text begin (7) Department of Education;
new text end

new text begin (8) Department of Commerce;
new text end

new text begin (9) Board of Chiropractic Examiners;
new text end

new text begin (10) Board of Dentistry;
new text end

new text begin (11) Board of Marriage and Family Therapy;
new text end

new text begin (12) Department of Human Services;
new text end

new text begin (13) Peace Officer Standards and Training (POST) Board; or
new text end

new text begin (14) Professional Educator Licensing and Standards Board.
new text end

new text begin (c) The commissioner shall provide to the court the electronically available data
maintained in the agency's database, including whether the guardian or conservator is or
has been licensed by the agency and whether a disciplinary action or a sanction against the
individual's license, including a condition, suspension, revocation, or cancellation, is in the
licensing agency's database.
new text end

new text begin Subd. 3.new text end

new text begin Procedure; maltreatment and state licensing agency data.new text end

new text begin Requests for
maltreatment and state licensing agency data checks must be submitted by the guardian or
conservator to the commissioner on the form or in the manner prescribed by the
commissioner. Upon receipt of a signed informed consent and payment under section
245C.10, the commissioner shall complete the maltreatment and state licensing agency
checks. Upon completion of the checks, the commissioner shall provide the requested
information to the courts on the form or in the manner prescribed by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Classification of maltreatment and state licensing agency data; access to
information.new text end

new text begin All data obtained by the commissioner for maltreatment and state licensing
agency checks completed under this section is classified as private data on individuals, as
defined in section 13.02, subdivision 12.
new text end

Sec. 9.

Minnesota Statutes 2022, section 245C.04, subdivision 1, is amended to read:

Subdivision 1.

Licensed programs; other child care programs.

(a) The commissioner
shall conduct a background study of an individual required to be studied under section
245C.03, subdivision 1, at least upon application for initial license for all license types.

(b) The commissioner shall conduct a background study of an individual required to be
studied under section 245C.03, subdivision 1, including a child care background study
subject as defined in section 245C.02, subdivision 6a, in a family child care program, licensed
child care center, certified license-exempt child care center, or legal nonlicensed child care
provider, on a schedule determined by the commissioner. Except as provided in section
245C.05, subdivision 5a, a child care background study must include submission of
fingerprints for a national criminal history record check and a review of the information
under section 245C.08. A background study for a child care program must be repeated
within five years from the most recent study conducted under this paragraph.

new text begin (c) At reauthorization or when a new background study is needed under section 119B.125,
subdivision 1a, for a legal nonlicensed child care provider authorized under chapter 119B:
new text end

new text begin (1) for a background study affiliated with a legal nonlicensed child care provider, the
individual shall provide information required under section 245C.05, subdivision 1,
paragraphs (a), (b), and (d), to the commissioner and be fingerprinted and photographed
under section 245C.05, subdivision 5; and
new text end

new text begin (2) the commissioner shall verify the information received under clause (1) and submit
the request in NETStudy 2.0 to complete the background study.
new text end

deleted text begin (c)deleted text end new text begin (d)new text end At reapplication for a family child care license:

(1) for a background study affiliated with a licensed family child care center deleted text begin or legal
nonlicensed child care providerdeleted text end , the individual shall provide information required under
section 245C.05, subdivision 1, paragraphs (a), (b), and (d), to the county agency, and be
fingerprinted and photographed under section 245C.05, subdivision 5;

(2) the county agency shall verify the information received under clause (1) and forward
the information to the commissioner new text begin and submit the request in NETStudy 2.0 new text end to complete
the background study; and

(3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08.

deleted text begin (d)deleted text end new text begin (e)new text end The commissioner is not required to conduct a study of an individual at the time
of reapplication for a license if the individual's background study was completed by the
commissioner of human services and the following conditions are met:

(1) a study of the individual was conducted either at the time of initial licensure or when
the individual became affiliated with the license holder;

(2) the individual has been continuously affiliated with the license holder since the last
study was conducted; and

(3) the last study of the individual was conducted on or after October 1, 1995.

deleted text begin (e)deleted text end new text begin (f)new text end The commissioner of human services shall conduct a background study of an
individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6),
who is newly affiliated with a child foster family setting license holder:

(1) the county or private agency shall collect and forward to the commissioner the
information required under section 245C.05, subdivisions 1 and 5, when the child foster
family setting applicant or license holder resides in the home where child foster care services
are provided; and

(2) the background study conducted by the commissioner of human services under this
paragraph must include a review of the information required under section 245C.08,
subdivisions 1, 3, and 4.

deleted text begin (f)deleted text end new text begin (g)new text end The commissioner shall conduct a background study of an individual specified
under section 245C.03, subdivision 1, paragraph (a), clauses (2) to (6), who is newly affiliated
with an adult foster care or family adult day services and with a family child care license
holder or a legal nonlicensed child care provider authorized under chapter 119B and:

(1) except as provided in section 245C.05, subdivision 5a, the county shall collect and
forward to the commissioner the information required under section 245C.05, subdivision
1, paragraphs (a) and (b), and subdivision 5, paragraph (b), for background studies conducted
by the commissioner for all family adult day services, for adult foster care when the adult
foster care license holder resides in the adult foster care residence, and for family child care
and legal nonlicensed child care authorized under chapter 119B;

(2) the license holder shall collect and forward to the commissioner the information
required under section 245C.05, subdivisions 1, paragraphs (a) and (b); and 5, paragraphs
(a) and (b), for background studies conducted by the commissioner for adult foster care
when the license holder does not reside in the adult foster care residence; and

(3) the background study conducted by the commissioner under this paragraph must
include a review of the information required under section 245C.08, subdivision 1, paragraph
(a), and subdivisions 3 and 4.

deleted text begin (g)deleted text end new text begin (h)new text end Applicants for licensure, license holders, and other entities as provided in this
chapter must submit completed background study requests to the commissioner using the
electronic system known as NETStudy before individuals specified in section 245C.03,
subdivision 1, begin positions allowing direct contact in any licensed program.

deleted text begin (h)deleted text end new text begin (i)new text end For an individual who is not on the entity's active roster, the entity must initiate
a new background study through NETStudy when:

(1) an individual returns to a position requiring a background study following an absence
of 120 or more consecutive days; or

(2) a program that discontinued providing licensed direct contact services for 120 or
more consecutive days begins to provide direct contact licensed services again.

The license holder shall maintain a copy of the notification provided to the commissioner
under this paragraph in the program's files. If the individual's disqualification was previously
set aside for the license holder's program and the new background study results in no new
information that indicates the individual may pose a risk of harm to persons receiving
services from the license holder, the previous set-aside shall remain in effect.

deleted text begin (i)deleted text end new text begin (j)new text end For purposes of this section, a physician licensed under chapter 147, advanced
practice registered nurse licensed under chapter 148, or physician assistant licensed under
chapter 147A is considered to be continuously affiliated upon the license holder's receipt
from the commissioner of health or human services of the physician's, advanced practice
registered nurse's, or physician assistant's background study results.

deleted text begin (j)deleted text end new text begin (k)new text end For purposes of family child care, a substitute caregiver must receive repeat
background studies at the time of each license renewal.

deleted text begin (k)deleted text end new text begin (l)new text end A repeat background study at the time of license renewal is not required if the
family child care substitute caregiver's background study was completed by the commissioner
on or after October 1, 2017, and the substitute caregiver is on the license holder's active
roster in NETStudy 2.0.

deleted text begin (l)deleted text end new text begin (m)new text end Before and after school programs authorized under chapter 119B, are exempt
from the background study requirements under section 123B.03, for an employee for whom
a background study under this chapter has been completed.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 10.

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

Subdivision 1.

Individual studied.

(a) The individual who is the subject of the
background study must provide the applicant, license holder, or other entity under section
245C.04 with sufficient information to ensure an accurate study, including:

(1) the individual's first, middle, and last name and all other names by which the
individual has been known;

(2) current home address, city, and state of residence;

(3) current zip code;

(4) sex;

(5) date of birth;

(6) driver's license number or state identification numbernew text begin or, for those without a driver's
license or state identification card, an acceptable form of identification as determined by
the commissionernew text end ; and

(7) upon implementation of NETStudy 2.0, the home address, city, county, and state of
residence for the past five years.

(b) Every subject of a background study conducted or initiated by counties or private
agencies under this chapter must also provide the home address, city, county, and state of
residence for the past five years.

(c) Every subject of a background study related to private agency adoptions or related
to child foster care licensed through a private agency, who is 18 years of age or older, shall
also provide the commissioner a signed consent for the release of any information received
from national crime information databases to the private agency that initiated the background
study.

(d) The subject of a background study shall provide fingerprints and a photograph as
required in subdivision 5.

(e) The subject of a background study shall submit a completed criminal and maltreatment
history records check consent form new text begin and criminal history disclosure formnew text end for applicable
national and state level record checks.

new text begin (f) A background study subject who has access to the NETStudy 2.0 applicant portal
must provide updated contact information to the commissioner via NETStudy 2.0 any time
the subject's personal information changes for as long as they remain affiliated on any roster.
new text end

new text begin (g) An entity must update contact information in NETStudy 2.0 for a background study
subject on the entity's roster any time the entity receives new contact information from the
study subject.
new text end

Sec. 11.

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

Subd. 2c.

Privacy notice to background study subject.

(a) Prior to initiating each
background study, the entity initiating the study must provide the commissioner's privacy
notice to the background study subject required under section 13.04, subdivision 2. The
notice must be available through the commissioner's electronic NETStudy and NETStudy
2.0 systems and shall include the information in paragraphs (b) and (c).

(b) The background study subject shall be informed that any previous background studies
that received a set-aside will be reviewed, and without further contact with the background
study subject, the commissioner may notify the agency that initiated the subsequent
background studydeleted text begin :
deleted text end

deleted text begin (1)deleted text end that the individual has a disqualification that has been set aside for the program or
agency that initiated the studydeleted text begin ;deleted text end new text begin .
new text end

deleted text begin (2) the reason for the disqualification; and
deleted text end

deleted text begin (3) that information about the decision to set aside the disqualification will be available
to the license holder upon request without the consent of the background study subject.
deleted text end

(1) the subject's fingerprints collected for purposes of completing the background study
under this chapter must not be retained by the Department of Public Safety, Bureau of
Criminal Apprehension, or by the commissioner. The Federal Bureau of Investigation will
not retain background study subjects' fingerprints;

(2) effective upon implementation of NETStudy 2.0, the subject's photographic image
will be retained by the commissioner, and if the subject has provided the subject's Social
Security number for purposes of the background study, the photographic image will be
available to prospective employers and agencies initiating background studies under this
chapter to verify the identity of the subject of the background study;

(3) the authorized fingerprint collection vendor or vendors shall, for purposes of verifying
the identity of the background study subject, be able to view the identifying information
entered into NETStudy 2.0 by the entity that initiated the background study, but shall not
retain the subject's fingerprints, photograph, or information from NETStudy 2.0. The
authorized fingerprint collection vendor or vendors shall retain no more than the subject's
name and the date and time the subject's fingerprints were recorded and sent, only as
necessary for auditing and billing activities;

(4) the commissioner shall provide the subject notice, as required in section 245C.17,
subdivision 1, paragraph (a), when an entity initiates a background study on the individual;

(5) the subject may request in writing a report listing the entities that initiated a
background study on the individual as provided in section 245C.17, subdivision 1, paragraph
(b);

(6) the subject may request in writing that information used to complete the individual's
background study in NETStudy 2.0 be destroyed if the requirements of section 245C.051,
paragraph (a), are met; and

(7) notwithstanding clause (6), the commissioner shall destroy:

(i) the subject's photograph after a period of two years when the requirements of section
245C.051, paragraph (c), are met; and

(ii) any data collected on a subject under this chapter after a period of two years following
the individual's death as provided in section 245C.051, paragraph (d).

new text begin EFFECTIVE DATE.new text end

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

Sec. 12.

Minnesota Statutes 2022, section 245C.05, subdivision 4, is amended to read:

Subd. 4.

Electronic transmission.

(a) For background studies conducted by the
Department of Human Services, the commissioner shall implement a secure system for the
electronic transmission of:

(1) background study information to the commissioner;

(2) background study results to the license holder;

(3) background study information obtained under this section and section 245C.08 to
counties and private agencies for background studies conducted by the commissioner for
child foster care, including a summary of nondisqualifying results, except as prohibited by
law; and

(4) background study results to county agencies for background studies conducted by
the commissioner for adult foster care and family adult day services and, upon
implementation of NETStudy 2.0, family child care deleted text begin and legal nonlicensed child care
authorized under chapter deleted text end deleted text begin 119Bdeleted text end .

(b) Unless the commissioner has granted a hardship variance under paragraph (c), a
license holder or an applicant must use the electronic transmission system known as
NETStudy or NETStudy 2.0 to submit all requests for background studies to the
commissioner as required by this chapter.

(c) A license holder or applicant whose program is located in an area in which high-speed
Internet is inaccessible may request the commissioner to grant a variance to the electronic
transmission requirement.

(d) Section 245C.08, subdivision 3, paragraph (c), applies to results transmitted under
this subdivision.

new text begin (e) The background study subject shall access background study-related documents
electronically in the applicant portal. A background study subject may request for the
commissioner to grant a variance to the requirement to access documents electronically in
the NETStudy 2.0 applicant portal and may also request paper documentation of their
background studies.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin The amendments to paragraph (a), clause (4), are effective April
28, 2025, and paragraph (e) is effective November 1, 2024.
new text end

Sec. 13.

Minnesota Statutes 2022, section 245C.08, subdivision 1, is amended to read:

Subdivision 1.

Background studies conducted by Department of Human Services.

(a)
For a background study conducted by the Department of Human Services, the commissioner
shall review:

(1) information related to names of substantiated perpetrators of maltreatment of
vulnerable adults that has been received by the commissioner as required under section
626.557, subdivision 9c, paragraph (j);

(2) the commissioner's records relating to the maltreatment of minors in licensed
programs, and from findings of maltreatment of minors as indicated through the social
service information system;

(3) information from juvenile courts as required in subdivision 4 for individuals listed
in section 245C.03, subdivision 1, paragraph (a), when there is reasonable cause;

(4) information from the Bureau of Criminal Apprehension, including information
regarding a background study subject's registration in Minnesota as a predatory offender
under section 243.166;

(5) except as provided in clause (6), information received as a result of submission of
fingerprints for a national criminal history record check, as defined in section 245C.02,
subdivision 13c, when the commissioner has reasonable cause for a national criminal history
record check as defined under section 245C.02, subdivision 15a, or as required under section
144.057, subdivision 1, clause (2);

(6) for a background study related to a child foster family setting application for licensure,
foster residence settings, children's residential facilities, a transfer of permanent legal and
physical custody of a child under sections 260C.503 to 260C.515, or adoptions, and for a
background study required for family child care, certified license-exempt child care, child
care centers, and legal nonlicensed child care authorized under chapter 119B, the
commissioner shall also review:

(i) information from the child abuse and neglect registry for any state in which the
background study subject has resided for the past five years;

(ii) when the background study subject is 18 years of age or older, or a minor under
section 245C.05, subdivision 5a, paragraph (c), information received following submission
of fingerprints for a national criminal history record check; and

(iii) when the background study subject is 18 years of age or older or a minor under
section 245C.05, subdivision 5a, paragraph (d), for licensed family child care, certified
license-exempt child care, licensed child care centers, and legal nonlicensed child care
authorized under chapter 119B, information obtained using non-fingerprint-based data
including information from the criminal and sex offender registries for any state in which
the background study subject resided for the past five years and information from the national
crime information database and the national sex offender registry; deleted text begin and
deleted text end

(7) for a background study required for family child care, certified license-exempt child
care centers, licensed child care centers, and legal nonlicensed child care authorized under
chapter 119B, the background study shall also include, to the extent practicable, a name
and date-of-birth search of the National Sex Offender Public websitenew text begin ; and
new text end

new text begin (8) for a background study required for treatment programs for sexual psychopathic
personalities or sexually dangerous persons, the background study shall only include a
review of the information required under paragraph (a), clauses (1) to (4)new text end .

(b) Notwithstanding expungement by a court, the commissioner may consider information
obtained under paragraph (a), clauses (3) and (4), unless the commissioner received notice
of the petition for expungement and the court order for expungement is directed specifically
to the commissioner.

(c) The commissioner shall also review criminal case information received according
to section 245C.04, subdivision 4a, from the Minnesota court information system that relates
to individuals who have already been studied under this chapter and who remain affiliated
with the agency that initiated the background study.

(d) When the commissioner has reasonable cause to believe that the identity of a
background study subject is uncertain, the commissioner may require the subject to provide
a set of classifiable fingerprints for purposes of completing a fingerprint-based record check
with the Bureau of Criminal Apprehension. Fingerprints collected under this paragraph
shall not be saved by the commissioner after they have been used to verify the identity of
the background study subject against the particular criminal record in question.

(e) The commissioner may inform the entity that initiated a background study under
NETStudy 2.0 of the status of processing of the subject's fingerprints.

new text begin EFFECTIVE DATE.new text end

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

Sec. 14.

Minnesota Statutes 2022, section 245C.10, subdivision 1d, is amended to read:

Subd. 1d.

new text begin State; new text end national criminal history record check fees.

The commissioner may
increase background study fees as necessary, commensurate with an increase in new text begin state Bureau
of Criminal Apprehension or new text end the national criminal history record check deleted text begin feedeleted text end new text begin feesnew text end . deleted text begin Thedeleted text end
deleted text begin commissioner shall report any fee increase under this subdivision to the legislature during
deleted text end deleted text begin the legislative session following the fee increase, so that the legislature may consider adoption
deleted text end deleted text begin of the fee increase into statute. By July 1 of every year, background study fees shall be set
deleted text end deleted text begin at the amount adopted by the legislature under this section.
deleted text end

Sec. 15.

Minnesota Statutes 2022, section 245C.10, subdivision 2, is amended to read:

Subd. 2.

Supplemental nursing services agencies.

The commissioner shall recover the
cost of the background studies initiated by supplemental nursing services agencies registered
under section 144A.71, subdivision 1, through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study
charged to the agency. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 16.

Minnesota Statutes 2022, section 245C.10, subdivision 2a, is amended to read:

Subd. 2a.

Occupations regulated by commissioner of health.

The commissioner shall
set fees to recover the cost of combined background studies and criminal background checks
initiated by applicants, licensees, and certified practitioners regulated under sections 148.511
to 148.5198 and chapter 153Anew text begin through a fee of no more than $44 per study charged to the
entitynew text end . The fees collected under this subdivision shall be deposited in the special revenue
fund and are appropriated to the commissioner for the purpose of conducting background
studies and criminal background checks.

new text begin EFFECTIVE DATE.new text end

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

Sec. 17.

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

Subd. 3.

Personal care provider organizations.

The commissioner shall recover the
cost of background studies initiated by a personal care provider organization under sections
256B.0651 to 256B.0654 and 256B.0659 through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study
charged to the organization responsible for submitting the background study form. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.

Sec. 18.

Minnesota Statutes 2022, section 245C.10, subdivision 4, is amended to read:

Subd. 4.

Temporary personnel agencies, new text begin personnel pool agencies,new text end educational
programs, and professional services agencies.

The commissioner shall recover the cost
of the background studies initiated by temporary personnel agencies, new text begin personnel pool agencies,new text end
educational programs, and professional services agencies that initiate background studies
under section 245C.03, subdivision 4, through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study
charged to the agency. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 19.

Minnesota Statutes 2022, section 245C.10, subdivision 5, is amended to read:

Subd. 5.

Adult foster care and family adult day services.

The commissioner shall
recover the cost of background studies required under section 245C.03, subdivision 1, for
the purposes of adult foster care and family adult day services licensing, through a fee of
no more than deleted text begin $42deleted text end new text begin $44new text end per study charged to the license holder. The fees collected under this
subdivision are appropriated to the commissioner for the purpose of conducting background
studies.

Sec. 20.

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

Subd. 6.

Unlicensed home and community-based waiver providers of service to
seniors and individuals with disabilities.

The commissioner shall recover the cost of
background studies initiated by unlicensed home and community-based waiver providers
of service to seniors and individuals with disabilities under section 256B.4912 through a
fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study.

Sec. 21.

Minnesota Statutes 2022, section 245C.10, subdivision 8, is amended to read:

Subd. 8.

Children's therapeutic services and supports providers.

The commissioner
shall recover the cost of background studies required under section 245C.03, subdivision
7, for the purposes of children's therapeutic services and supports under section 256B.0943,
through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study charged to the license holder. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.

Sec. 22.

Minnesota Statutes 2022, section 245C.10, subdivision 9, is amended to read:

Subd. 9.

Human services licensed programs.

The commissioner shall recover the cost
of background studies required under section 245C.03, subdivision 1, for all programs that
are licensed by the commissioner, except child foster care when the applicant or license
holder resides in the home where child foster care services are provided, family child care,
child care centers, certified license-exempt child care centers, and legal nonlicensed child
care authorized under chapter 119B, through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study charged
to the license holder. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 23.

Minnesota Statutes 2022, section 245C.10, subdivision 9a, is amended to read:

Subd. 9a.

Child care programs.

The commissioner shall recover the cost of a background
study required for family child care, certified license-exempt child care centers, licensed
child care centers, and legal nonlicensed child care providers authorized under chapter 119B
through a fee of no more than deleted text begin $40deleted text end new text begin $44new text end per study charged to the license holder. A fee of no
more than deleted text begin $42deleted text end new text begin $44new text end per study shall be charged for studies conducted under section 245C.05,
subdivision 5a, paragraph (a). The fees collected under this subdivision are appropriated to
the commissioner to conduct background studies.

Sec. 24.

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

Subd. 10.

Community first services and supports organizations.

The commissioner
shall recover the cost of background studies initiated by an agency-provider delivering
services under section 256B.85, subdivision 11, or a financial management services provider
providing service functions under section 256B.85, subdivision 13, through a fee of no more
than deleted text begin $42deleted text end new text begin $44new text end per study, charged to the organization responsible for submitting the background
study form. The fees collected under this subdivision are appropriated to the commissioner
for the purpose of conducting background studies.

Sec. 25.

Minnesota Statutes 2022, section 245C.10, subdivision 11, is amended to read:

Subd. 11.

Providers of housing support.

The commissioner shall recover the cost of
background studies initiated by providers of housing support under section 256I.04 through
a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study. The fees collected under this subdivision are
appropriated to the commissioner for the purpose of conducting background studies.

Sec. 26.

Minnesota Statutes 2022, section 245C.10, subdivision 12, is amended to read:

Subd. 12.

Child protection workers or social services staff having responsibility for
child protective duties.

The commissioner shall recover the cost of background studies
initiated by county social services agencies and local welfare agencies for individuals who
are required to have a background study under section 260E.36, subdivision 3, through a
fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study. The fees collected under this subdivision are
appropriated to the commissioner for the purpose of conducting background studies.

Sec. 27.

Minnesota Statutes 2022, section 245C.10, subdivision 13, is amended to read:

Subd. 13.

Providers of special transportation service.

The commissioner shall recover
the cost of background studies initiated by providers of special transportation service under
section 174.30 through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study. The fees collected under
this subdivision are appropriated to the commissioner for the purpose of conducting
background studies.

Sec. 28.

Minnesota Statutes 2022, section 245C.10, subdivision 14, is amended to read:

Subd. 14.

Children's residential facilities.

The commissioner shall recover the cost of
background studies initiated by a licensed children's residential facility through a fee of no
more than deleted text begin $51deleted text end new text begin $53new text end per study. Fees collected under this subdivision are appropriated to the
commissioner for purposes of conducting background studies.

Sec. 29.

Minnesota Statutes 2022, section 245C.10, subdivision 15, is amended to read:

Subd. 15.

Guardians and conservators.

The commissioner shall recover the cost of
conducting deleted text begin background studiesdeleted text end new text begin maltreatment and state licensing agency checksnew text end for guardians
and conservators under section deleted text begin 524.5-118deleted text end new text begin 245C.033 new text end through a fee of no more than deleted text begin $110
per studydeleted text end new text begin $50new text end . The fees collected under this subdivision are appropriated to the commissioner
for the purpose of conducting deleted text begin background studiesdeleted text end new text begin maltreatment and state licensing agency
checksnew text end . The fee deleted text begin for conducting an alternative background study for appointment of a
professional guardian or conservator must be paid by the guardian or conservator. In other
cases, the fee must be paid as follows:deleted text end new text begin must be paid directly to and in the manner prescribed
by the commissioner before any maltreatment and state licensing agency checks under
section 245C.033 may be conducted.
new text end

deleted text begin (1) if the matter is proceeding in forma pauperis, the fee must be paid as an expense for
purposes of section 524.5-502, paragraph (a);
deleted text end

deleted text begin (2) if there is an estate of the ward or protected person, the fee must be paid from the
estate; or
deleted text end

deleted text begin (3) in the case of a guardianship or conservatorship of a person that is not proceeding
in forma pauperis, the fee must be paid by the guardian, conservator, or the court.
deleted text end

Sec. 30.

Minnesota Statutes 2022, section 245C.10, subdivision 16, is amended to read:

Subd. 16.

Providers of housing deleted text begin supportdeleted text end new text begin stabilizationnew text end services.

The commissioner shall
recover the cost of background studies initiated by providers of housing deleted text begin supportdeleted text end new text begin stabilizationnew text end
services under section 256B.051 through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study. The fees
collected under this subdivision are appropriated to the commissioner for the purpose of
conducting background studies.

Sec. 31.

Minnesota Statutes 2022, section 245C.10, subdivision 17, is amended to read:

Subd. 17.

Early intensive developmental and behavioral intervention providers.

The
commissioner shall recover the cost of background studies required under section 245C.03,
subdivision 15, for the purposes of early intensive developmental and behavioral intervention
under section 256B.0949, through a fee of no more than deleted text begin $42deleted text end new text begin $44new text end per study charged to the
enrolled agency. The fees collected under this subdivision are appropriated to the
commissioner for the purpose of conducting background studies.

Sec. 32.

Minnesota Statutes 2022, section 245C.10, subdivision 20, is amended to read:

Subd. 20.

Professional Educators Licensing Standards Board.

The commissioner
shall recover the cost of background studies initiated by the Professional Educators Licensing
Standards Board through a fee of no more than deleted text begin $51deleted text end new text begin $53new text end per study. Fees collected under this
subdivision are appropriated to the commissioner for purposes of conducting background
studies.

Sec. 33.

Minnesota Statutes 2022, section 245C.10, subdivision 21, is amended to read:

Subd. 21.

Board of School Administrators.

The commissioner shall recover the cost
of background studies initiated by the Board of School Administrators through a fee of no
more than deleted text begin $51deleted text end new text begin $53new text end per study. Fees collected under this subdivision are appropriated to the
commissioner for purposes of conducting background studies.

Sec. 34.

Minnesota Statutes 2022, section 245C.15, subdivision 2, is amended to read:

Subd. 2.

15-year disqualification.

(a) An individual is disqualified under section 245C.14
if: (1) less than 15 years have passed since the discharge of the sentence imposed, if any,
for the offense; and (2) the individual has committed a felony-level violation of any of the
following offenses: sections new text begin 152.021, subdivision 1 or 2b, (aggravated controlled substance
crime in the first degree; sale crimes); 152.022, subdivision 1 (controlled substance crime
in the second degree; sale crimes); 152.023, subdivision 1 (controlled substance crime in
the third degree; sale crimes); 152.024, subdivision 1 (controlled substance crime in the
fourth degree; sale crimes); new text end 256.98 (wrongfully obtaining assistance); 268.182 (fraud);
393.07, subdivision 10, paragraph (c) (federal SNAP fraud); 609.165 (felon ineligible to
possess firearm); 609.2112, 609.2113, or 609.2114 (criminal vehicular homicide or injury);
609.215 (suicide); 609.223 or 609.2231 (assault in the third or fourth degree); repeat offenses
under 609.224 (assault in the fifth degree); 609.229 (crimes committed for benefit of a
gang); 609.2325 (criminal abuse of a vulnerable adult); 609.2335 (financial exploitation of
a vulnerable adult); 609.235 (use of drugs to injure or facilitate crime); 609.24 (simple
robbery); 609.255 (false imprisonment); 609.2664 (manslaughter of an unborn child in the
first degree); 609.2665 (manslaughter of an unborn child in the second degree); 609.267
(assault of an unborn child in the first degree); 609.2671 (assault of an unborn child in the
second degree); 609.268 (injury or death of an unborn child in the commission of a crime);
609.27 (coercion); 609.275 (attempt to coerce); 609.466 (medical assistance fraud); 609.495
(aiding an offender); 609.498, subdivision 1 or 1b (aggravated first-degree or first-degree
tampering with a witness); 609.52 (theft); 609.521 (possession of shoplifting gear); 609.525
(bringing stolen goods into Minnesota); 609.527 (identity theft); 609.53 (receiving stolen
property); 609.535 (issuance of dishonored checks); 609.562 (arson in the second degree);
609.563 (arson in the third degree); 609.582 (burglary); 609.59 (possession of burglary
tools); 609.611 (insurance fraud); 609.625 (aggravated forgery); 609.63 (forgery); 609.631
(check forgery; offering a forged check); 609.635 (obtaining signature by false pretense);
609.66 (dangerous weapons); 609.67 (machine guns and short-barreled shotguns); 609.687
(adulteration); 609.71 (riot); 609.713 (terroristic threats); 609.82 (fraud in obtaining credit);
609.821 (financial transaction card fraud); 617.23 (indecent exposure), not involving a
minor; repeat offenses under 617.241 (obscene materials and performances; distribution
and exhibition prohibited; penalty); new text begin or new text end 624.713 (certain persons not to possess firearms)deleted text begin ;
chapter 152 (drugs; controlled substance); or Minnesota Statutes 2012, section 609.21; or
a felony-level conviction involving alcohol or drug usedeleted text end .

(b) An individual is disqualified under section 245C.14 if less than 15 years has passed
since the individual's aiding and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.

(c) An individual is disqualified under section 245C.14 if less than 15 years has passed
since the termination of the individual's parental rights under section 260C.301, subdivision
1, paragraph (b), or subdivision 3.

(d) An individual is disqualified under section 245C.14 if less than 15 years has passed
since the discharge of the sentence imposed for an offense in any other state or country, the
elements of which are substantially similar to the elements of the offenses listed in paragraph
(a).

(e) If the individual studied commits one of the offenses listed in paragraph (a), but the
sentence or level of offense is a gross misdemeanor or misdemeanor, the individual is
disqualified but the disqualification look-back period for the offense is the period applicable
to the gross misdemeanor or misdemeanor disposition.

(f) When a disqualification is based on a judicial determination other than a conviction,
the disqualification period begins from the date of the court order. When a disqualification
is based on an admission, the disqualification period begins from the date of an admission
in court. When a disqualification is based on an Alford Plea, the disqualification period
begins from the date the Alford Plea is entered in court. When a disqualification is based
on a preponderance of evidence of a disqualifying act, the disqualification date begins from
the date of the dismissal, the date of discharge of the sentence imposed for a conviction for
a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective for background studies requested on or
after August 1, 2024.
new text end

Sec. 35.

Minnesota Statutes 2022, section 245C.15, is amended by adding a subdivision
to read:

new text begin Subd. 4b.new text end

new text begin Five-year disqualification.new text end

new text begin (a) An individual is disqualified under section
245C.14 if: (1) less than five years have passed since the discharge of the sentence imposed,
if any, for the offense; and (2) the individual has committed a felony, gross misdemeanor,
or misdemeanor-level violation of any of the following offenses: section 152.021, subdivision
2 or 2a (controlled substance possession crime in the first degree; methamphetamine
manufacture crime); 152.022, subdivision 2 (controlled substance possession crime in the
second degree); 152.023, subdivision 2 (controlled substance possession crime in the third
degree); 152.024, subdivision 2 (controlled substance possession crime in the fourth degree);
152.025 (controlled substance crime in the fifth degree); 152.0261 (importing controlled
substances across state borders); 152.0262 (possession of substances with intent to
manufacture methamphetamine); 152.027, subdivision 6, paragraph (c) (sale of synthetic
cannabinoids); 152.096 (conspiracy to commit controlled substance crime); or 152.097
(simulated controlled substances).
new text end

new text begin (b) An individual is disqualified under section 245C.14 if less than five years have passed
since the individual's aiding and abetting, attempt, or conspiracy to commit any of the
offenses listed in paragraph (a), as each of these offenses is defined in Minnesota Statutes.
new text end

new text begin (c) An individual is disqualified under section 245C.14 if less than five years have passed
since the discharge of the sentence imposed for an offense in any other state or country, the
elements of which are substantially similar to the elements of any of the offenses listed in
paragraph (a).
new text end

new text begin (d) When a disqualification is based on a judicial determination other than a conviction,
the disqualification period begins from the date of the court order. When a disqualification
is based on an admission, the disqualification period begins from the date of an admission
in court. When a disqualification is based on an Alford plea, the disqualification period
begins from the date the Alford plea is entered in court. When a disqualification is based
on a preponderance of evidence of a disqualifying act, the disqualification date begins from
the date of the dismissal, the date of discharge of the sentence imposed for a conviction for
a disqualifying crime of similar elements, or the date of the incident, whichever occurs last.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective for background studies requested on or
after August 1, 2024.
new text end

Sec. 36.

Minnesota Statutes 2022, section 245C.17, subdivision 2, is amended to read:

Subd. 2.

Disqualification notice sent to subject.

(a) If the information in the study
indicates the individual is disqualified from direct contact with, or from access to, persons
served by the program, the commissioner shall disclose to the individual studied:

(1) the information causing disqualification;

(2) instructions on how to request a reconsideration of the disqualification;

(3) an explanation of any restrictions on the commissioner's discretion to set aside the
disqualification under section 245C.24, when applicable to the individual;

deleted text begin (4) a statement that, if the individual's disqualification is set aside under section 245C.22,
the applicant, license holder, or other entity that initiated the background study will be
provided with the reason for the individual's disqualification and an explanation that the
factors under section 245C.22, subdivision 4, which were the basis of the decision to set
aside the disqualification shall be made available to the license holder upon request without
the consent of the subject of the background study;
deleted text end

deleted text begin (5) a statement indicating that if the individual's disqualification is set aside or the facility
is granted a variance under section 245C.30, the individual's identity and the reason for the
individual's disqualification will become public data under section 245C.22, subdivision 7,
when applicable to the individual;
deleted text end

deleted text begin (6)deleted text end new text begin (4)new text end a statement that when a subsequent background study is initiated on the individual
following a set-aside of the individual's disqualification, and the commissioner makes a
determination under section 245C.22, subdivision 5, paragraph (b), that the previous set-aside
applies to the subsequent background study, the applicant, license holder, or other entity
that initiated the background study will be informed in the notice under section 245C.22,
subdivision 5, paragraph (c)deleted text begin :deleted text end new text begin ,
new text end

deleted text begin (i) of the reason for the individual's disqualification;
deleted text end

deleted text begin (ii)deleted text end that the individual's disqualification is set aside for that program or agency; and

deleted text begin (iii) that information about the factors under section 245C.22, subdivision 4, that were
the basis of the decision to set aside the disqualification are available to the license holder
upon request without the consent of the background study subject; and
deleted text end

deleted text begin (7)deleted text end new text begin (5)new text end the commissioner's determination of the individual's immediate risk of harm
under section 245C.16.

(b) If the commissioner determines under section 245C.16 that an individual poses an
imminent risk of harm to persons served by the program where the individual will have
direct contact with, or access to, people receiving services, the commissioner's notice must
include an explanation of the basis of this determination.

(c) If the commissioner determines under section 245C.16 that an individual studied
does not pose a risk of harm that requires immediate removal, the individual shall be informed
of the conditions under which the agency that initiated the background study may allow the
individual to have direct contact with, or access to, people receiving services, as provided
under subdivision 3.

new text begin EFFECTIVE DATE.new text end

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

Sec. 37.

Minnesota Statutes 2022, section 245C.17, subdivision 3, is amended to read:

Subd. 3.

Disqualification notification.

(a) The commissioner shall notify an applicant,
license holder, or other entity as provided in this chapter who is not the subject of the study:

(1) that the commissioner has found information that disqualifies the individual studied
from being in a position allowing direct contact with, or access to, people served by the
program; and

(2) the commissioner's determination of the individual's risk of harm under section
245C.16.

(b) If the commissioner determines under section 245C.16 that an individual studied
poses an imminent risk of harm to persons served by the program where the individual
studied will have direct contact with, or access to, people served by the program, the
commissioner shall order the license holder to immediately remove the individual studied
from any position allowing direct contact with, or access to, people served by the program.

(c) If the commissioner determines under section 245C.16 that an individual studied
poses a risk of harm that requires continuous, direct supervision, the commissioner shall
order the applicant, license holder, or other entities as provided in this chapter to:

(1) immediately remove the individual studied from any position allowing direct contact
with, or access to, people receiving services; or

(2) before allowing the disqualified individual to be in a position allowing direct contact
with, or access to, people receiving services, the applicant, license holder, or other entity,
as provided in this chapter, must:

deleted text begin (i) obtain from the disqualified individual a copy of the individual's notice of
disqualification from the commissioner that explains the reason for disqualification;
deleted text end

deleted text begin (ii)deleted text end new text begin (i)new text end ensure that the individual studied is under continuous, direct supervision when
in a position allowing direct contact with, or access to, people receiving services during the
period in which the individual may request a reconsideration of the disqualification under
section 245C.21; and

deleted text begin (iii)deleted text end new text begin (ii)new text end ensure that the disqualified individual requests reconsideration within 30 days
of receipt of the notice of disqualification.

(d) If the commissioner determines under section 245C.16 that an individual studied
does not pose a risk of harm that requires continuous, direct supervision, the commissioner
shall order the applicant, license holder, or other entities as provided in this chapter to:

(1) immediately remove the individual studied from any position allowing direct contact
with, or access to, people receiving services; or

(2) before allowing the disqualified individual to be in any position allowing direct
contact with, or access to, people receiving services, the applicant, license holder, or other
entity as provided in this chapter mustdeleted text begin :
deleted text end

deleted text begin (ii)deleted text end ensure that the disqualified individual requests reconsideration within 15 days of
receipt of the notice of disqualification.

(e) The commissioner shall not notify the applicant, license holder, or other entity as
provided in this chapter of the information contained in the subject's background study
unless:

(1) the basis for the disqualification is failure to cooperate with the background study
deleted text begin or substantiated maltreatment under section 626.557 or chapter deleted text end deleted text begin 260Edeleted text end ;

(2) the Data Practices Act under chapter 13 provides for release of the information; or

(3) the individual studied authorizes the release of the information.

new text begin EFFECTIVE DATE.new text end

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

Sec. 38.

Minnesota Statutes 2022, section 245C.17, subdivision 6, is amended to read:

Subd. 6.

Notice to county agency.

For studies on individuals related to a license to
provide adult foster care when the applicant or license holder resides in the adult foster care
residence and family adult day services and, effective upon implementation of NETStudy
2.0, family child care deleted text begin and legal nonlicensed child care authorized under chapter 119Bdeleted text end , the
commissioner shall also provide a notice of the background study results to the county
agency that initiated the background study.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 39.

Minnesota Statutes 2022, section 245C.21, subdivision 1a, is amended to read:

Subd. 1a.

Submission of reconsideration request.

(a) For disqualifications related to
studies conducted by county agencies for family child care, and for disqualifications related
to studies conducted by the commissioner for child foster care, adult foster care, and family
adult day services when the applicant or license holder resides in the home where services
are provided, the individual shall submit the request for reconsideration to the county agency
that initiated the background study.

(b) For disqualifications related to studies conducted by the commissioner for child
foster care providers monitored by private licensing agencies under section 245A.16, the
individual shall submit the request for reconsideration to the private agency that initiated
the background study.

(c) A reconsideration request shall be submitted within 30 days of the individual's receipt
of the disqualification notice deleted text begin or the time frames specified in subdivision 2, whichever time
frame is shorterdeleted text end .

(d) The county or private agency shall forward the individual's request for reconsideration
and provide the commissioner with a recommendation whether to set aside the individual's
disqualification.

new text begin EFFECTIVE DATE.new text end

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

Sec. 40.

Minnesota Statutes 2022, section 245C.21, subdivision 2, is amended to read:

Subd. 2.

Time frame for requesting reconsideration.

(a) When the commissioner
sends an individual a notice of disqualification based on a finding under section 245C.16,
subdivision 2, paragraph (a), clause (1) or (2), the disqualified individual must submit the
request for a reconsideration within 30 calendar days of the individual's receipt of the notice
of disqualification. If mailed, the request for reconsideration must be postmarked and sent
to the commissioner within 30 calendar days of the individual's receipt of the notice of
disqualification. If a request for reconsideration is made by personal service, it must be
received by the commissioner within 30 calendar days after the individual's receipt of the
notice of disqualification. Upon showing that the information under subdivision 3 cannot
be obtained within 30 days, the disqualified individual may request additional time, not to
exceed 30 days, to obtain the information.

(b) When the commissioner sends an individual a notice of disqualification based on a
finding under section 245C.16, subdivision 2, paragraph (a), clause (3), the disqualified
individual must submit the request for reconsideration within deleted text begin 15deleted text end new text begin 30new text end calendar days of the
individual's receipt of the notice of disqualification. If mailed, the request for reconsideration
must be postmarked and sent to the commissioner within deleted text begin 15deleted text end new text begin 30new text end calendar days of the
individual's receipt of the notice of disqualification. If a request for reconsideration is made
by personal service, it must be received by the commissioner within deleted text begin 15deleted text end new text begin 30new text end calendar days
after the individual's receipt of the notice of disqualification.

(c) An individual who was determined to have maltreated a child under chapter 260E
or a vulnerable adult under section 626.557, and who is disqualified on the basis of serious
or recurring maltreatment, may request a reconsideration of both the maltreatment and the
disqualification determinations. The request must be submitted within 30 calendar days of
the individual's receipt of the notice of disqualification. If mailed, the request for
reconsideration must be postmarked and sent to the commissioner within 30 calendar days
of the individual's receipt of the notice of disqualification. If a request for reconsideration
is made by personal service, it must be received by the commissioner within 30 calendar
days after the individual's receipt of the notice of disqualification.

(d) Except for family child care and child foster care, reconsideration of a maltreatment
determination under sections 260E.33 and 626.557, subdivision 9d, and reconsideration of
a disqualification under section 245C.22, shall not be conducted when:

(1) a denial of a license under section 245A.05, or a licensing sanction under section
245A.07, is based on a determination that the license holder is responsible for maltreatment
or the disqualification of a license holder based on serious or recurring maltreatment;

(2) the denial of a license or licensing sanction is issued at the same time as the
maltreatment determination or disqualification; and

(3) the license holder appeals the maltreatment determination, disqualification, and
denial of a license or licensing sanction. In such cases, a fair hearing under section 256.045
must not be conducted under sections 245C.27, 260E.33, and 626.557, subdivision 9d.
Under section 245A.08, subdivision 2a, the scope of the consolidated contested case hearing
must include the maltreatment determination, disqualification, and denial of a license or
licensing sanction.

Notwithstanding clauses (1) to (3), if the license holder appeals the maltreatment
determination or disqualification, but does not appeal the denial of a license or a licensing
sanction, reconsideration of the maltreatment determination shall be conducted under sections
260E.33 and 626.557, subdivision 9d, and reconsideration of the disqualification shall be
conducted under section 245C.22. In such cases, a fair hearing shall also be conducted as
provided under sections 245C.27, 260E.33, and 626.557, subdivision 9d.

new text begin EFFECTIVE DATE.new text end

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

Sec. 41.

Minnesota Statutes 2022, section 245C.22, subdivision 7, is amended to read:

Subd. 7.

Classification of certain data.

(a) Notwithstanding section 13.46, except as
provided in paragraph deleted text begin (f)deleted text end new text begin (e)new text end , upon setting aside a disqualification under this section, the
identity of the disqualified individual who received the set-aside and the individual's
disqualifying characteristics are deleted text begin publicdeleted text end new text begin privatenew text end data deleted text begin if the set-aside was:deleted text end new text begin on individuals, as
defined in section 13.02, subdivision 12.
new text end

deleted text begin (1) for any disqualifying characteristic under section 245C.15, except a felony-level
conviction for a drug-related offense within the past five years, when the set-aside relates
to a child care center or a family child care provider licensed under chapter 245A, certified
license-exempt child care center, or legal nonlicensed family child care; or
deleted text end

deleted text begin (2) for a disqualifying characteristic under section 245C.15, subdivision 2.
deleted text end

(b) Notwithstanding section 13.46, upon granting a variance to a license holder under
section 245C.30, the identity of the disqualified individual who is the subject of the variance,
the individual's disqualifying characteristics under section 245C.15, and the terms of the
variance are deleted text begin public data, except as provided in paragraph (c), clause (6), when the variance:deleted text end new text begin
private data on individuals, as defined in section 13.02, subdivision 12.
new text end

deleted text begin (1) is issued to a child care center or a family child care provider licensed under chapter
245A; or
deleted text end

deleted text begin (2) relates to an individual with a disqualifying characteristic under section 245C.15,
subdivision 2.
deleted text end

(1) a disqualification is not set aside and no variance is granted, except as provided under
section 13.46, subdivision 4;

(2) the data are not public under paragraph (a) or (b);

(3) the disqualification is rescinded because the information relied upon to disqualify
the individual is incorrect;

(4) the disqualification relates to a license to provide relative child foster care. As used
in this clause, "relative" has the meaning given it under section 260C.007, subdivision 26b
or 27;

(5) the disqualified individual is a household member of a licensed foster care provider
and:

(i) the disqualified individual previously received foster care services from this licensed
foster care provider;

(ii) the disqualified individual was subsequently adopted by this licensed foster care
provider; and

(iii) the disqualifying act occurred before the adoption; or

(6) a variance is granted to a child care center or family child care license holder for an
individual's disqualification that is based on a felony-level conviction for a drug-related
offense that occurred within the past five years.

deleted text begin (d) Licensed family child care providers and child care centers must provide notices as
required under section 245C.301.
deleted text end

deleted text begin (e)deleted text end new text begin (d)new text end Notwithstanding paragraphs (a) and (b), the identity of household members who
are the subject of a disqualification related set-aside or variance is not public data if:

(1) the household member resides in the residence where the family child care is provided;

(2) the subject of the set-aside or variance is under the age of 18 years; and

(3) the set-aside or variance only relates to a disqualification under section 245C.15,
subdivision 4, for a misdemeanor-level theft crime as defined in section 609.52.

deleted text begin (f)deleted text end new text begin (e)new text end When the commissioner has reason to know that a disqualified individual has
received an order for expungement for the disqualifying record that does not limit the
commissioner's access to the record, and the record was opened or exchanged with the
commissioner for purposes of a background study under this chapter, the data that would
otherwise become public under paragraph (a) or (b) remain private data.

new text begin EFFECTIVE DATE.new text end

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

Sec. 42.

Minnesota Statutes 2022, section 245C.23, subdivision 1, is amended to read:

Subdivision 1.

Disqualification that is rescinded or set aside.

(a) If the commissioner
rescinds or sets aside a disqualification, the commissioner shall notify the applicant, license
holder, or other entity in writing or by electronic transmission of the decision.

(b) In the notice from the commissioner that a disqualification has been rescinded, the
commissioner must inform the applicant, license holder, or other entity that the information
relied upon to disqualify the individual was incorrect.

deleted text begin (c) Except as provided in paragraphs (d) and (e), in the notice from the commissioner
that a disqualification has been set aside, the commissioner must inform the applicant,
license holder, or other entity of the reason for the individual's disqualification and that
information about which factors under section 245C.22, subdivision 4, were the basis of
the decision to set aside the disqualification are available to the license holder upon request
without the consent of the background study subject.
deleted text end

deleted text begin (d) When the commissioner has reason to know that a disqualified individual has received
an order for expungement for the disqualifying record that does not limit the commissioner's
access to the record, and the record was opened or exchanged with the commissioner for
purposes of a background study under this chapter, the information provided under paragraph
(c) must only inform the applicant, license holder, or other entity that the disqualifying
criminal record is sealed under a court order.
deleted text end

deleted text begin (e) The notification requirements in paragraph (c) do not apply when the set aside is
granted to an individual related to a background study for a licensed child care center,
certified license-exempt child care center, or family child care license holder, or for a legal
nonlicensed child care provider authorized under chapter 119B, and the individual is
disqualified for a felony-level conviction for a drug-related offense that occurred within the
past five years. The notice that the individual's disqualification is set aside must inform the
applicant, license holder, or legal nonlicensed child care provider that the disqualifying
criminal record is not public.
deleted text end

new text begin (c) In response to a reconsideration request, the commissioner must inform the applicant,
license holder, or other entity that the reason for the individual's disqualification and the
information about which factors under section 245C.22, subdivision 4, were the basis of
the reconsideration decision are not public data.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 43.

Minnesota Statutes 2022, section 245C.23, subdivision 2, is amended to read:

Subd. 2.

Commissioner's notice of disqualification that is not set aside.

(a) The
commissioner shall notify the license holder of the disqualification and order the license
holder to immediately remove the individual from any position allowing direct contact with
persons receiving services from the license holder if:

(1) the individual studied does not submit a timely request for reconsideration under
section 245C.21;

(2) the individual submits a timely request for reconsideration, but the commissioner
does not set aside the disqualification for that license holder under section 245C.22, unless
the individual has a right to request a hearing under section 245C.27, 245C.28, or 256.045;

(3) an individual who has a right to request a hearing under sections 245C.27 and 256.045,
or 245C.28 and chapter 14 for a disqualification that has not been set aside, does not request
a hearing within the specified time; or

(4) an individual submitted a timely request for a hearing under sections 245C.27 and
256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
disqualification under section 245A.08, subdivision 5, or 256.045.

(b) If the commissioner does not set aside the disqualification under section 245C.22,
and the license holder was previously ordered under section 245C.17 to immediately remove
the disqualified individual from direct contact with persons receiving services or to ensure
that the individual is under continuous, direct supervision when providing direct contact
services, the order remains in effect pending the outcome of a hearing under sections 245C.27
and 256.045, or 245C.28 and chapter 14.

(c) If the commissioner does not set aside the disqualification under section 245C.22,
and the license holder was not previously ordered under section 245C.17 to immediately
remove the disqualified individual from direct contact with persons receiving services or
to ensure that the individual is under continuous direct supervision when providing direct
contact services, the commissioner shall order the individual to remain under continuous
direct supervision pending the outcome of a hearing under sections 245C.27 and 256.045,
or 245C.28 and chapter 14.

(d) For background studies related to child foster care when the applicant or license
holder resides in the home where services are provided, the commissioner shall also notify
the county or private agency that initiated the study of the results of the reconsideration.

(e) For background studies related to family child care, deleted text begin legal nonlicensed child care,deleted text end
adult foster care programs when the applicant or license holder resides in the home where
services are provided, and family adult day services, the commissioner shall also notify the
county that initiated the study of the results of the reconsideration.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 44.

Minnesota Statutes 2022, section 245C.30, subdivision 2, is amended to read:

Subd. 2.

Disclosure of reason for disqualification.

(a) The commissioner may not grant
a variance for a disqualified individual unless the applicant, license-exempt child care center
certification holder, or license holder requests the variance and the disqualified individual
provides written consent for the commissioner to disclose to the applicant, license-exempt
child care center certification holder, or license holder the reason for the disqualification.

(b) This subdivision does not apply to programs licensed to provide family child care
for children, foster care for children in the provider's own home, or foster care or day care
services for adults in the provider's own home. deleted text begin When the commissioner grants a variance
for a disqualified individual in connection with a license to provide the services specified
in this paragraph, the disqualified individual's consent is not required to disclose the reason
for the disqualification to the license holder in the variance issued under subdivision 1,
provided that the commissioner may not disclose the reason for the disqualification if the
disqualification is based on a felony-level conviction for a drug-related offense within the
past five years.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 45.

Minnesota Statutes 2022, section 245C.32, subdivision 2, is amended to read:

Subd. 2.

Use.

(a) The commissioner may also use these systems and records to obtain
and provide criminal history data from the Bureau of Criminal Apprehension, criminal
history data held by the commissioner, and data about substantiated maltreatment under
section 626.557 or chapter 260E, for other purposes, provided that:

(1) the background study is specifically authorized in statute; or

(2) the request is made with the informed consent of the subject of the study as provided
in section 13.05, subdivision 4.

(b) An individual making a request under paragraph (a), clause (2), must agree in writing
not to disclose the data to any other individual without the consent of the subject of the data.

(c)new text begin The commissioner may use these systems to share background study documentation
electronically with entities and individuals who are the subject of a background study.
new text end

new text begin (d)new text end The commissioner may recover the cost of obtaining and providing background study
data by charging the individual or entity requesting the study a fee deleted text begin of no more than $42 per
studydeleted text end new text begin as described in section 245C.10new text end . The fees collected under this paragraph are
appropriated to the commissioner for the purpose of conducting background studies.

Sec. 46.

Minnesota Statutes 2022, section 524.5-118, is amended to read:

524.5-118 deleted text begin BACKGROUND STUDYdeleted text end new text begin MALTREATMENT AND STATE LICENSING
AGENCY CHECKS; CRIMINAL HISTORY CHECKnew text end .

Subdivision 1.

When required; exception.

(a) The court shall require deleted text begin a background
studydeleted text end new text begin maltreatment and state licensing agency checks and a criminal history checknew text end under
this section:

(1) before the appointment of a guardian or conservator, unless deleted text begin a background study hasdeleted text end new text begin
maltreatment and state licensing agency checks and a criminal history check havenew text end been
done on the person under this section within the previous five years; and

(2) once every five years after the appointment, if the person continues to serve as a
guardian or conservator.

(b) The deleted text begin background studydeleted text end new text begin maltreatment and state licensing agency checks and the
criminal history checknew text end must include:

(1) criminal history data from the Bureau of Criminal Apprehensiondeleted text begin , other criminal
history data held by the commissioner of human services, and data regarding whether the
person has been a perpetrator of substantiated maltreatment of a vulnerable adult or minordeleted text end ;

(2) criminal history data from a national criminal history record check deleted text begin as defined in
section 245C.02, subdivision 13cdeleted text end ; deleted text begin and
deleted text end

(3) state licensing agency data if a search of the database or databases of the agencies
listed in subdivision 2a shows that the proposed guardian or conservator has ever held a
professional license directly related to the responsibilities of a professional fiduciary from
an agency listed in subdivision 2a that was conditioned, suspended, revoked, or cancelednew text begin ;
and
new text end

new text begin (4) data on whether the person has been a perpetrator of substantiated maltreatment of
a vulnerable adult or a minornew text end .

(c) If the guardian or conservator is not an individual, the deleted text begin background studydeleted text end new text begin maltreatment
and state licensing agency checks and the criminal history checknew text end must be done on all
individuals currently employed by the proposed guardian or conservator who will be
responsible for exercising powers and duties under the guardianship or conservatorship.

(d) new text begin Notwithstanding paragraph (a), new text end if the court determines that it would be in the best
interests of the person subject to guardianship or conservatorship to appoint a guardian or
conservator before the deleted text begin background studydeleted text end new text begin maltreatment and state licensing agency checks
and the criminal history checknew text end can be completed, the court may make the appointment
pending the results of the deleted text begin studydeleted text end new text begin checksnew text end , however, the deleted text begin background studydeleted text end new text begin maltreatment and
state licensing agency checks and the criminal history checknew text end must then be completed as
soon as reasonably possible after appointmentdeleted text begin , no later than 30 days after appointmentdeleted text end .

(e) The deleted text begin feedeleted text end new text begin feesnew text end for deleted text begin background studiesdeleted text end new text begin the maltreatment and state licensing agency
checks and the criminal history checknew text end conducted under this section deleted text begin isdeleted text end new text begin arenew text end specified in deleted text begin sectiondeleted text end new text begin
sectionsnew text end 245C.10, subdivision deleted text begin 14deleted text end new text begin 15, and 299C.10, subdivisions 4 and 5new text end . The deleted text begin feedeleted text end new text begin feesnew text end for
conducting deleted text begin a background studydeleted text end new text begin maltreatment and state licensing agency checks and the
criminal history checknew text end for new text begin the new text end appointment of a professional guardian or conservator must
be paid by the guardian or conservator. In other cases, the fee must be paid as follows:

(1) if the matter is proceeding in forma pauperis, the fee is an expense for purposes of
section 524.5-502, paragraph (a);

(2) if there is an estate of the person subject to guardianship or conservatorship, the fee
must be paid from the estate; or

(3) in the case of a guardianship or conservatorship of the person that is not proceeding
in forma pauperis, the court may order that the fee be paid by the guardian or conservator
or by the court.

(f) The requirements of this subdivision do not apply if the guardian or conservator is:

(1) a state agency or county;

(2) a parent or guardian of a person proposed to be subject to guardianship or
conservatorship who has a developmental disability, if the parent or guardian has raised the
person proposed to be subject to guardianship or conservatorship in the family home until
the time the petition is filed, unless counsel appointed for the person proposed to be subject
to guardianship or conservatorship under section 524.5-205, paragraph (e); 524.5-304,
paragraph (b); 524.5-405, paragraph (a); or 524.5-406, paragraph (b), recommends a
background deleted text begin studydeleted text end new text begin checknew text end ; or

(3) a bank with trust powers, bank and trust company, or trust company, organized under
the laws of any state or of the United States and which is regulated by the commissioner of
commerce or a federal regulator.

Subd. 2.

Procedure; deleted text begin criminal history and maltreatment records backgrounddeleted text end new text begin
maltreatment and state licensing agency checks and criminal historynew text end check.

(a) The
deleted text begin courtdeleted text end new text begin guardian or conservatornew text end shall request the deleted text begin commissioner of human servicesdeleted text end new text begin Bureau of
Criminal Apprehensionnew text end to complete a deleted text begin background study under section 245C.32deleted text end new text begin criminal
history checknew text end . The request must be accompanied by the applicable fee and acknowledgment
that the deleted text begin study subjectdeleted text end new text begin guardian or conservatornew text end received a privacy notice deleted text begin required under
subdivision 3deleted text end . The deleted text begin commissioner of human servicesdeleted text end new text begin Bureau of Criminal Apprehensionnew text end shall
conduct a national criminal history record check. The deleted text begin study subjectdeleted text end new text begin guardian or conservatornew text end
shall submit a set of classifiable fingerprints. The fingerprints must be recorded on a
fingerprint card provided by the deleted text begin commissioner of human servicesdeleted text end new text begin Bureau of Criminal
Apprehensionnew text end .

(b) The deleted text begin commissioner of human servicesdeleted text end new text begin Bureau of Criminal Apprehensionnew text end shall provide
the court with criminal history data as defined in section 13.87 deleted text begin from the Bureau of Criminal
Apprehension in the Department of Public Safety, other criminal history data held by the
commissioner of human services, data regarding substantiated maltreatment of vulnerable
adults under section 626.557, and substantiated maltreatment of minors under chapter deleted text end deleted text begin 260Edeleted text end deleted text begin ,deleted text end
and criminal history information from other states or jurisdictions as indicated from a national
criminal history record check within 20 working days of receipt of a request. deleted text begin If the subject
of the study has been the perpetrator of substantiated maltreatment of a vulnerable adult or
minor, the response must include a copy of the public portion of the investigation
memorandum under section 626.557, subdivision 12b, or the public portion of the
investigation memorandum under section 260E.30. The commissioner shall provide the
court with information from a review of information according to subdivision 2a if the study
subject provided information indicating current or prior affiliation with a state licensing
agency.
deleted text end

(c) new text begin In accordance with section 245C.033, the commissioner of human services shall
provide the court with data regarding substantiated maltreatment of vulnerable adults under
section 626.557 and substantiated maltreatment of minors under chapter 260E within 25
working days of receipt of a request. If the guardian or conservator has been the perpetrator
of substantiated maltreatment of a vulnerable adult or minor, the response must include a
copy of any available public portion of the investigation memorandum under section 626.557,
subdivision 12b, or any available public portion of the investigation memorandum under
section 260E.30.
new text end

new text begin (d) new text end Notwithstanding section 260E.30 or 626.557, subdivision 12b, if the commissioner
of human services or a county lead agency or lead investigative agency has information that
a person deleted text begin on whom a background study was previously donedeleted text end under this section has been
determined to be a perpetrator of maltreatment of a vulnerable adult or minor, the
commissioner or the county may provide this information to the court that deleted text begin requested the
background study. The commissioner may also provide the court with additional criminal
history or substantiated maltreatment information that becomes available after the background
study is donedeleted text end new text begin is determining eligibility for the guardian or conservatornew text end .

Subd. 2a.

Procedure; state licensing agency data.

(a) deleted text begin The court shall requestdeleted text end new text begin In response
to a request submitted under section 245C.033,new text end the commissioner of human services deleted text begin todeleted text end new text begin shallnew text end
provide deleted text begin the court within 25 working days of receipt of the request withdeleted text end licensing agency
data for licenses directly related to the responsibilities of a professional fiduciary if the deleted text begin study
subject indicatesdeleted text end new text begin guardian or conservator has anew text end current or prior affiliation from the following
agencies in Minnesota:

(1) Lawyers Responsibility Board;

(2) State Board of Accountancy;

(3) Board of Social Work;

(4) Board of Psychology;

(5) Board of Nursing;

(6) Board of Medical Practice;

(7) Department of Education;

(8) Department of Commerce;

(9) Board of Chiropractic Examiners;

(10) Board of Dentistry;

(11) Board of Marriage and Family Therapy;

(12) Department of Human Services;

(13) Peace Officer Standards and Training (POST) Board; and

(14) Professional Educator Licensing and Standards Board.

(b) deleted text begin The commissioner shall enter into agreements with these agencies to provide the
commissioner with electronic access to the relevant licensing data, and to provide the
commissioner with a quarterly list of new sanctions issued by the agency.
deleted text end

deleted text begin (c)deleted text end The commissioner shall provide new text begin information new text end to the court deleted text begin the electronically available
data maintained in the agency's database, including whether the proposed guardian or
conservator is or has been licensed by the agency, and if the licensing agency database
indicates a disciplinary action or a sanction against the individual's license, including a
condition, suspension, revocation, or cancellationdeleted text end new text begin in accordance with section 245C.033new text end .

deleted text begin (d) If the proposed guardian or conservator has resided in a state other than Minnesota
in the previous ten years, licensing agency data under this section shall also include the
licensing agency data from any other state where the proposed guardian or conservator
reported to have resided during the previous ten years if the study subject indicates current
or prior affiliation. If the proposed guardian or conservator has or has had a professional
license in another state that is directly related to the responsibilities of a professional fiduciary
from one of the agencies listed under paragraph (a), state licensing agency data shall also
include data from the relevant licensing agency of that state.
deleted text end

deleted text begin (e) The commissioner is not required to repeat a search for Minnesota or out-of-state
licensing data on an individual if the commissioner has provided this information to the
court within the prior five years.
deleted text end

deleted text begin (f) The commissioner shall review the information in paragraph (c) at least once every
four months to determine if an individual who has been studied within the previous five
years:
deleted text end

deleted text begin (1) has new disciplinary action or sanction against the individual's license; or
deleted text end

deleted text begin (2) did not disclose a prior or current affiliation with a Minnesota licensing agency.
deleted text end

deleted text begin (g) If the commissioner's review in paragraph (f) identifies new information, the
commissioner shall provide any new information to the court.
deleted text end

Subd. 3.

Forms and systems.

deleted text begin The courtdeleted text end new text begin In accordance with section 245C.033, the
commissionernew text end must provide the deleted text begin study subjectdeleted text end new text begin guardian or conservatornew text end with a privacy notice
new text begin for maltreatment and state licensing agency checks new text end that complies with section deleted text begin 245C.05,
subdivision 2c. The commissioner of human services shall use the NETStudy 2.0 system
to conduct a background study under this sectiondeleted text end new text begin 13.04, subdivision 2. The Bureau of
Criminal Apprehension must provide the guardian or conservator with a privacy notice for
a criminal history checknew text end .

Subd. 4.

Rights.

The court shall notify the deleted text begin subject of a background studydeleted text end new text begin guardian or
conservatornew text end that the deleted text begin subjectdeleted text end new text begin guardian or conservatornew text end has the following rights:

(1) the right to be informed that the court will request deleted text begin a background study on the subjectdeleted text end new text begin
maltreatment and state licensing checks and a criminal history check on the guardian or
conservatornew text end for the purpose of determining whether the person's appointment or continued
appointment is in the best interests of the person subject to guardianship or conservatorship;

(2) the right to be informed of the results of the deleted text begin studydeleted text end new text begin checksnew text end and to obtain from the
court a copy of the results; and

(3) the right to challenge the accuracy and completeness of information contained in the
results under section 13.04, subdivision 4, except to the extent precluded by section 256.045,
subdivision 3.

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

new text begin (a)new text end new text begin Minnesota Statutes 2022, sections 245C.02, subdivision 14b; 245C.032; and 245C.30,
subdivision 1a,new text end new text begin are repealed.
new text end

new text begin (b)new text end new text begin Minnesota Statutes 2022, section 245C.11, subdivision 3,new text end new text begin is repealed.
new text end

new text begin (c)new text end new text begin Minnesota Statutes 2022, section 245C.031, subdivisions 5, 6, and 7,new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin Paragraph (a) is effective January 1, 2024, paragraph (b) is
effective April 28, 2025, and paragraph (c) is effective July 1, 2023.
new text end

ARTICLE 8

LICENSING

Section 1.

Minnesota Statutes 2022, section 119B.16, subdivision 1a, is amended to read:

Subd. 1a.

Fair hearing allowed for providers.

(a) This subdivision applies to providers
caring for children receiving child care assistance.

(b) A provider may request a fair hearing according to sections 256.045 and 256.046
only if a county agency or the commissioner:

(1) denies or revokes a provider's authorization, unless the action entitles the provider
tonew text begin :
new text end

new text begin (i)new text end an administrative review under section 119B.161;new text begin or
new text end

new text begin (ii) a contested case hearing or an administrative reconsideration under section 245.095;
new text end

(2) assigns responsibility for an overpayment to a provider under section 119B.11,
subdivision 2a;

(3) establishes an overpayment for failure to comply with section 119B.125, subdivision
6;

(4) seeks monetary recovery or recoupment under section 245E.02, subdivision 4,
paragraph (c), clause (2);

(5) initiates an administrative fraud disqualification hearing; or

(6) issues a payment and the provider disagrees with the amount of the payment.

(c) A provider may request a fair hearing by submitting a written request to the
Department of Human Services, Appeals Division. A provider's request must be received
by the Appeals Division no later than 30 days after the date a county or the commissioner
mails the notice.

(d) The provider's appeal request must contain the following:

(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the
dollar amount involved for each disputed item;

(2) the computation the provider believes to be correct, if applicable;

(3) the statute or rule relied on for each disputed item; and

(4) the name, address, and telephone number of the person at the provider's place of
business with whom contact may be made regarding the appeal.

Sec. 2.

Minnesota Statutes 2022, section 245.095, is amended to read:

245.095 LIMITS ON RECEIVING PUBLIC FUNDS.

Subdivision 1.

Prohibition.

(a) If a provider, vendor, or individual enrolled, licensed,
receiving funds under a grant contract, or registered in any program administered by the
commissioner, including under the commissioner's powers and authorities in section 256.01,
is excluded from that program, the commissioner shall:

(1) prohibit the excluded provider, vendor, or individual from enrolling, becoming
licensed, receiving grant funds, or registering in any other program administered by the
commissioner; and

(2) disenroll, revoke or suspend a license, disqualify, or debar the excluded provider,
vendor, or individual in any other program administered by the commissioner.

new text begin (b) If a provider, vendor, or individual enrolled, licensed, receiving funds under a grant
contract, or registered in any program administered by the commissioner, including under
the commissioner's powers and authorities in section 256.01, is excluded from that program,
the commissioner may:
new text end

new text begin (1) prohibit any associated entities or associated individuals from enrolling, becoming
licensed, receiving grant funds, or registering in any other program administered by the
commissioner; and
new text end

new text begin (2) disenroll, revoke or suspend a license of, disqualify, or debar any associated entities
or associated individuals in any other program administered by the commissioner.
new text end

new text begin (c) If a provider, vendor, or individual enrolled, licensed, or otherwise receiving funds
under any contract or registered in any program administered by a Minnesota state or federal
agency is excluded from that program, the commissioner of human services may:
new text end

new text begin (1) prohibit the excluded provider, vendor, individual, or any associated entities or
associated individuals from enrolling, becoming licensed, receiving grant funds, or registering
in any program administered by the commissioner; and
new text end

new text begin (2) disenroll, revoke or suspend a license of, disqualify, or debar the excluded provider,
vendor, individual, or any associated entities or associated individuals in any program
administered by the commissioner.
new text end

deleted text begin (b)deleted text end new text begin (d)new text end The duration of deleted text begin thisdeleted text end new text begin anew text end prohibition, disenrollment, revocation, suspension,
disqualification, or debarmentnew text begin under paragraph (a)new text end must last for the longest applicable
sanction or disqualifying period in effect for the provider, vendor, or individual permitted
by state or federal law.new text begin The duration of a prohibition, disenrollment, revocation, suspension,
disqualification, or debarment under paragraphs (b) and (c) may last until up to the longest
applicable sanction or disqualifying period in effect for the provider, vendor, individual,
associated entity, or associated individual as permitted by state or federal law.
new text end

Subd. 2.

Definitions.

(a) For purposes of this section, the following definitions have the
meanings given deleted text begin themdeleted text end .

new text begin (b) "Associated entity" means a provider or vendor owned or controlled by an excluded
individual.
new text end

new text begin (c) "Associated individual" means an individual or entity that has a relationship with
the business or its owners or controlling individuals, such that the individual or entity would
have knowledge of the financial practices of the program in question.
new text end

deleted text begin (b)deleted text end new text begin (d)new text end "Excluded" means deleted text begin disenrolled, disqualified, having a license that has been revoked
or suspended under chapter deleted text end deleted text begin 245Adeleted text end deleted text begin , or debarred or suspended under Minnesota Rules, part
1230.1150, or excluded pursuant to section 256B.064, subdivision 3deleted text end new text begin removed under other
authorities from a program administered by a Minnesota state or federal agency, including
a final determination to stop paymentsnew text end .

deleted text begin (c)deleted text end new text begin (e)new text end "Individual" means a natural person providing products or services as a provider
or vendor.

deleted text begin (d)deleted text end new text begin (f)new text end "Provider" deleted text begin includes any entity or individual receiving payment from a program
administered by the Department of Human Services, and an owner, controlling individual,
license holder, director, or managerial official of an entity receiving payment from a program
administered by the Department of Human Servicesdeleted text end new text begin means any entity, individual, owner,
controlling individual, license holder, director, or managerial official of an entity receiving
payment from a program administered by a Minnesota state or federal agencynew text end .

new text begin Subd. 3.new text end

new text begin Notice.new text end

new text begin Within five days of taking an action under subdivision (1), paragraph
(a), (b), or (c), against a provider, vendor, individual, associated individual, or associated
entity, the commissioner must send notice of the action to the provider, vendor, individual,
associated individual, or associated entity. The notice must state:
new text end

new text begin (1) the basis for the action;
new text end

new text begin (2) the effective date of the action;
new text end

new text begin (3) the right to appeal the action; and
new text end

new text begin (4) the requirements and procedures for reinstatement.
new text end

new text begin Subd. 4.new text end

new text begin Appeal.new text end

new text begin Upon receipt of a notice under subdivision 3, a provider, vendor,
individual, associated individual, or associated entity may request a contested case hearing,
as defined in section 14.02, subdivision 3, by filing with the commissioner a written request
of appeal. The scope of any contested case hearing is solely limited to action taken under
this section. The commissioner must receive the appeal request no later than 30 days after
the date the notice was mailed to the provider, vendor, individual, associated individual, or
associated entity. The appeal request must specify:
new text end

new text begin (1) each disputed item and the reason for the dispute;
new text end

new text begin (2) the authority in statute or rule upon which the provider, vendor, individual, associated
individual, or associated entity relies for each disputed item;
new text end

new text begin (3) the name and address of the person or entity with whom contacts may be made
regarding the appeal; and
new text end

new text begin (4) any other information required by the commissioner.
new text end

new text begin Subd. 5.new text end

new text begin Withholding of payments.new text end

new text begin (a) Except as otherwise provided by state or federal
law, the commissioner may withhold payments to a provider, vendor, individual, associated
individual, or associated entity in any program administered by the commissioner if the
commissioner determines there is a credible allegation of fraud for which an investigation
is pending for a program administered by a Minnesota state or federal agency.
new text end

new text begin (b) For purposes of this subdivision, "credible allegation of fraud" means an allegation
that has been verified by the commissioner from any source, including but not limited to:
new text end

new text begin (1) fraud hotline complaints;
new text end

new text begin (2) claims data mining;
new text end

new text begin (3) patterns identified through provider audits, civil false claims cases, and law
enforcement investigations; and
new text end

new text begin (4) court filings and other legal documents, including but not limited to police reports,
complaints, indictments, informations, affidavits, declarations, and search warrants.
new text end

new text begin (c) The commissioner must send notice of the withholding of payments within five days
of taking such action. The notice must:
new text end

new text begin (1) state that payments are being withheld according to this subdivision;
new text end

new text begin (2) set forth the general allegations related to the withholding action, except the notice
need not disclose specific information concerning an ongoing investigation;
new text end

new text begin (3) state that the withholding is for a temporary period and cite the circumstances under
which the withholding will be terminated; and
new text end

new text begin (4) inform the provider, vendor, individual, associated individual, or associated entity
of the right to submit written evidence to contest the withholding action for consideration
by the commissioner.
new text end

new text begin (d) If the commissioner withholds payments under this subdivision, the provider, vendor,
individual, associated individual, or associated entity has a right to request administrative
reconsideration. A request for administrative reconsideration must be made in writing, state
with specificity the reasons the payment withholding decision is in error, and include
documents to support the request. Within 60 days from receipt of the request, the
commissioner shall judiciously review allegations, facts, evidence available to the
commissioner, and information submitted by the provider, vendor, individual, associated
individual, or associated entity to determine whether the payment withholding should remain
in place.
new text end

new text begin (e) The commissioner shall stop withholding payments if the commissioner determines
there is insufficient evidence of fraud by the provider, vendor, individual, associated
individual, or associated entity or when legal proceedings relating to the alleged fraud are
completed, unless the commissioner has sent notice under subdivision 3 to the provider,
vendor, individual, associated individual, or associated entity.
new text end

new text begin (f) The withholding of payments is a temporary action and is not subject to appeal under
section 256.045 or chapter 14.
new text end

Sec. 3.

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

Subd. 2c.

Annual or annually; family child care deleted text begin training requirementsdeleted text end .

For the
purposes of sections 245A.50 to 245A.53, "annual" or "annually" means deleted text begin the 12-month
period beginning on the license effective date or the annual anniversary of the effective date
and ending on the day prior to the annual anniversary of the license effective datedeleted text end new text begin each
calendar yearnew text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 4.

Minnesota Statutes 2022, section 245A.02, is amended by adding a subdivision to
read:

new text begin Subd. 5b.new text end

new text begin Cradleboard.new text end

new text begin "Cradleboard" means a board or frame on which an infant is
secured using blankets or other material, such as fabric or leather sides, and laces and often
has a frame extending to protect the infant's head. The infant is always placed with the
infant's head facing outward, and the infant remains supervised in the cradleboard while
sleeping or being carried.
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. 5.

Minnesota Statutes 2022, section 245A.02, subdivision 6b, is amended to read:

Subd. 6b.

Experience.

For purposes of child care centers, "experience" deleted text begin includesdeleted text end new text begin meansnew text end
paid or unpaid employment deleted text begin serving children as a teacher, assistant teacher, aide, or a student
intern in a licensed child care center, in a public or nonpublic school, or in a program licensed
as a family day care or group family day care provider.deleted text end new text begin :
new text end

new text begin (1) caring for children as a teacher, assistant teacher, aide, or student intern:
new text end

new text begin (i) in a licensed child care center, a licensed family day care or group family day care,
or a Tribally licensed child care program in any United States state or territory; or
new text end

new text begin (ii) in a public or nonpublic school;
new text end

new text begin (2) caring for children as a staff person or unsupervised volunteer in a certified,
license-exempt child care center under chapter 245H; or
new text end

new text begin (3) providing direct contact services in a home or residential facility serving children
with disabilities that requires a background study under section 245C.03.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 6.

Minnesota Statutes 2022, section 245A.03, subdivision 2, is amended to read:

Subd. 2.

Exclusion from licensure.

(a) This chapter does not apply to:

(1) residential or nonresidential programs that are provided to a person by an individual
who is related unless the residential program is a child foster care placement made by a
local social services agency or a licensed child-placing agency, except as provided in
subdivision 2a;

(2) nonresidential programs that are provided by an unrelated individual to persons from
a single related family;

(3) residential or nonresidential programs that are provided to adults who do not misuse
substances or have a substance use disorder, a mental illness, a developmental disability, a
functional impairment, or a physical disability;

(4) sheltered workshops or work activity programs that are certified by the commissioner
of employment and economic development;

(5) programs operated by a public school for children 33 months or older;

(6) nonresidential programs primarily for children that provide care or supervision for
periods of less than three hours a day while the child's parent or legal guardian is in the
same building as the nonresidential program or present within another building that is
directly contiguous to the building in which the nonresidential program is located;

(7) nursing homes or hospitals licensed by the commissioner of health except as specified
under section 245A.02;

(8) board and lodge facilities licensed by the commissioner of health that do not provide
children's residential services under Minnesota Rules, chapter 2960, mental health or
substance use disorder treatment;

(9) homes providing programs for persons placed by a county or a licensed agency for
legal adoption, unless the adoption is not completed within two years;

(10) programs licensed by the commissioner of corrections;

(11) recreation programs for children or adults that are operated or approved by a park
and recreation board whose primary purpose is to provide social and recreational activities;

(12) programs operated by a school as defined in section 120A.22, subdivision 4; YMCA
as defined in section 315.44; YWCA as defined in section 315.44; or JCC as defined in
section 315.51, whose primary purpose is to provide child care or services to school-age
children;

(13) Head Start nonresidential programs which operate for less than 45 days in each
calendar year;

(14) noncertified boarding care homes unless they provide services for five or more
persons whose primary diagnosis is mental illness or a developmental disability;

(15) programs for children such as scouting, boys clubs, girls clubs, and sports and art
programs, and nonresidential programs for children provided for a cumulative total of less
than 30 days in any 12-month period;

(16) residential programs for persons with mental illness, that are located in hospitals;

(17) the religious instruction of school-age children; Sabbath or Sunday schools; or the
congregate care of children by a church, congregation, or religious society during the period
used by the church, congregation, or religious society for its regular worship;

(18) camps licensed by the commissioner of health under Minnesota Rules, chapter
4630;

(19) mental health outpatient services for adults with mental illness or children with
emotional disturbance;

(20) residential programs serving school-age children whose sole purpose is cultural or
educational exchange, until the commissioner adopts appropriate rules;

(21) community support services programs as defined in section 245.462, subdivision
6, and family community support services as defined in section 245.4871, subdivision 17;

(22) the placement of a child by a birth parent or legal guardian in a preadoptive home
for purposes of adoption as authorized by section 259.47;

(23) settings registered under chapter 144D which provide home care services licensed
by the commissioner of health to fewer than seven adults;

(24) substance use disorder treatment activities of licensed professionals in private
practice as defined in section 245G.01, subdivision 17;

(25) consumer-directed community support service funded under the Medicaid waiver
for persons with developmental disabilities when the individual who provided the service
is:

(i) the same individual who is the direct payee of these specific waiver funds or paid by
a fiscal agent, fiscal intermediary, or employer of record; and

(ii) not otherwise under the control of a residential or nonresidential program that is
required to be licensed under this chapter when providing the service;

(26) a program serving only children who are age 33 months or older, that is operated
by a nonpublic school, for no more than four hours per day per child, with no more than 20
children at any one time, and that is accredited by:

(i) an accrediting agency that is formally recognized by the commissioner of education
as a nonpublic school accrediting organization; or

(ii) an accrediting agency that requires background studies and that receives and
investigates complaints about the services provided.

A program that asserts its exemption from licensure under item (ii) shall, upon request
from the commissioner, provide the commissioner with documentation from the accrediting
agency that verifies: that the accreditation is current; that the accrediting agency investigates
complaints about services; and that the accrediting agency's standards require background
studies on all people providing direct contact services;

(27) a program operated by a nonprofit organization incorporated in Minnesota or another
state that serves youth in kindergarten through grade 12; provides structured, supervised
youth development activities; and has learning opportunities take place before or after
school, on weekends, or during the summer or other seasonal breaks in the school calendar.
A program exempt under this clause is not eligible for child care assistance under chapter
119B. A program exempt under this clause must:

(i) have a director or supervisor on site who is responsible for overseeing written policies
relating to the management and control of the daily activities of the program, ensuring the
health and safety of program participants, and supervising staff and volunteers;

(ii) have obtained written consent from a parent or legal guardian for each youth
participating in activities at the site; and

(iii) have provided written notice to a parent or legal guardian for each youth at the site
that the program is not licensed or supervised by the state of Minnesota and is not eligible
to receive child care assistance payments;

(28) a county that is an eligible vendor under section 254B.05 to provide care coordination
and comprehensive assessment services; deleted text begin or
deleted text end

(29) a recovery community organization that is an eligible vendor under section 254B.05
to provide peer recovery support servicesdeleted text begin .deleted text end new text begin ; or
new text end

new text begin (30) Head Start programs that serve only children who are at least three years old but
not yet six years old.
new text end

(b) For purposes of paragraph (a), clause (6), a building is directly contiguous to a
building in which a nonresidential program is located if it shares a common wall with the
building in which the nonresidential program is located or is attached to that building by
skyway, tunnel, atrium, or common roof.

(c) Except for the home and community-based services identified in section 245D.03,
subdivision 1, nothing in this chapter shall be construed to require licensure for any services
provided and funded according to an approved federal waiver plan where licensure is
specifically identified as not being a condition for the services and funding.

new text begin EFFECTIVE DATE.new text end

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

Sec. 7.

Minnesota Statutes 2022, section 245A.04, subdivision 1, is amended to read:

Subdivision 1.

Application for licensure.

(a) An individual, organization, or government
entity that is subject to licensure under section 245A.03 must apply for a license. The
application must be made on the forms and in the manner prescribed by the commissioner.
The commissioner shall provide the applicant with instruction in completing the application
and provide information about the rules and requirements of other state agencies that affect
the applicant. An applicant seeking licensure in Minnesota with headquarters outside of
Minnesota must have a program office located within 30 miles of the Minnesota border.
An applicant who intends to buy or otherwise acquire a program or services licensed under
this chapter that is owned by another license holder must apply for a license under this
chapter and comply with the application procedures in this section and section 245A.03.

The commissioner shall act on the application within 90 working days after a complete
application and any required reports have been received from other state agencies or
departments, counties, municipalities, or other political subdivisions. The commissioner
shall not consider an application to be complete until the commissioner receives all of the
required information.

When the commissioner receives an application for initial licensure 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.

(b) An application for licensure must identify all controlling individuals as defined in
section 245A.02, subdivision 5a, and must designate one individual to be the authorized
agent. The application must be signed by the authorized agent and must include the authorized
agent's first, middle, and last name; mailing address; and email address. By submitting an
application for licensure, the authorized agent consents to electronic communication with
the commissioner throughout the application process. The authorized agent must be
authorized to accept service on behalf of all of the controlling individuals. A government
entity that holds multiple licenses under this chapter may designate one authorized agent
for all licenses issued under this chapter or may designate a different authorized agent for
each license. Service on the authorized agent is service on all of the controlling individuals.
It is not a defense to any action arising under this chapter that service was not made on each
controlling individual. The designation of a controlling individual as the authorized agent
under this paragraph does not affect the legal responsibility of any other controlling individual
under this chapter.

(c) An applicant or license holder must have a policy that prohibits license holders,
employees, subcontractors, and volunteers, when directly responsible for persons served
by the program, from abusing prescription medication or being in any manner under the
influence of a chemical that impairs the individual's ability to provide services or care. The
license holder must train employees, subcontractors, and volunteers about the program's
drug and alcohol policy.

(d) An applicant and license holder must have a program grievance procedure that permits
persons served by the program and their authorized representatives to bring a grievance to
the highest level of authority in the program.

(e) The commissioner may limit communication during the application process to the
authorized agent or the controlling individuals identified on the license application and for
whom a background study was initiated under chapter 245C.new text begin Upon implementation of the
provider licensing and reporting hub, applicants and license holders must use the hub in the
manner prescribed by the commissioner.new text end The commissioner may require the applicant,
except for child foster care, to demonstrate competence in the applicable licensing
requirements by successfully completing a written examination. The commissioner may
develop a prescribed written examination format.

(f) When an applicant is an individual, the applicant must provide:

(1) the applicant's taxpayer identification numbers including the Social Security number
or Minnesota tax identification number, and federal employer identification number if the
applicant has employees;

(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, if any;

(3) if doing business under a different name, the doing business as (DBA) name, as
registered with the secretary of state;

(4) if applicable, the applicant's National Provider Identifier (NPI) number and Unique
Minnesota Provider Identifier (UMPI) number; and

(5) at the request of the commissioner, the notarized signature of the applicant or
authorized agent.

(g) When an applicant is an organization, the applicant must provide:

(1) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;

(2) at the request of the commissioner, a copy of the most recent filing with the secretary
of state that includes the complete business name, and if doing business under a different
name, the doing business as (DBA) name, as registered with the secretary of state;

(3) the first, middle, and last name, and address for all individuals who will be controlling
individuals, including all officers, owners, and managerial officials as defined in section
245A.02, subdivision 5a, and the date that the background study was initiated by the applicant
for each controlling individual;

(4) if applicable, the applicant's NPI number and UMPI number;

(5) the documents that created the organization and that determine the organization's
internal governance and the relations among the persons that own the organization, have
an interest in the organization, or are members of the organization, in each case as provided
or authorized by the organization's governing statute, which may include a partnership
agreement, bylaws, articles of organization, organizational chart, and operating agreement,
or comparable documents as provided in the organization's governing statute; and

(6) the notarized signature of the applicant or authorized agent.

(h) When the applicant is a government entity, the applicant must provide:

(1) the name of the government agency, political subdivision, or other unit of government
seeking the license and the name of the program or services that will be licensed;

(2) the applicant's taxpayer identification numbers including the Minnesota tax
identification number and federal employer identification number;

(3) a letter signed by the manager, administrator, or other executive of the government
entity authorizing the submission of the license application; and

(4) if applicable, the applicant's NPI number and UMPI number.

(i) At the time of application for licensure or renewal of a license under this chapter, the
applicant or license holder must acknowledge on the form provided by the commissioner
if the applicant or license holder elects to receive any public funding reimbursement from
the commissioner for services provided under the license that:

(1) the applicant's or license holder's compliance with the provider enrollment agreement
or registration requirements for receipt of public funding may be monitored by the
commissioner as part of a licensing investigation or licensing inspection; and

(2) noncompliance with the provider enrollment agreement or registration requirements
for receipt of public funding that is identified through a licensing investigation or licensing
inspection, or noncompliance with a licensing requirement that is a basis of enrollment for
reimbursement for a service, may result in:

(i) a correction order or a conditional license under section 245A.06, or sanctions under
section 245A.07;

(ii) nonpayment of claims submitted by the license holder for public program
reimbursement;

(iii) recovery of payments made for the service;

(iv) disenrollment in the public payment program; or

(v) other administrative, civil, or criminal penalties as provided by law.

new text begin EFFECTIVE DATE.new text end

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

Sec. 8.

Minnesota Statutes 2022, section 245A.04, subdivision 4, is amended to read:

Subd. 4.

Inspections; waiver.

(a) Before issuing a license under this chapter, the
commissioner shall conduct an inspection of the program. The inspection must include but
is not limited to:

(1) an inspection of the physical plant;

(2) an inspection of records and documents;

(3) observation of the program in operation; and

(4) an inspection for the health, safety, and fire standards in licensing requirements for
a child care license holder.

(b) The observation in paragraph (a), clause (3), is not required prior to issuing a license
under subdivision 7. If the commissioner issues a license under this chapter, these
requirements must be completed within one year after the issuance of the license.

(c) Before completing a licensing inspection in a family child care program or child care
center, the licensing agency must offer the license holder an exit interview to discuss
violations or potential violations of law or rule observed during the inspection and offer
technical assistance on how to comply with applicable laws and rules. The commissioner
shall not issue a correction order or negative licensing action for violations of law or rule
not discussed in an exit interview, unless a license holder chooses not to participate in an
exit interview or not to complete the exit interview. If the license holder is unable to complete
the exit interview, the licensing agency must offer an alternate time for the license holder
to complete the exit interview.

(d) If a family child care license holder disputes a county licensor's interpretation of a
licensing requirement during a licensing inspection or exit interview, the license holder
may, within five business days after the exit interview or licensing inspection, request
clarification from the commissioner, in writing, in a manner prescribed by the commissioner.
The license holder's request must describe the county licensor's interpretation of the licensing
requirement at issue, and explain why the license holder believes the county licensor's
interpretation is inaccurate. The commissioner and the county must include the license
holder in all correspondence regarding the disputed interpretation, and must provide an
opportunity for the license holder to contribute relevant information that may impact the
commissioner's decision. The county licensor must not issue a correction order related to
the disputed licensing requirement until the commissioner has provided clarification to the
license holder about the licensing requirement.

(e) The commissioner or the county shall inspect at least deleted text begin annuallydeleted text end new text begin once each calendar
yearnew text end a child care provider licensed under this chapter and Minnesota Rules, chapter 9502
or 9503, for compliance with applicable licensing standards.

(f) No later than November 19, 2017, the commissioner shall make publicly available
on the department's website the results of inspection reports of all child care providers
licensed under this chapter and under Minnesota Rules, chapter 9502 or 9503, and the
number of deaths, serious injuries, and instances of substantiated child maltreatment that
occurred in licensed child care settings each year.

new text begin EFFECTIVE DATE.new text end

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

Sec. 9.

Minnesota Statutes 2022, section 245A.04, subdivision 7a, is amended to read:

Subd. 7a.

Notification required.

(a) A license holder must notify the commissioner, in
a manner prescribed by the commissioner, and obtain the commissioner's approval before
making any change that would alter the license information listed under subdivision 7,
paragraph (a).

(b) A license holder must also notify the commissioner, in a manner prescribed by the
commissioner, before making any change:

(1) to the license holder's authorized agent as defined in section 245A.02, subdivision
3b;

(2) to the license holder's controlling individual as defined in section 245A.02, subdivision
5a;

(3) to the license holder information on file with the secretary of state;

(4) in the location of the program or service licensed under this chapter; and

(5) to the federal or state tax identification number associated with the license holder.

(c) When, for reasons beyond the license holder's control, a license holder cannot provide
the commissioner with prior notice of the changes in paragraph (b), clauses (1) to (3), the
license holder must notify the commissioner by the tenth business day after the change and
must provide any additional information requested by the commissioner.

(d) When a license holder notifies the commissioner of a change to the license holder
information on file with the secretary of state, the license holder must provide amended
articles of incorporation and other documentation of the change.

new text begin (e) Upon implementation of the provider licensing and reporting hub, license holders
must enter and update information in the hub in a manner prescribed by the commissioner.
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. 10.

Minnesota Statutes 2022, section 245A.05, is amended to read:

245A.05 DENIAL OF APPLICATION.

(a) The commissioner may deny a license if an applicant or controlling individual:

(1) fails to submit a substantially complete application after receiving notice from the
commissioner under section 245A.04, subdivision 1;

(2) fails to comply with applicable laws or rules;

(3) knowingly withholds relevant information from or gives false or misleading
information to the commissioner in connection with an application for a license or during
an investigation;

(4) has a disqualification that has not been set aside under section 245C.22 and no
variance has been granted;

(5) has an individual living in the household who received a background study under
section 245C.03, subdivision 1, paragraph (a), clause (2), who has a disqualification that
has not been set aside under section 245C.22, and no variance has been granted;

(6) is associated with an individual who received a background study under section
245C.03, subdivision 1, paragraph (a), clause (6), who may have unsupervised access to
children or vulnerable adults, and who has a disqualification that has not been set aside
under section 245C.22, and no variance has been granted;

(7) fails to comply with section 245A.04, subdivision 1, paragraph (f) or (g);

(8) fails to demonstrate competent knowledge as required by section 245A.04, subdivision
6;

(9) has a history of noncompliance as a license holder or controlling individual with
applicable laws or rules, including but not limited to this chapter and chapters 119B and
245C;

(10) is prohibited from holding a license according to section 245.095; or

(11) for a family foster setting, new text begin has or has an individual who is living in the household
where the licensed services are provided or is otherwise subject to a background study who
new text end has nondisqualifying background study information, as described in section 245C.05,
subdivision 4, that reflects on the deleted text begin individual'sdeleted text end new text begin applicant'snew text end ability to safely provide care to
foster children.

(b) An applicant whose application has been denied by the commissioner must be given
notice of the denial, which must state the reasons for the denial in plain language. Notice
must be given by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or through the provider licensing
and reporting hubnew text end . The notice must state the reasons the application was denied and must
inform the applicant of the right to a contested case hearing under chapter 14 and Minnesota
Rules, parts 1400.8505 to 1400.8612. The applicant may appeal the denial by notifying the
commissioner in writing by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or through the provider
licensing and reporting hubnew text end . If mailed, the appeal must be postmarked and sent to the
commissioner within 20 calendar days after the applicant received the notice of denial. If
an appeal request is made by personal service, it must be received by the commissioner
within 20 calendar days after the applicant received the notice of denial. new text begin If the order is issued
through the provider hub, the appeal must be received by the commissioner within 20
calendar days from the date the commissioner issued the order through the hub.new text end Section
245A.08 applies to hearings held to appeal the commissioner's denial of an application.

new text begin EFFECTIVE DATE.new text end

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

Sec. 11.

Minnesota Statutes 2022, section 245A.055, subdivision 2, is amended to read:

Subd. 2.

Reconsideration of closure.

If a license is closed, the commissioner must
notify the license holder of closure by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or through the
provider licensing and reporting hubnew text end . If mailed, the notice of closure must be mailed to the
last known address of the license holder and must inform the license holder why the license
was closed and that the license holder has the right to request reconsideration of the closure.
If the license holder believes that the license was closed in error, the license holder may ask
the commissioner to reconsider the closure. The license holder's request for reconsideration
must be made in writing and must include documentation that the licensed program has
served a client in the previous 12 months. The request for reconsideration must be postmarked
and sent to the commissioner new text begin or submitted through the provider licensing and reporting hub
new text end within 20 calendar days after the license holder receives the notice of closure. new text begin Upon
implementation of the provider licensing and reporting hub, the provider must use the hub
to request reconsideration. If the order is issued through the provider hub, the reconsideration
must be received by the commissioner within 20 calendar days from the date the
commissioner issued the order through the hub. new text end A timely request for reconsideration stays
imposition of the license closure until the commissioner issues a decision on the request for
reconsideration.

new text begin EFFECTIVE DATE.new text end

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

Sec. 12.

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

Subdivision 1.

Contents of correction orders and conditional licenses.

(a) If the
commissioner finds that the applicant or license holder has failed to comply with an
applicable law or rule and this failure does not imminently endanger the health, safety, or
rights of the persons served by the program, the commissioner may issue a correction order
and an order of conditional license to the applicant or license holder. When issuing a
conditional license, the commissioner shall consider the nature, chronicity, or severity of
the violation of law or rule and the effect of the violation on the health, safety, or rights of
persons served by the program. The correction order or conditional license must state the
following in plain language:

(1) the conditions that constitute a violation of the law or rule;

(2) the specific law or rule violated;

(3) the time allowed to correct each violation; and

(4) if a license is made conditional, the length and terms of the conditional license, and
the reasons for making the license conditional.

(b) Nothing in this section prohibits the commissioner from proposing a sanction as
specified in section 245A.07, prior to issuing a correction order or conditional license.

new text begin (c) The commissioner may issue a correction order and an order of conditional license
to the applicant or license holder through the provider licensing and reporting hub.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 13.

Minnesota Statutes 2022, section 245A.06, subdivision 2, is amended to read:

Subd. 2.

Reconsideration of correction orders.

(a) If the applicant or license holder
believes that the contents of the commissioner's correction order are in error, the applicant
or license holder may ask the Department of Human Services to reconsider the parts of the
correction order that are alleged to be in error. The request for reconsideration must be made
in writing and must be postmarked and sent to the commissioner within 20 calendar days
after receipt of the correction order by the applicant or license holdernew text begin or submitted in the
provider licensing and reporting hub within 20 calendar days from the date the commissioner
issued the order through the hubnew text end , and:

(1) specify the parts of the correction order that are alleged to be in error;

(2) explain why they are in error; and

(3) include documentation to support the allegation of error.

new text begin Upon implementation of the provider licensing and reporting hub, the provider must use
the hub to request reconsideration. new text end A request for reconsideration does not stay any provisions
or requirements of the correction order. The commissioner's disposition of a request for
reconsideration is final and not subject to appeal under chapter 14.

(b) This paragraph applies only to licensed family child care providers. A licensed family
child care provider who requests reconsideration of a correction order under paragraph (a)
may also request, on a form and in the manner prescribed by the commissioner, that the
commissioner expedite the review if:

(1) the provider is challenging a violation and provides a description of how complying
with the corrective action for that violation would require the substantial expenditure of
funds or a significant change to their program; and

(2) describes what actions the provider will take in lieu of the corrective action ordered
to ensure the health and safety of children in care pending the commissioner's review of the
correction order.

new text begin EFFECTIVE DATE.new text end

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

Sec. 14.

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

Subd. 4.

Notice of conditional license; reconsideration of conditional license.

new text begin (a) new text end If
a license is made conditional, the license holder must be notified of the order by certified
mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or through the provider licensing and reporting hubnew text end . If mailed,
the notice must be mailed to the address shown on the application or the last known address
of the license holder. The notice must state the reasons the conditional license was ordered
and must inform the license holder of the right to request reconsideration of the conditional
license by the commissioner. The license holder may request reconsideration of the order
of conditional license by notifying the commissioner by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin ,
or through the provider licensing and reporting hubnew text end . The request must be made in writing.
If sent by certified mail, the request must be postmarked and sent to the commissioner within
ten calendar days after the license holder received the order. If a request is made by personal
service, it must be received by the commissioner within ten calendar days after the license
holder received the order. new text begin If the order is issued through the provider hub, the request must
be received by the commissioner within ten calendar days from the date the commissioner
issued the order through the hub.new text end The license holder may submit with the request for
reconsideration written argument or evidence in support of the request for reconsideration.
A timely request for reconsideration shall stay imposition of the terms of the conditional
license until the commissioner issues a decision on the request for reconsideration. If the
commissioner issues a dual order of conditional license under this section and an order to
pay a fine under section 245A.07, subdivision 3, the license holder has a right to a contested
case hearing under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The
scope of the contested case hearing shall include the fine and the conditional license. In this
case, a reconsideration of the conditional license will not be conducted under this section.
If the license holder does not appeal the fine, the license holder does not have a right to a
contested case hearing and a reconsideration of the conditional license must be conducted
under this subdivision.

new text begin (b) new text end The commissioner's disposition of a request for reconsideration is final and not
subject to appeal under chapter 14.

new text begin EFFECTIVE DATE.new text end

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

Sec. 15.

Minnesota Statutes 2022, section 245A.07, subdivision 1, is amended to read:

Subdivision 1.

Sanctions; appeals; license.

(a) In addition to making a license conditional
under section 245A.06, the commissioner may suspend or revoke the license, impose a fine,
or secure an injunction against the continuing operation of the program of a license holder
whonew text begin :
new text end

new text begin (1)new text end does not comply with applicable law or ruledeleted text begin , or whodeleted text end new text begin ;
new text end

new text begin (2)new text end has nondisqualifying background study information, as described in section 245C.05,
subdivision 4, that reflects on the license holder's ability to safely provide care to foster
childrennew text begin ; or
new text end

new text begin (3) has an individual living in the household where the licensed services are provided
or is otherwise subject to a background study, and the individual has nondisqualifying
background study information, as described in section 245C.05, subdivision 4, that reflects
on the license holder's ability to safely provide care to foster childrennew text end .

When applying sanctions authorized under this section, the commissioner shall consider
the nature, chronicity, or severity of the violation of law or rule and the effect of the violation
on the health, safety, or rights of persons served by the program.

(b) If a license holder appeals the suspension or revocation of a license and the license
holder continues to operate the program pending a final order on the appeal, the commissioner
shall issue the license holder a temporary provisional license. Unless otherwise specified
by the commissioner, variances in effect on the date of the license sanction under appeal
continue under the temporary provisional license. If a license holder fails to comply with
applicable law or rule while operating under a temporary provisional license, the
commissioner may impose additional sanctions under this section and section 245A.06, and
may terminate any prior variance. If a temporary provisional license is set to expire, a new
temporary provisional license shall be issued to the license holder upon payment of any fee
required under section 245A.10. The temporary provisional license shall expire on the date
the final order is issued. If the license holder prevails on the appeal, a new nonprovisional
license shall be issued for the remainder of the current license period.

(c) If a license holder is under investigation and the license issued under this chapter is
due to expire before completion of the investigation, the program shall be issued a new
license upon completion of the reapplication requirements and payment of any applicable
license fee. Upon completion of the investigation, a licensing sanction may be imposed
against the new license under this section, section 245A.06, or 245A.08.

(d) Failure to reapply or closure of a license issued under this chapter by the license
holder prior to the completion of any investigation shall not preclude the commissioner
from issuing a licensing sanction under this section or section 245A.06 at the conclusion
of the investigation.

new text begin EFFECTIVE DATE.new text end

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

Sec. 16.

Minnesota Statutes 2022, section 245A.07, subdivision 3, is amended to read:

Subd. 3.

License suspension, revocation, or fine.

(a) The commissioner may suspend
or revoke a license, or impose a fine if:

(1) a license holder fails to comply fully with applicable laws or rules including but not
limited to the requirements of this chapter and chapter 245C;

(2) a license holder, a controlling individual, or an individual living in the household
where the licensed services are provided or is otherwise subject to a background study has
been disqualified and the disqualification was not set aside and no variance has been granted;

(3) a license holder knowingly withholds relevant information from or gives false or
misleading information to the commissioner in connection with an application for a license,
in connection with the background study status of an individual, during an investigation,
or regarding compliance with applicable laws or rules;

(4) a license holder is excluded from any program administered by the commissioner
under section 245.095; deleted text begin or
deleted text end

(5) revocation is required under section 245A.04, subdivision 7, paragraph (d)deleted text begin .deleted text end new text begin ;
new text end

new text begin (6) for a family foster setting, a license holder, or an individual living in the household
where the licensed services are provided or who is otherwise subject to a background study
has nondisqualifying background study information, as described in section 245C.05,
subdivision 4, that reflects on the license holder's ability to safely provide care to foster
children; or
new text end

new text begin (7) suspension is necessary under subdivision 2a, paragraph (b), clause (2).
new text end

A license holder who has had a license issued under this chapter suspended, revoked,
or has been ordered to pay a fine must be given notice of the action by certified mail deleted text begin ordeleted text end new text begin , bynew text end
personal servicenew text begin , or through the provider licensing and reporting hubnew text end . If mailed, the notice
must be mailed to the address shown on the application or the last known address of the
license holder. The notice must state in plain language the reasons the license was suspended
or revoked, or a fine was ordered.

(b) If the license was suspended or revoked, the notice must inform the license holder
of the right to a contested case hearing under chapter 14 and Minnesota Rules, parts
1400.8505 to 1400.8612. The license holder may appeal an order suspending or revoking
a license. The appeal of an order suspending or revoking a license must be made in writing
by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or through the provider licensing and reporting
hubnew text end . If mailed, the appeal must be postmarked and sent to the commissioner within ten
calendar days after the license holder receives notice that the license has been suspended
or revoked. If a request is made by personal service, it must be received by the commissioner
within ten calendar days after the license holder received the order. new text begin If the order is issued
through the provider hub, the appeal must be received by the commissioner within ten
calendar days from the date the commissioner issued the order through the hub.new text end Except as
provided in subdivision 2a, paragraph (c), if a license holder submits a timely appeal of an
order suspending or revoking a license, the license holder may continue to operate the
program as provided in section 245A.04, subdivision 7, paragraphs (f) and (g), until the
commissioner issues a final order on the suspension or revocation.

(c)(1) If the license holder was ordered to pay a fine, the notice must inform the license
holder of the responsibility for payment of fines and the right to a contested case hearing
under chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The appeal of an
order to pay a fine must be made in writing by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or
through the provider licensing and reporting hubnew text end . If mailed, the appeal must be postmarked
and sent to the commissioner within ten calendar days after the license holder receives
notice that the fine has been ordered. If a request is made by personal service, it must be
received by the commissioner within ten calendar days after the license holder received the
order.new text begin If the order is issued through the provider hub, the appeal must be received by the
commissioner within ten calendar days from the date the commissioner issued the order
through the hub.
new text end

(2) The license holder shall pay the fines assessed on or before the payment date specified.
If the license holder fails to fully comply with the order, the commissioner may issue a
second fine or suspend the license until the license holder complies. If the license holder
receives state funds, the state, county, or municipal agencies or departments responsible for
administering the funds shall withhold payments and recover any payments made while the
license is suspended for failure to pay a fine. A timely appeal shall stay payment of the fine
until the commissioner issues a final order.

(3) A license holder shall promptly notify the commissioner of human services, in writing,
when a violation specified in the order to forfeit a fine is corrected. If upon reinspection the
commissioner determines that a violation has not been corrected as indicated by the order
to forfeit a fine, the commissioner may issue a second fine. The commissioner shall notify
the license holder by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or through the provider licensing
and reporting hubnew text end that a second fine has been assessed. The license holder may appeal the
second fine as provided under this subdivision.

(4) Fines shall be assessed as follows:

(i) the license holder shall forfeit $1,000 for each determination of maltreatment of a
child under chapter 260E or the maltreatment of a vulnerable adult under section 626.557
for which the license holder is determined responsible for the maltreatment under section
260E.30, subdivision 4, paragraphs (a) and (b), or 626.557, subdivision 9c, paragraph (c);

(ii) if the commissioner determines that a determination of maltreatment for which the
license holder is responsible is the result of maltreatment that meets the definition of serious
maltreatment as defined in section 245C.02, subdivision 18, the license holder shall forfeit
$5,000;

(iii) for a program that operates out of the license holder's home and a program licensed
under Minnesota Rules, parts 9502.0300 to 9502.0445, the fine assessed against the license
holder shall not exceed $1,000 for each determination of maltreatment;

(iv) the license holder shall forfeit $200 for each occurrence of a violation of law or rule
governing matters of health, safety, or supervision, including but not limited to the provision
of adequate staff-to-child or adult ratios, and failure to comply with background study
requirements under chapter 245C; and

(v) the license holder shall forfeit $100 for each occurrence of a violation of law or rule
other than those subject to a $5,000, $1,000, or $200 fine in items (i) to (iv).

For purposes of this section, "occurrence" means each violation identified in the
commissioner's fine order. Fines assessed against a license holder that holds a license to
provide home and community-based services, as identified in section 245D.03, subdivision
1, and a community residential setting or day services facility license under chapter 245D
where the services are provided, may be assessed against both licenses for the same
occurrence, but the combined amount of the fines shall not exceed the amount specified in
this clause for that occurrence.

(5) When a fine has been assessed, the license holder may not avoid payment by closing,
selling, or otherwise transferring the licensed program to a third party. In such an event, the
license holder will be personally liable for payment. In the case of a corporation, each
controlling individual is personally and jointly liable for payment.

(d) Except for background study violations involving the failure to comply with an order
to immediately remove an individual or an order to provide continuous, direct supervision,
the commissioner shall not issue a fine under paragraph (c) relating to a background study
violation to a license holder who self-corrects a background study violation before the
commissioner discovers the violation. A license holder who has previously exercised the
provisions of this paragraph to avoid a fine for a background study violation may not avoid
a fine for a subsequent background study violation unless at least 365 days have passed
since the license holder self-corrected the earlier background study violation.

new text begin EFFECTIVE DATE.new text end

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

Sec. 17.

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

new text begin Subd. 12.new text end

new text begin License holder qualifications for child foster care. new text end

new text begin (a) Child foster care
license holders must maintain the ability to care for a foster child and ensure a safe home
environment for children placed in their care. License holders must immediately notify the
licensing agency of:
new text end

new text begin (1) any changes to the license holder or household member's physical or behavioral
health that may affect the license holder's ability to care for a foster child or pose a risk to
a foster child's health; or
new text end

new text begin (2) changes related to the care of a child or vulnerable adult for whom the license holder
is a parent or legally responsible, including living out of the home for treatment for physical
or behavioral health, modified parenting time arrangements, legal custody, or placement in
foster care.
new text end

new text begin (b) The licensing agency may request a license holder or household member to undergo
an evaluation by a specialist in areas such as physical or behavioral health to evaluate the
license holder's ability to provide a safe environment for a foster child. Prior to assigning
a specialist to evaluate, the licensing agency must tell the license holder or household
member why the licensing agency has requested a specialist evaluation and request a release
of information from the license holder or household member.
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. 18.

Minnesota Statutes 2022, section 245A.14, subdivision 4, is amended to read:

Subd. 4.

Special family child care homes.

new text begin (a) new text end Nonresidential child care programs
serving 14 or fewer children that are conducted at a location other than the license holder's
own residence shall be licensed under this section and the rules governing family child care
or group family child care if:

deleted text begin (a)deleted text end new text begin (1)new text end the license holder is the primary provider of care and the nonresidential child
care program is conducted in a dwelling that is located on a residential lot;

deleted text begin (b)deleted text end new text begin (2)new text end the license holder is an employer who may or may not be the primary provider
of care, and the purpose for the child care program is to provide child care services to
children of the license holder's employees;

deleted text begin (c)deleted text end new text begin (3)new text end the license holder is a church or religious organization;

deleted text begin (d)deleted text end new text begin (4)new text end the license holder is a community collaborative child care provider. For purposes
of this subdivision, a community collaborative child care provider is a provider participating
in a cooperative agreement with a community action agency as defined in section 256E.31;

deleted text begin (e)deleted text end new text begin (5)new text end the license holder is a not-for-profit agency that provides child care in a dwelling
located on a residential lot and the license holder maintains two or more contracts with
community employers or other community organizations to provide child care services.
The county licensing agency may grant a capacity variance to a license holder licensed
under this deleted text begin paragraphdeleted text end new text begin clausenew text end to exceed the licensed capacity of 14 children by no more than
five children during transition periods related to the work schedules of parents, if the license
holder meets the following requirements:

deleted text begin (1)deleted text end new text begin (i)new text end the program does not exceed a capacity of 14 children more than a cumulative
total of four hours per day;

deleted text begin (2)deleted text end new text begin (ii)new text end the program meets a one to seven staff-to-child ratio during the variance period;

deleted text begin (3)deleted text end new text begin (iii)new text end all employees receive at least an extra four hours of training per year than required
in the rules governing family child care each year;

deleted text begin (4)deleted text end new text begin (iv)new text end the facility has square footage required per child under Minnesota Rules, part
9502.0425;

deleted text begin (5)deleted text end new text begin (v)new text end the program is in compliance with local zoning regulations;

deleted text begin (6)deleted text end new text begin (vi)new text end the program is in compliance with the applicable fire code as follows:

deleted text begin (i)deleted text end new text begin (A)new text end if the program serves more than five children older than 2-1/2 years of age, but
no more than five children 2-1/2 years of age or less, the applicable fire code is educational
occupancy, as provided in Group E Occupancy under the Minnesota State Fire Code deleted text begin 2015deleted text end new text begin
2020new text end , Section 202; or

deleted text begin (ii)deleted text end new text begin (B)new text end if the program serves more than five children 2-1/2 years of age or less, the
applicable fire code is Group I-4 deleted text begin Occupanciesdeleted text end new text begin Occupancynew text end , as provided in the Minnesota
State Fire Code deleted text begin 2015deleted text end new text begin 2020new text end , Section 202, unless the rooms in which the children new text begin 2-1/2 years
of age or younger new text end are cared for are located on a level of exit discharge and each of these
child care rooms has an exit door directly to the exterior, then the applicable fire code is
Group E deleted text begin occupanciesdeleted text end new text begin Occupancynew text end , as provided in the Minnesota State Fire Code deleted text begin 2015deleted text end new text begin 2020new text end ,
Section 202; and

deleted text begin (7)deleted text end new text begin (vii)new text end any age and capacity limitations required by the fire code inspection and square
footage determinations shall be printed on the license; or

deleted text begin (f)deleted text end new text begin (6)new text end the license holder is the primary provider of care and has located the licensed
child care program in a commercial space, if the license holder meets the following
requirements:

deleted text begin (1)deleted text end new text begin (i)new text end the program is in compliance with local zoning regulations;

deleted text begin (2)deleted text end new text begin (ii)new text end the program is in compliance with the applicable fire code as follows:

deleted text begin (ii)deleted text end new text begin (B)new text end if the program serves more than five children 2-1/2 years of age or less, the
applicable fire code is Group I-4 deleted text begin Occupanciesdeleted text end new text begin Occupancynew text end , as provided under the Minnesota
State Fire Code deleted text begin 2015deleted text end new text begin 2020new text end , Section 202new text begin , unless the rooms in which the children 2-1/2 years
of age or younger are cared for are located on a level of exit discharge and each of these
child care rooms has an exit door directly to the exterior, then the applicable fire code is
Group E Occupancy, as provided in the Minnesota State Fire Code 2020, Section 202new text end ;

deleted text begin (3)deleted text end new text begin (iii)new text end any age and capacity limitations required by the fire code inspection and square
footage determinations are printed on the license; and

deleted text begin (4)deleted text end new text begin (iv)new text end the license holder prominently displays the license issued by the commissioner
which contains the statement "This special family child care provider is not licensed as a
child care center."

deleted text begin (g)deleted text end new text begin (b)new text end Notwithstanding Minnesota Rules, part 9502.0335, subpart 12, the commissioner
may issue up to four licenses to an organization licensed under paragraph deleted text begin (b), (c), or (e)deleted text end new text begin (a),
clause (2), (3), or (5)new text end . Each license must have its own primary provider of care as required
under paragraph deleted text begin (i)deleted text end new text begin (d)new text end . Each license must operate as a distinct and separate program in
compliance with all applicable laws and regulations.

deleted text begin (h)deleted text end new text begin (c)new text end For licenses issued under paragraph deleted text begin (b), (c), (d), (e), or (f)deleted text end new text begin (a), clause (2), (3),
(4), (5), or (6)new text end , the commissioner may approve up to four licenses at the same location or
under one contiguous roof if each license holder is able to demonstrate compliance with all
applicable rules and laws. Each licensed program must operate as a distinct program and
within the capacity, age, and ratio distributions of each license.

deleted text begin (i)deleted text end new text begin (d)new text end For a license issued under paragraph deleted text begin (b), (c), or (e)deleted text end new text begin (a), clause (2), (3), or (5)new text end , the
license holder must designate a person to be the primary provider of care at the licensed
location on a form and in a manner prescribed by the commissioner. The license holder
shall notify the commissioner in writing before there is a change of the person designated
to be the primary provider of care. The primary provider of care:

(1) must be the person who will be the provider of care at the program and present during
the hours of operation;

(2) must operate the program in compliance with applicable laws and regulations under
chapter 245A and Minnesota Rules, chapter 9502;

(3) is considered a child care background study subject as defined in section 245C.02,
subdivision 6a, and must comply with background study requirements in chapter 245C;

(4) must complete the training that is required of license holders in section 245A.50;
and

(5) is authorized to communicate with the county licensing agency and the department
on matters related to licensing.

deleted text begin (j)deleted text end new text begin (e)new text end For any license issued under this subdivision, the license holder must ensure that
any other caregiver, substitute, or helper who assists in the care of children meets the training
requirements in section 245A.50 and background study requirements under chapter 245C.

Sec. 19.

Minnesota Statutes 2022, section 245A.1435, is amended to read:

245A.1435 REDUCTION OF RISK OF SUDDEN UNEXPECTED INFANT DEATH
IN LICENSED PROGRAMS.

(a) When a license holder is placing an infant to sleep, the license holder must place the
infant on the infant's back, unless the license holder has documentation from the infant's
physician, advanced practice registered nurse, or physician assistant directing an alternative
sleeping position for the infant. The physician, advanced practice registered nurse, or
physician assistant directive must be on a form deleted text begin approveddeleted text end new text begin developednew text end by the commissioner
and must remain on file at the licensed location. An infant who independently rolls onto its
stomach after being placed to sleep on its back may be allowed to remain sleeping on its
stomach if the infant is at least six months of age or the license holder has a signed statement
from the parent indicating that the infant regularly rolls over at home.

(b) The license holder must place the infant in a crib directly on a firm mattress with a
fitted sheet that is appropriate to the mattress size, that fits tightly on the mattress, and
overlaps the underside of the mattress so it cannot be dislodged by pulling on the corner of
the sheet with reasonable effort. The license holder must not place anything in the crib with
the infant except for the infant's pacifier, as defined in Code of Federal Regulations, title
16, part 1511. new text begin The pacifier must be free from any sort of attachment. new text end The requirements of
this section apply to license holders serving infants younger than one year of age. Licensed
child care providers must meet the crib requirements under section 245A.146. A correction
order shall not be issued under this paragraph unless there is evidence that a violation
occurred when an infant was present in the license holder's care.

(c) If an infant falls asleep before being placed in a crib, the license holder must move
the infant to a crib as soon as practicable, and must keep the infant within sight of the license
holder until the infant is placed in a crib. When an infant falls asleep while being held, the
license holder must consider the supervision needs of other children in care when determining
how long to hold the infant before placing the infant in a crib to sleep. The sleeping infant
must not be in a position where the airway may be blocked or with anything covering the
infant's face.

new text begin (d) When a license holder places an infant under one year of age down to sleep, the
infant's clothing or sleepwear must not have weighted materials, a hood, or a bib.
new text end

new text begin (e) A license holder may place an infant under one year of age down to sleep wearing
a helmet if the license holder has signed documentation by a physician, advanced practice
registered nurse, physician assistant, licensed occupational therapist, or licensed physical
therapist on a form developed by the commissioner.
new text end

deleted text begin (d)deleted text end new text begin (f)new text end Placing a swaddled infant down to sleep in a licensed setting is not recommended
for an infant of any age and is prohibited for any infant who has begun to roll over
independently. However, with the written consent of a parent or guardian according to this
paragraph, a license holder may place the infant who has not yet begun to roll over on its
own down to sleep in a deleted text begin one-piece sleeper equipped with an attached system that fastens
securely only across the upper torso, with no constriction of the hips or legs, to create adeleted text end
swaddle. new text begin A swaddle is defined as a one-piece sleepwear that wraps over the infant's arms,
fastens securely only across the infant's upper torso, and does not constrict the infant's hips
or legs. If a swaddle is used by a license holder, the license holder must ensure that it meets
the requirements of paragraph (d) and is not so tight that it restricts the infant's ability to
breathe or so loose that the fabric could cover the infant's nose and mouth. new text end Prior to any use
of swaddling for sleep by a provider licensed under this chapter, the license holder must
obtain informed written consent for the use of swaddling from the parent or guardian of the
infant on a form deleted text begin provideddeleted text end new text begin developednew text end by the commissioner deleted text begin and prepared in partnership with
the Minnesota Sudden Infant Death Centerdeleted text end .

new text begin (g) A license holder may request a variance to this section to permit the use of a
cradleboard when requested by a parent or guardian for a cultural accommodation. A variance
for the use of a cradleboard may be issued only by the commissioner. The variance request
must be submitted on a form developed by the commissioner in partnership with Tribal
welfare agencies and the Department of Health.
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. 20.

Minnesota Statutes 2022, section 245A.146, subdivision 3, is amended to read:

Subd. 3.

License holder documentation of cribs.

(a) Annually, from the date printed
on the license, all license holders shall check all their cribs' brand names and model numbers
against the United States Consumer Product Safety Commission website listing of unsafe
cribs.

(b) The license holder shall maintain written documentation to be reviewed on site for
each crib showing that the review required in paragraph (a) has been completed, and which
of the following conditions applies:

(1) the crib was not identified as unsafe on the United States Consumer Product Safety
Commission website;

(2) the crib was identified as unsafe on the United States Consumer Product Safety
Commission website, but the license holder has taken the action directed by the United
States Consumer Product Safety Commission to make the crib safe; or

(3) the crib was identified as unsafe on the United States Consumer Product Safety
Commission website, and the license holder has removed the crib so that it is no longer
used by or accessible to children in care.

(c) Documentation of the review completed under this subdivision shall be maintained
by the license holder on site and made available to parents or guardians of children in care
and the commissioner.

(d) Notwithstanding Minnesota Rules, part 9502.0425, a family child care provider that
complies with this section may use a mesh-sided or fabric-sided play yard, pack and play,
or playpen or crib that has not been identified as unsafe on the United States Consumer
Product Safety Commission website for the care or sleeping of infants.

(e) On at least a monthly basis, the family child care license holder shall perform safety
inspections of every mesh-sided or fabric-sided play yard, pack and play, or playpen used
by or that is accessible to any child in care, and must document the following:

(1) there are no tears, holes, or loose or unraveling threads in mesh or fabric sides of
crib;

(2) the weave of the mesh on the crib is no larger than one-fourth of an inch;

(3) no mesh fabric is unsecure or unattached to top rail and floor plate of crib;

(4) no tears or holes to top rail of crib;

(5) the mattress floor board is not soft and does not exceed one inch thick;

(6) the mattress floor board has no rips or tears in covering;

(7) the mattress floor board in use is deleted text begin a waterproofdeleted text end new text begin annew text end original mattress or replacement
mattress provided by the manufacturer of the crib;

(8) there are no protruding or loose rivets, metal nuts, or bolts on the crib;

(9) there are no knobs or wing nuts on outside crib legs;

(10) there are no missing, loose, or exposed staples; and

(11) the latches on top and side rails used to collapse crib are secure, they lock properly,
and are not loose.

new text begin (f) If a cradleboard is used in a licensed setting, the license holder must check the
cradleboard not less than monthly to ensure the cradleboard is structurally sound and there
are no loose or protruding parts. The license holder shall maintain written documentation
of this review.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 21.

Minnesota Statutes 2022, section 245A.16, subdivision 1, is amended to read:

Subdivision 1.

Delegation of authority to agencies.

(a) County agencies and private
agencies that have been designated or licensed by the commissioner to perform licensing
functions and activities under section 245A.04 deleted text begin and background studies for family child care
under chapter deleted text end deleted text begin 245Cdeleted text end ; to recommend denial of applicants under section 245A.05; to issue
correction orders, to issue variances, and recommend a conditional license under section
245A.06; or to recommend suspending or revoking a license or issuing a fine under section
245A.07, shall comply with rules and directives of the commissioner governing those
functions and with this section. The following variances are excluded from the delegation
of variance authority and may be issued only by the commissioner:

(1) dual licensure of family child care and child foster care, dual licensure of child and
adult foster care, and adult foster care and family child care;

(2) adult foster care maximum capacity;

(3) adult foster care minimum age requirement;

(4) child foster care maximum age requirement;

(5) variances regarding disqualified individuals deleted text begin except that, before the implementation
of NETStudy 2.0, county agencies may issue variances under section 245C.30 regarding
disqualified individuals when the county is responsible for conducting a consolidated
reconsideration according to sections 245C.25 and 245C.27, subdivision 2, clauses (a) and
(b), of a county maltreatment determination and a disqualification based on serious or
recurring maltreatmentdeleted text end ;

(6) the required presence of a caregiver in the adult foster care residence during normal
sleeping hours;

(7) variances to requirements relating to chemical use problems of a license holder or a
household member of a license holder; deleted text begin and
deleted text end

(8) variances to section 245A.53 for a time-limited period. If the commissioner grants
a variance under this clause, the license holder must provide notice of the variance to all
parents and guardians of the children in carenew text begin ; and
new text end

new text begin (9) variances to section 245A.1435 for the use of a cradleboard for a cultural
accommodationnew text end .

Except as provided in section 245A.14, subdivision 4, paragraph (e), a county agency must
not grant a license holder a variance to exceed the maximum allowable family child care
license capacity of 14 children.

(b) A county agency that has been designated by the commissioner to issue family child
care variances must:

(1) publish the county agency's policies and criteria for issuing variances on the county's
public website and update the policies as necessary; and

(2) annually distribute the county agency's policies and criteria for issuing variances to
all family child care license holders in the county.

deleted text begin (c) Before the implementation of NETStudy 2.0, county agencies must report information
about disqualification reconsiderations under sections 245C.25 and 245C.27, subdivision
2, paragraphs (a) and (b), and variances granted under paragraph (a), clause (5), to the
commissioner at least monthly in a format prescribed by the commissioner.
deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end For family child care programs, the commissioner shall require a county agency
to conduct one unannounced licensing review at least annually.

deleted text begin (e)deleted text end new text begin (d)new text end For family adult day services programs, the commissioner may authorize licensing
reviews every two years after a licensee has had at least one annual review.

deleted text begin (f)deleted text end new text begin (e)new text end A license issued under this section may be issued for up to two years.

deleted text begin (g)deleted text end new text begin (f)new text end During implementation of chapter 245D, the commissioner shall consider:

(1) the role of counties in quality assurance;

(2) the duties of county licensing staff; and

(3) the possible use of joint powers agreements, according to section 471.59, with counties
through which some licensing duties under chapter 245D may be delegated by the
commissioner to the counties.

Any consideration related to this paragraph must meet all of the requirements of the corrective
action plan ordered by the federal Centers for Medicare and Medicaid Services.

deleted text begin (h)deleted text end new text begin (g)new text end Licensing authority specific to section 245D.06, subdivisions 5, 6, 7, and 8, or
successor provisions; and section 245D.061 or successor provisions, for family child foster
care programs providing out-of-home respite, as identified in section 245D.03, subdivision
1, paragraph (b), clause (1), is excluded from the delegation of authority to county and
private agencies.

deleted text begin (i)deleted text end new text begin (h)new text end A county agency shall report to the commissioner, in a manner prescribed by the
commissioner, the following information for a licensed family child care program:

(1) the results of each licensing review completed, including the date of the review, and
any licensing correction order issued;

(2) any death, serious injury, or determination of substantiated maltreatment; and

(3) any fires that require the service of a fire department within 48 hours of the fire. The
information under this clause must also be reported to the state fire marshal within two
business days of receiving notice from a licensed family child care provider.

new text begin EFFECTIVE DATE.new text end

new text begin Paragraph (a), clause (9), is effective January 1, 2024, and all
other changes are effective the day following final enactment.
new text end

Sec. 22.

Minnesota Statutes 2022, section 245A.16, subdivision 9, is amended to read:

Subd. 9.

Licensed family foster settings.

(a) Before recommending to grant a license,
deny a license under section 245A.05, or revoke a license under section 245A.07 for
nondisqualifying background study information received under section 245C.05, subdivision
4, paragraph (a), clause (3), for a licensed family foster setting, a county agency or private
agency that has been designated or licensed by the commissioner must review the followingnew text begin
for the license holder, the applicant, and an individual living in the household where the
licensed services are provided or who is otherwise subject to a background studynew text end :

(1) the type of offenses;

(2) the number of offenses;

(3) the nature of the offenses;

(4) the age of the individual at the time of the offenses;

(5) the length of time that has elapsed since the last offense;

(6) the relationship of the offenses and the capacity to care for a child;

(7) evidence of rehabilitation;

(8) information or knowledge from community members regarding the individual's
capacity to provide foster care;

(9) any available information regarding child maltreatment reports or child in need of
protection or services petitions, or related cases, in which the individual has been involved
or implicated, and documentation that the individual has remedied issues or conditions
identified in child protection or court records that are relevant to safely caring for a child;

(10) a statement from the study subject;

(11) a statement from the license holder; and

(12) other aggravating and mitigating factors.

(b) For purposes of this section, "evidence of rehabilitation" includes but is not limited
to the following:

(1) maintaining a safe and stable residence;

(2) continuous, regular, or stable employment;

(3) successful participation in an education or job training program;

(4) positive involvement with the community or extended family;

(5) compliance with the terms and conditions of probation or parole following the
individual's most recent conviction;

(6) if the individual has had a substance use disorder, successful completion of a substance
use disorder assessment, substance use disorder treatment, and recommended continuing
care, if applicable, demonstrated abstinence from controlled substances, as defined in section
152.01, subdivision 4, or the establishment of a sober network;

(7) if the individual has had a mental illness or documented mental health issues,
demonstrated completion of a mental health evaluation, participation in therapy or other
recommended mental health treatment, or appropriate medication management, if applicable;

(8) if the individual's offense or conduct involved domestic violence, demonstrated
completion of a domestic violence or anger management program, and the absence of any
orders for protection or harassment restraining orders against the individual since the previous
offense or conduct;

(9) written letters of support from individuals of good repute, including but not limited
to employers, members of the clergy, probation or parole officers, volunteer supervisors,
or social services workers;

(10) demonstrated remorse for convictions or conduct, or demonstrated positive behavior
changes; and

(11) absence of convictions or arrests since the previous offense or conduct, including
any convictions that were expunged or pardoned.

(c) An applicant for a family foster setting license must sign all releases of information
requested by the county or private licensing agency.

(d) When licensing a relative for a family foster setting, the commissioner shall also
consider the importance of maintaining the child's relationship with relatives as an additional
significant factor in determining whether an application will be denied.

(e) When recommending that the commissioner deny or revoke a license, the county or
private licensing agency must send a summary of the review completed according to
paragraph (a), on a form developed by the commissioner, to the commissioner and include
any recommendation for licensing action.

new text begin EFFECTIVE DATE.new text end

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

Sec. 23.

Minnesota Statutes 2022, section 245A.16, is amended by adding a subdivision
to read:

new text begin Subd. 10.new text end

new text begin Licensing and reporting hub.new text end

new text begin Upon implementation of the provider licensing
and reporting hub, county staff who perform licensing functions must use the hub in the
manner prescribed by the commissioner.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 24.

Minnesota Statutes 2022, section 245A.16, is amended by adding a subdivision
to read:

new text begin Subd. 11.new text end

new text begin Electronic checklist use by family child care licensors.new text end

new text begin County staff who
perform family child care licensing functions must use the commissioner's electronic licensing
checklist in the manner prescribed by the commissioner.
new text end

Sec. 25.

Minnesota Statutes 2022, section 245A.18, subdivision 2, is amended to read:

Subd. 2.

Child passenger restraint systems; training requirement.

(a) Programs
licensed by the Department of Human Services under new text begin this chapter and new text end Minnesota Rules,
chapter 2960, that serve a child or children under eight years of age must document training
that fulfills the requirements in this subdivision.

(b) Before a license holder, staff person, or caregiver transports a child or children under
age eight in a motor vehicle, the person transporting the child must satisfactorily complete
training on the proper use and installation of child restraint systems in motor vehicles.
Training completed under this section may be used to meet initial or ongoing training under
Minnesota Rules, part 2960.3070, subparts 1 and 2.

(c) Training required under this section must be completed at orientation or initial training
and repeated at least once every five years. At a minimum, the training must address the
proper use of child restraint systems based on the child's size, weight, and age, and the
proper installation of a car seat or booster seat in the motor vehicle used by the license
holder to transport the child or children.

(d) Training under paragraph (c) must be provided by individuals who are certified and
approved by the deleted text begin Department of Public Safety,deleted text end Office of Traffic Safetynew text begin within the Department
of Public Safetynew text end . License holders may obtain a list of certified and approved trainers through
the Department of Public Safety website or by contacting the agency.

(e) Notwithstanding paragraph (a), for an emergency relative placement under section
245A.035, the commissioner may grant a variance to the training required by this subdivision
for a relative who completes a child seat safety check up. The child seat safety check up
trainer must be approved by the Department of Public Safety, Office of Traffic Safety, and
must provide one-on-one instruction on placing a child of a specific age in the exact child
passenger restraint in the motor vehicle in which the child will be transported. Once granted
a variance, and if all other licensing requirements are met, the relative applicant may receive
a license and may transport a relative foster child younger than eight years of age. A child
seat safety check up must be completed each time a child requires a different size car seat
according to car seat and vehicle manufacturer guidelines. A relative license holder must
complete training that meets the other requirements of this subdivision prior to placement
of another foster child younger than eight years of age in the home or prior to the renewal
of the child foster care license.

Sec. 26.

new text begin [245A.42] CHILD CARE CENTER HIRING PRACTICES.
new text end

new text begin As part of the employment assessment process, a child care center license holder or staff
person may observe how a prospective employee interacts with children in the licensed
facility. The prospective employee is not considered a child care background study subject
under section 245C.02, subdivision 6a, provided the prospective employee is under
continuous direct supervision by a staff person when the prospective employee has physical
access to a child served by the center. The observation period shall not be longer than two
hours, and a prospective employee must not be counted in staff-to-child ratios.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 27.

Minnesota Statutes 2022, section 245A.50, subdivision 3, is amended to read:

Subd. 3.

First aid.

(a) Before initial licensure and before caring for a child, license
holders, second adult caregivers, and substitutes must be trained in pediatric first aid. The
first aid training must have been provided by an individual approved to provide first aid
instruction. First aid training may be less than eight hours and persons qualified to provide
first aid training include individuals approved as first aid instructors. License holders, second
adult caregivers, and substitutes must repeat pediatric first aid training every two years.
deleted text begin When the training expires, it must be retaken no later than the day before the anniversary
of the license holder's license effective date.deleted text end new text begin License holders, second adult caregivers, and
substitutes must not let the training expire.
new text end

(b) Video training reviewed and approved by the county licensing agency satisfies the
training requirement of this subdivision.

new text begin EFFECTIVE DATE.new text end

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

Sec. 28.

Minnesota Statutes 2022, section 245A.50, subdivision 4, is amended to read:

Subd. 4.

Cardiopulmonary resuscitation.

(a) Before initial licensure and before caring
for a child, license holders, second adult caregivers, and substitutes must be trained in
pediatric cardiopulmonary resuscitation (CPR), including CPR techniques for infants and
children, and in the treatment of obstructed airways. The CPR training must have been
provided by an individual approved to provide CPR instruction. License holders, second
adult caregivers, and substitutes must repeat pediatric CPR training at least once every two
years and must document the training in the license holder's records. deleted text begin When the training
expires, it must be retaken no later than the day before the anniversary of the license holder's
license effective date.deleted text end new text begin License holders, second adult caregivers, and substitutes must not let
the training expire.
new text end

(b) Persons providing CPR training must use CPR training that has been developed:

(1) by the American Heart Association or the American Red Cross and incorporates
psychomotor skills to support the instruction; or

(2) using nationally recognized, evidence-based guidelines for CPR training and
incorporates psychomotor skills to support the instruction.

new text begin EFFECTIVE DATE.new text end

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

Sec. 29.

Minnesota Statutes 2022, section 245A.50, subdivision 5, is amended to read:

Subd. 5.

Sudden unexpected infant death and abusive head trauma training.

(a)
License holders must ensure and document that before the license holder, second adult
caregivers, substitutes, and helpers assist in the care of infants, they are instructed on the
standards in section 245A.1435 and receive training on reducing the risk of sudden
unexpected infant death. In addition, license holders must ensure and document that before
the license holder, second adult caregivers, substitutes, and helpers assist in the care of
infants and children under school age, they receive training on reducing the risk of abusive
head trauma from shaking infants and young children. The training in this subdivision may
be provided as initial training under subdivision 1 or ongoing annual training under
subdivision 7.

(b) Sudden unexpected infant death reduction training required under this subdivision
must, at a minimum, address the risk factors related to sudden unexpected infant death,
means of reducing the risk of sudden unexpected infant death in child care, and license
holder communication with parents regarding reducing the risk of sudden unexpected infant
death.

(c) Abusive head trauma training required under this subdivision must, at a minimum,
address the risk factors related to shaking infants and young children, means of reducing
the risk of abusive head trauma in child care, and license holder communication with parents
regarding reducing the risk of abusive head trauma.

(d) Training for family and group family child care providers must be developed by the
commissioner in conjunction with the Minnesota Sudden Infant Death Center and approved
by the Minnesota Center for Professional Development. Sudden unexpected infant death
reduction training and abusive head trauma training may be provided in a single course of
no more than two hours in length.

(e) Sudden unexpected infant death reduction training and abusive head trauma training
required under this subdivision must be completed in person or as allowed under subdivision
10, clause (1) or (2), at least once every two years. deleted text begin When the training expires, it must be
retaken no later than the day before the anniversary of the license holder's license effective
date.deleted text end On the years when the individual receiving training is not receiving training in person
or as allowed under subdivision 10, clause (1) or (2), the individual receiving training in
accordance with this subdivision must receive sudden unexpected infant death reduction
training and abusive head trauma training through a video of no more than one hour in
length. The video must be developed or approved by the commissioner.

(f) An individual who is related to the license holder as defined in section 245A.02,
subdivision 13, and who is involved only in the care of the license holder's own infant or
child under school age and who is not designated to be a second adult caregiver, helper, or
substitute for the licensed program, is exempt from the sudden unexpected infant death and
abusive head trauma training.

new text begin EFFECTIVE DATE.new text end

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

Sec. 30.

Minnesota Statutes 2022, section 245A.50, subdivision 6, is amended to read:

Subd. 6.

Child passenger restraint systems; training requirement.

(a) A license
holder must comply with all seat belt and child passenger restraint system requirements
under section 169.685.

(b) Family and group family child care programs licensed by the Department of Human
Services that serve a child or children under eight years of age must document training that
fulfills the requirements in this subdivision.

(1) Before a license holder, second adult caregiver, substitute, or helper transports a
child or children under age eight in a motor vehicle, the person placing the child or children
in a passenger restraint must satisfactorily complete training on the proper use and installation
of child restraint systems in motor vehicles. Training completed under this subdivision may
be used to meet initial training under subdivision 1 or ongoing training under subdivision
7.

(2) Training required under this subdivision must be at least one hour in length, completed
at initial training, and repeated at least once every five years. deleted text begin When the training expires, it
must be retaken no later than the day before the anniversary of the license holder's license
effective date.deleted text end At a minimum, the training must address the proper use of child restraint
systems based on the child's size, weight, and age, and the proper installation of a car seat
or booster seat in the motor vehicle used by the license holder to transport the child or
children.

(3) Training under this subdivision must be provided by individuals who are certified
and approved by the Department of Public Safety, Office of Traffic Safety. License holders
may obtain a list of certified and approved trainers through the Department of Public Safety
website or by contacting the agency.

(c) Child care providers that only transport school-age children as defined in section
245A.02, subdivision 19, paragraph (f), in child care buses as defined in section 169.448,
subdivision 1, paragraph (e), are exempt from this subdivision.

new text begin EFFECTIVE DATE.new text end

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

Sec. 31.

Minnesota Statutes 2022, section 245A.50, subdivision 9, is amended to read:

Subd. 9.

Supervising for safety; training requirement.

(a) Courses required by this
subdivision must include the following health and safety topics:

(1) preventing and controlling infectious diseases;

(2) administering medication;

(3) preventing and responding to allergies;

(4) ensuring building and physical premises safety;

(5) handling and storing biological contaminants;

(6) preventing and reporting child abuse and maltreatment; and

(7) emergency preparedness.

(b) Before initial licensure and before caring for a child, all family child care license
holders and each second adult caregiver shall complete and document the completion of
the six-hour Supervising for Safety for Family Child Care course developed by the
commissioner.

(c) The license holder must ensure and document that, before caring for a child, all
substitutes have completed the four-hour Basics of Licensed Family Child Care for
Substitutes course developed by the commissioner, which must include health and safety
topics as well as child development and learning.

(d) The family child care license holder and each second adult caregiver shall complete
and document:

(1) the annual completion of either:

(i) a two-hour active supervision course developed by the commissioner; or

(ii) any courses in the ensuring safety competency area under the health, safety, and
nutrition standard of the Knowledge and Competency Framework that the commissioner
has identified as an active supervision training course; and

(2) the completion at least once every five years of the two-hour courses Health and
Safety I and Health and Safety II. deleted text begin When the training is due for the first time or expires, it
must be taken no later than the day before the anniversary of the license holder's license
effective date.deleted text end A license holder's or second adult caregiver's completion of either training
in a given year meets the annual active supervision training requirement in clause (1).

(e) At least once every three years, license holders must ensure and document that
substitutes have completed the four-hour Basics of Licensed Family Child Care for
Substitutes course. deleted text begin When the training expires, it must be retaken no later than the day before
the anniversary of the license holder's license effective date.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 32.

Minnesota Statutes 2022, section 245A.52, subdivision 1, is amended to read:

Subdivision 1.

Means of escape.

(a)(1) At least one emergency escape route separate
from the main exit from the space must be available in each room used for sleeping by
anyone receiving licensed care, and (2) a basement used for child care. One means of escape
must be a stairway or door leading to the floor of exit discharge. The other must be a door
or window leading directly outside. A window used as an emergency escape route must be
openable without special knowledge.

(b) In homes with construction that began before deleted text begin May 2, 2016deleted text end new text begin March 31, 2020new text end , the
interior of the window leading directly outside must have a net clear opening area of not
less than 4.5 square feet or 648 square inches and have minimum clear opening dimensions
of 20 inches wide and 20 inches high. new text begin The net clear opening dimensions shall be the result
of normal operation of the opening. new text end The opening must be no higher than 48 inches from the
floor. The height to the window may be measured from a platform if a platform is located
below the window.

(c) In homes with construction that began on or after deleted text begin May 2, 2016deleted text end new text begin March 31, 2020new text end , the
interior of the window leading directly outside must have minimum clear opening dimensions
of 20 inches wide and 24 inches high. The net clear opening dimensions shall be the result
of normal operation of the opening. The opening must be no higher than 44 inches from the
floor.

deleted text begin (d)deleted text end Additional requirements are dependent on the distance of the openings from the ground
outside the window: (1) windows or other openings with a sill height not more than 44
inches above or below the finished ground level adjacent to the opening (grade-floor
emergency escape and rescue openings) must have a minimum opening of five square feet;
and (2) non-grade-floor emergency escape and rescue openings must have a minimum
opening of 5.7 square feet.

Sec. 33.

Minnesota Statutes 2022, section 245A.52, subdivision 3, is amended to read:

Subd. 3.

Heating and venting systems.

new text begin (a) new text end Notwithstanding Minnesota Rules, part
9502.0425, subpart 7, new text begin item C, new text end items that can be ignited and support combustion, including
but not limited to plastic, fabric, and wood products must not be located withinnew text begin :
new text end

new text begin (1)new text end 18 inches of a gas or fuel-oil heater or furnacedeleted text begin .deleted text end new text begin ; or
new text end

new text begin (2) 36 inches of a solid-fuel-burning appliance.
new text end

new text begin (b)new text end If a license holder produces manufacturer instructions listing a smaller distance, then
the manufacturer instructions control the distance combustible items must be from gas,
fuel-oil, or solid-fuel burning heaters or furnaces.

Sec. 34.

Minnesota Statutes 2022, section 245A.52, subdivision 5, is amended to read:

Subd. 5.

Carbon monoxide and smoke alarms.

(a) All homes must have an approved
and operational carbon monoxide alarm installed within ten feet of each room used for
sleeping children in care.

(b) Smoke alarms that have been listed by the Underwriter Laboratory must be properly
installed and maintained deleted text begin on all levels including basements, but not including crawl spaces
and uninhabitable attics, and in hallways outside rooms used for sleeping children in care.deleted text end new text begin
in hallways outside of rooms used for sleeping children and on all levels, including basements
but not including crawl spaces and uninhabitable attics.
new text end

(c) In homes with construction that began on or after deleted text begin May 2, 2016deleted text end new text begin March 31, 2020new text end ,
smoke alarms must be installed and maintained in each room used for sleeping children in
care.

Sec. 35.

Minnesota Statutes 2022, section 245A.52, is amended by adding a subdivision
to read:

new text begin Subd. 8.new text end

new text begin Fire code variances.new text end

new text begin When a variance is requested of the standards contained
in subdivision 1, 2, 3, 4, or 5, an applicant or provider must submit written approval from
the state fire marshal of the variance requested and the alternative measures identified to
ensure the safety of children in care.
new text end

Sec. 36.

Minnesota Statutes 2022, section 245A.66, is amended by adding a subdivision
to read:

new text begin Subd. 4.new text end

new text begin Ongoing training requirement.new text end

new text begin (a) In addition to the orientation training
required by the applicable licensing rules and statutes, children's residential facility and
private child-placing agency license holders must provide a training annually on the
maltreatment of minors reporting requirements and definitions in chapter 260E to each
mandatory reporter, as described in section 260E.06, subdivision 1.
new text end

new text begin (b) In addition to the orientation training required by the applicable licensing rules and
statutes, all family child foster care license holders and caregivers and foster residence
setting staff and volunteers that are mandatory reporters as described in section 260E.06,
subdivision 1, must complete training each year on the maltreatment of minors reporting
requirements and definitions in chapter 260E.
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. 37.

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

Subd. 3.

Appeal of department action.

A provider's rights related to the department's
action taken under this chapter against a provider are established in sections 119B.16 deleted text begin anddeleted text end new text begin ,new text end
119B.161new text begin , 119B.162, and 245.095new text end .

Sec. 38.

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

Subdivision 1.

License requirements.

(a) An applicant for a license to provide substance
use disorder treatment must comply with the general requirements in section 626.557;
chapters 245A, 245C, and 260E; and Minnesota Rules, chapter 9544.

(b) The commissioner may grant variances to the requirements in this chapter that do
not affect the client's health or safety if the conditions in section 245A.04, subdivision 9,
are met.

new text begin (c) If a program is licensed according to this chapter and is part of a certified community
behavioral health clinic under section 245.735, the license holder must comply with the
requirements in section 245.735, subdivisions 4b to 4e, as part of the licensing requirements
under this chapter.
new text end

Sec. 39.

Minnesota Statutes 2022, section 245G.13, subdivision 2, is amended to read:

Subd. 2.

Staff development.

(a) A license holder must ensure that each staff member
has the training described in this subdivision.

(b) Each staff member must be trained every two years in:

(1) client confidentiality rules and regulations and client ethical boundaries; and

(2) emergency procedures and client rights as specified in sections 144.651, 148F.165,
and 253B.03.

(c) Annually each staff member with direct contact must be trained on mandatory
reporting as specified in sections 245A.65, 626.557, and 626.5572, and chapter 260E,
including specific training covering the license holder's policies for obtaining a release of
client information.

(d) Upon employment and annually thereafter, each staff member with direct contact
must receive training on HIV minimum standards according to section 245A.19.

new text begin (e) The license holder must ensure that each mandatory reporter, as described in section
260E.06, subdivision 1, is trained on the maltreatment of minors reporting requirements
and definitions in chapter 260E before the mandatory reporter has direct contact, as defined
in section 245C.02, subdivision 11, with a person served by the program.
new text end

deleted text begin (e)deleted text end new text begin (f)new text end A treatment director, supervisor, nurse, or counselor must have a minimum of 12
hours of training in co-occurring disorders that includes competencies related to philosophy,
trauma-informed care, screening, assessment, diagnosis and person-centered treatment
planning, documentation, programming, medication, collaboration, mental health
consultation, and discharge planning. A new staff member who has not obtained the training
must complete the training within six months of employment. A staff member may request,
and the license holder may grant, credit for relevant training obtained before employment,
which must be documented in the staff member's personnel file.

new text begin EFFECTIVE DATE.new text end

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

Sec. 40.

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

new text begin Subd. 2a.new text end

new text begin Authorized agent.new text end

new text begin "Authorized agent" means the individual designated by
the certification holder who is responsible for communicating with the commissioner of
human services regarding all items pursuant to this chapter.
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. 41.

Minnesota Statutes 2022, section 245H.01, subdivision 3, is amended to read:

Subd. 3.

Center operator or program operator.

"Center operator" or "program operator"
means the person exercising supervision or control over the center's or program's operations,
planning, and functioning. deleted text begin There may be more than one designated center operator or
program operator.
deleted 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. 42.

Minnesota Statutes 2022, section 245H.01, subdivision 5, is amended to read:

Subd. 5.

Certified license-exempt child care center.

"Certified license-exempt child
care center" means the commissioner's written authorization for a child care center excluded
from licensure under section 245A.03, subdivision 2, paragraph (a), clause (5), (11) to (13),
(15), (18), deleted text begin ordeleted text end (26)new text begin , or (30)new text end , to register to receive child care assistance payments under chapter
119B.

new text begin EFFECTIVE DATE.new text end

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

Sec. 43.

Minnesota Statutes 2022, section 245H.02, is amended to read:

245H.02 WHO MUST BE CERTIFIED.

A program that is exempt from licensure under section 245A.03, subdivision 2, paragraph
(a), clause (5), (11) to (13), (15), (18), deleted text begin ordeleted text end (26), deleted text begin and is authorized to receive child care
assistance payments under chapter 119Bdeleted text end new text begin or (30)new text end , must be a certified license-exempt child
care center according to this sectionnew text begin to receive child care assistance payments under chapter
119Bnew text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 44.

Minnesota Statutes 2022, section 245H.03, subdivision 2, is amended to read:

Subd. 2.

Application submission.

The commissioner shall provide application
instructions and information about the rules and requirements of other state agencies that
affect the applicant. The certification application must be submitted in a manner prescribed
by the commissioner. new text begin Upon implementation of the provider licensing and reporting hub,
applicants must use the hub in the manner prescribed by the commissioner. new text end The commissioner
shall act on the application within 90 working days of receiving a completed application.

new text begin EFFECTIVE DATE.new text end

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

Sec. 45.

Minnesota Statutes 2022, section 245H.03, subdivision 4, is amended to read:

Subd. 4.

Reconsideration of certification denial.

(a) The applicant may request
reconsideration of the denial by notifying the commissioner by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal
servicenew text begin , or through the provider licensing and reporting hubnew text end . The request must be made in
writing. If sent by certified mail, the request must be postmarked and sent to the
commissioner within 20 calendar days after the applicant received the order. If a request is
made by personal service, it must be received by the commissioner within 20 calendar days
after the applicant received the order. new text begin If the order is issued through the provider hub, the
request must be received by the commissioner within 20 calendar days from the date the
commissioner issued the order through the hub.new text end The applicant may submit with the request
for reconsideration a written argument or evidence in support of the request for
reconsideration.

(b) The commissioner's disposition of a request for reconsideration is final and not
subject to appeal under chapter 14.

new text begin EFFECTIVE DATE.new text end

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

Sec. 46.

Minnesota Statutes 2022, section 245H.03, is amended by adding a subdivision
to read:

new text begin Subd. 5.new text end

new text begin Notification required.new text end

new text begin (a) A certification holder must notify the commissioner,
in a manner prescribed by the commissioner, and obtain the commissioner's approval before
making any changes:
new text end

new text begin (1) to the certification holder as defined in section 245H.01, subdivision 4;
new text end

new text begin (2) to the authorized agent as defined in section 245H.01, subdivision 2a;
new text end

new text begin (3) to the certification holder information on file with the secretary of state or Department
of Revenue;
new text end

new text begin (4) in the location of the program certified under this chapter;
new text end

new text begin (5) to the ages of children served by the program; or
new text end

new text begin (6) to the certified center's schedule including its:
new text end

new text begin (i) yearly schedule;
new text end

new text begin (ii) hours of operation; or
new text end

new text begin (iii) days of the week it is open.
new text end

new text begin (b) When, for reasons beyond the certification holder's control, a certification holder
cannot provide the commissioner with prior notice of the changes in paragraph (a), the
certification holder must notify the commissioner by the tenth business day after the change
and must provide any additional information requested by the commissioner.
new text end

new text begin (c) When a certification holder notifies the commissioner of a change to the certification
holder information on file with the secretary of state, the certification holder must provide
documentation of the change.
new text end

new text begin (d) Upon implementation of the provider licensing and reporting hub, certification holders
must enter and update information in the hub in a manner prescribed by the commissioner.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 47.

Minnesota Statutes 2022, section 245H.05, is amended to read:

245H.05 MONITORING AND INSPECTIONS.

(a) The commissioner must conduct an on-site inspection of a certified license-exempt
child care center at least deleted text begin annuallydeleted text end new text begin once each calendar yearnew text end to determine compliance with
the health, safety, and fire standards specific to a certified license-exempt child care center.

(b) No later than November 19, 2017, the commissioner shall make publicly available
on the department's website the results of inspection reports for all certified centers including
the number of deaths, serious injuries, and instances of substantiated child maltreatment
that occurred in certified centers each year.

new text begin EFFECTIVE DATE.new text end

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

Sec. 48.

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

Subdivision 1.

Correction order requirements.

new text begin (a) new text end If the applicant or certification
holder failed to comply with a law or rule, the commissioner may issue a correction order.
The correction order must state:

(1) the condition that constitutes a violation of the law or rule;

(2) the specific law or rule violated; and

(3) the time allowed to correct each violation.

new text begin (b) The commissioner may issue a correction order to the applicant or certification holder
through the provider licensing and reporting hub.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 49.

Minnesota Statutes 2022, section 245H.06, subdivision 2, is amended to read:

Subd. 2.

Reconsideration request.

(a) If the applicant or certification holder believes
that the commissioner's correction order is erroneous, the applicant or certification holder
may ask the commissioner to reconsider the part of the correction order that is allegedly
erroneous. A request for reconsideration must be made in writingdeleted text begin ,deleted text end new text begin andnew text end postmarkeddeleted text begin ,deleted text end new text begin or
submitted through the provider licensing and reporting hubnew text end and sent to the commissioner
within 20 calendar days after the applicant or certification holder received the correction
order, and must:

(1) specify the part of the correction order that is allegedly erroneous;

(2) explain why the specified part is erroneous; and

(3) include documentation to support the allegation of error.

(b) A request for reconsideration does not stay any provision or requirement of the
correction order. The commissioner's disposition of a request for reconsideration is final
and not subject to appeal.

new text begin (c) Upon implementation of the provider licensing and reporting hub, the provider must
use the hub to request reconsideration. If the order is issued through the provider hub, the
request must be received by the commissioner within 20 calendar days from the date the
commissioner issued the order through the hub.
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. 50.

Minnesota Statutes 2022, section 245H.07, subdivision 1, is amended to read:

Subdivision 1.

Generally.

(a) The commissioner may decertify a center if a certification
holder:

(1) failed to comply with an applicable law or rule;

(2) knowingly withheld relevant information from or gave false or misleading information
to the commissioner in connection with an application for certification, in connection with
the background study status of an individual, during an investigation, or regarding compliance
with applicable laws or rules; or

(3) has authorization to receive child care assistance payments revoked pursuant to
chapter 119B.

(b) When considering decertification, the commissioner shall consider the nature,
chronicity, or severity of the violation of law or rule.

(c) When a center is decertified, the center is ineligible to receive a child care assistance
payment under chapter 119B.

new text begin (d) The commissioner may issue a decertification order to a certification holder through
the provider licensing and reporting hub.
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. 51.

Minnesota Statutes 2022, section 245H.07, subdivision 2, is amended to read:

Subd. 2.

Reconsideration of decertification.

(a) The certification holder may request
reconsideration of the decertification by notifying the commissioner by certified mail deleted text begin ordeleted text end new text begin ,
bynew text end personal servicenew text begin , or through the provider licensing and reporting hubnew text end . The request must
be made in writing. If sent by certified mail, the request must be postmarked and sent to the
commissioner within 20 calendar days after the certification holder received the order. If a
request is made by personal service, it must be received by the commissioner within 20
calendar days after the certification holder received the order. new text begin If the order is issued through
the provider hub, the request must be received by the commissioner within 20 calendar days
from the date the commissioner issued the order through the hub.new text end With the request for
reconsideration, the certification holder may submit a written argument or evidence in
support of the request for reconsideration.

(b) The commissioner's disposition of a request for reconsideration is final and not
subject to appeal under chapter 14.

new text begin EFFECTIVE DATE.new text end

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

Sec. 52.

Minnesota Statutes 2022, section 245H.08, subdivision 4, is amended to read:

Subd. 4.

Maximum group size.

(a) For a child six weeks old through 16 months old,
the maximum group size shall be no more than eight children.

(b) For a child 16 months old through 33 months old, the maximum group size shall be
no more than 14 children.

(d) For a child in kindergarten through 13 years old, a maximum group size shall be no
more than 30 children.

(e) The maximum group size applies at all times except during group activity coordination
time not exceeding 15 minutes, during a meal, outdoor activity, field trip, nap and rest, and
special activity including a film, guest speaker, indoor large muscle activity, or holiday
program.

new text begin (f) Notwithstanding paragraph (d), a certified center may continue to serve a child 14
years of age or older if one of the following conditions is true:
new text end

new text begin (1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e); or
new text end

new text begin (2) the certified center serves only school-age children in a setting that has students
enrolled in no grade higher than 8th grade.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 53.

Minnesota Statutes 2022, section 245H.08, subdivision 5, is amended to read:

Subd. 5.

Ratios.

(a) The minimally acceptable staff-to-child ratios are:

six weeks old through 16 months old	1:4
16 months old through 33 months old	1:7
33 months old through prekindergarten	1:10
kindergarten through 13 years old	1:15

(b) Kindergarten includes a child of sufficient age to have attended the first day of
kindergarten or who is eligible to enter kindergarten within the next four months.

new text begin (d) Notwithstanding paragraph (a), a certified center may continue to serve a child 14
years of age or older if one of the following conditions is true:
new text end

new text begin (1) the child remains eligible for child care assistance under section 119B.09, subdivision
1, paragraph (e); or
new text end

new text begin (2) the certified center serves only school-age children in a setting that has students
enrolled in no grade higher than 8th grade.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 54.

Minnesota Statutes 2022, section 245H.13, subdivision 3, is amended to read:

Subd. 3.

Administration of medication.

(a) A certified center that chooses to administer
medicine must meet the requirements in this subdivision.

(b) The certified center must obtain written permission from the child's parent or legal
guardian before administering prescription medicine,new text begin nonprescription medicine,new text end diapering
product, sunscreen lotion, and insect repellent.

(c) The certified center must administer nonprescription medicine, diapering product,
sunscreen lotion, and insect repellent according to the manufacturer's instructions unless
provided written instructions by a licensed health professional to use a product differently.

(d) The certified center must obtain and follow written instructions from the prescribing
health professional before administering prescription medicine. Medicine with the child's
first and last name and current prescription information on the label is considered written
instructions.

(e) The certified center must ensure allnew text begin prescription and nonprescriptionnew text end medicine is:

(1) kept in the medicine's original container with a legible label stating the child's first
and last name;

(2) given only to the child whose name is on the label;

(3) not given after an expiration date on the label; and

(4) returned to the child's parent or legal guardian or destroyed, if unused.

(f) The certified center must document in the child's record the administration ofnew text begin
prescription and nonprescriptionnew text end medication, including the child's first and last name; the
name of the medication or prescription number; the date, time, and dosage; and the name
and signature of the person who administered the medicine. This documentation must be
available to the child's parent or legal guardian.

(g) The certified center must storenew text begin prescription and nonprescriptionnew text end medicines, insect
repellents, and diapering products according to directions on the original container.

new text begin EFFECTIVE DATE.new text end

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

Sec. 55.

Minnesota Statutes 2022, section 245H.13, subdivision 7, is amended to read:

Subd. 7.

Risk reduction plan.

(a) The certified center must develop a risk reduction
plan that identifies risks to children served by the child care center. The assessment of risk
must include risks presented by (1) the physical plant where the certified services are
provided, including electrical hazards; and (2) the environment, including the proximity to
busy roads and bodies of water.

(b) The certification holder must establish policies and procedures to minimize identified
risks. After any change to the risk reduction plan, the certification holder must inform staff
of the change in the risk reduction plan and document that staff were informed of the change.

new text begin (c) If middle-school-age children are enrolled in the center and combined with elementary
children, the certification holder must establish policies and procedures to ensure adequate
supervision as defined in subdivision 10 when children are grouped together.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 56.

Minnesota Statutes 2022, section 245I.011, subdivision 3, is amended to read:

Subd. 3.

Certification required.

(a) An individual, organization, or government entity
that is exempt from licensure under section 245A.03, subdivision 2, paragraph (a), clause
(19), and chooses to be identified as a certified mental health clinic must:

(1) be a mental health clinic that is certified under section 245I.20;

(2) comply with all of the responsibilities assigned to a license holder by this chapter
except subdivision 1; and

(3) comply with all of the responsibilities assigned to a certification holder by chapter
245A.

(b) An individual, organization, or government entity described by this subdivision must
obtain a criminal background study for each staff person or volunteer who provides direct
contact services to clients.

new text begin (c) If a clinic is certified according to this chapter and is part of a certified community
behavioral health clinic under section 245.735, the license holder must comply with the
requirements in section 245.735, subdivisions 4b to 4e, as part of the licensing requirements
under this chapter.
new text end

Sec. 57.

Minnesota Statutes 2022, section 245I.20, subdivision 10, is amended to read:

Subd. 10.

Application procedures.

(a) The applicant for certification must submit any
documents that the commissioner requires on forms approved by the commissioner.new text begin Upon
implementation of the provider licensing and reporting hub, applicants must use the hub in
the manner prescribed by the commissioner.
new text end

(b) Upon submitting an application for certification, an applicant must pay the application
fee required by section 245A.10, subdivision 3.

(d) When the commissioner receives an application for initial certification that is
incomplete because the applicant failed to submit required documents or is deficient because
the submitted documents do not meet certification requirements, the commissioner must
provide the applicant with written notice that the application is incomplete or deficient. In
the notice, the commissioner must identify the particular documents that are missing or
deficient and give the applicant 45 days to submit a second application that is complete. An
applicant's failure to submit a complete application within 45 days after receiving notice
from the commissioner is a basis for certification denial.

(e) The commissioner must give notice of a denial to an applicant when the commissioner
has made the decision to deny the certification application. In the notice of denial, the
commissioner must state the reasons for the denial in plain language. The commissioner
must send or deliver the notice of denial to an applicant by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal
servicenew text begin or through the provider licensing and reporting hubnew text end . In the notice of denial, the
commissioner must state the reasons that the commissioner denied the application and must
inform the applicant of the applicant's right to request a contested case hearing under chapter
14 and Minnesota Rules, parts 1400.8505 to 1400.8612. The applicant may appeal the denial
by notifying the commissioner in writing by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal servicenew text begin , or through
the provider licensing and reporting hubnew text end . If mailed, the appeal must be postmarked and sent
to the commissioner within 20 calendar days after the applicant received the notice of denial.
If an applicant delivers an appeal by personal service, the commissioner must receive the
appeal within 20 calendar days after the applicant received the notice of denial. new text begin If the order
is issued through the provider hub, the request must be received by the commissioner within
20 calendar days from the date the commissioner issued the order through the hub.
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. 58.

Minnesota Statutes 2022, section 245I.20, subdivision 13, is amended to read:

Subd. 13.

Correction orders.

(a) If the applicant or certification holder fails to comply
with a law or rule, the commissioner may issue a correction order. The correction order
must state:

(1) the condition that constitutes a violation of the law or rule;

(2) the specific law or rule that the applicant or certification holder has violated; and

(3) the time that the applicant or certification holder is allowed to correct each violation.

(b) If the applicant or certification holder believes that the commissioner's correction
order is erroneous, the applicant or certification holder may ask the commissioner to
reconsider the part of the correction order that is allegedly erroneous. An applicant or
certification holder must make a request for reconsideration in writing. The request must
be postmarked and sent to the commissioner new text begin or submitted in the provider licensing and
reporting hub new text end within 20 calendar days after the applicant or certification holder received
the correction order; and the request must:

(1) specify the part of the correction order that is allegedly erroneous;

(2) explain why the specified part is erroneous; and

(3) include documentation to support the allegation of error.

(c) A request for reconsideration does not stay any provision or requirement of the
correction order. The commissioner's disposition of a request for reconsideration is final
and not subject to appeal.

(d) If the commissioner finds that the applicant or certification holder failed to correct
the violation specified in the correction order, the commissioner may decertify the certified
mental health clinic according to subdivision 14.

(e) Nothing in this subdivision prohibits the commissioner from decertifying a mental
health clinic according to subdivision 14.

new text begin (f) The commissioner may issue a correction order to the applicant or certification holder
through the provider licensing and reporting hub. If the order is issued through the provider
hub, the request must be received by the commissioner within 20 calendar days from the
date the commissioner issued the order through the hub.
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. 59.

Minnesota Statutes 2022, section 245I.20, subdivision 14, is amended to read:

Subd. 14.

Decertification.

(a) The commissioner may decertify a mental health clinic
if a certification holder:

(1) failed to comply with an applicable law or rule; or

(2) knowingly withheld relevant information from or gave false or misleading information
to the commissioner in connection with an application for certification, during an
investigation, or regarding compliance with applicable laws or rules.

(b) When considering decertification of a mental health clinic, the commissioner must
consider the nature, chronicity, or severity of the violation of law or rule and the effect of
the violation on the health, safety, or rights of clients.

(c) If the commissioner decertifies a mental health clinic, the order of decertification
must inform the certification holder of the right to have a contested case hearing under
chapter 14 and Minnesota Rules, parts 1400.8505 to 1400.8612. new text begin The commissioner may
issue the order through the provider licensing and reporting hub. new text end The certification holder
may appeal the decertification. The certification holder must appeal a decertification in
writing and send or deliver the appeal to the commissioner by certified mail deleted text begin ordeleted text end new text begin , bynew text end personal
servicenew text begin , or through the provider licensing and reporting hubnew text end . If the certification holder mails
the appeal, the appeal must be postmarked and sent to the commissioner within ten calendar
days after the certification holder receives the order of decertification. If the certification
holder delivers an appeal by personal service, the commissioner must receive the appeal
within ten calendar days after the certification holder received the order. new text begin If the order is
issued through the provider hub, the request must be received by the commissioner within
20 calendar days from the date the commissioner issued the order through the hub.new text end If a
certification holder submits a timely appeal of an order of decertification, the certification
holder may continue to operate the program until the commissioner issues a final order on
the decertification.

(d) If the commissioner decertifies a mental health clinic pursuant to paragraph (a),
clause (1), based on a determination that the mental health clinic was responsible for
maltreatment, and if the certification holder appeals the decertification according to paragraph
(c), and appeals the maltreatment determination under section 260E.33, the final
decertification determination is stayed until the commissioner issues a final decision regarding
the maltreatment appeal.

new text begin EFFECTIVE DATE.new text end

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

Sec. 60.

Minnesota Statutes 2022, section 245I.20, subdivision 16, is amended to read:

Subd. 16.

Notifications required and noncompliance.

(a) A certification holder must
notify the commissioner, in a manner prescribed by the commissioner, and obtain the
commissioner's approval before making any change to the name of the certification holder
or the location of the mental health clinic.new text begin Upon implementation of the provider licensing
and reporting hub, certification holders must enter and update information in the hub in a
manner prescribed by the commissioner.
new text end

(b) Changes in mental health clinic organization, staffing, treatment, or quality assurance
procedures that affect the ability of the certification holder to comply with the minimum
standards of this section must be reported in writing by the certification holder to the
commissioner within 15 days of the occurrence. Review of the change must be conducted
by the commissioner. A certification holder with changes resulting in noncompliance in
minimum standards must receive written notice and may have up to 180 days to correct the
areas of noncompliance before being decertified. Interim procedures to resolve the
noncompliance on a temporary basis must be developed and submitted in writing to the
commissioner for approval within 30 days of the commissioner's determination of the
noncompliance. Not reporting an occurrence of a change that results in noncompliance
within 15 days, failure to develop an approved interim procedure within 30 days of the
determination of the noncompliance, or nonresolution of the noncompliance within 180
days will result in immediate decertification.

(c) The mental health clinic may be required to submit written information to the
department to document that the mental health clinic has maintained compliance with this
section and mental health clinic procedures.

new text begin EFFECTIVE DATE.new text end

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

Sec. 61.

Minnesota Statutes 2022, section 260E.09, is amended to read:

260E.09 REPORTING REQUIREMENTS.

(a) An oral report shall be made immediately by telephone or otherwise. An oral report
made by a person required under section 260E.06, subdivision 1, to report shall be followed
within 72 hours, exclusive of weekends and holidays, by a report in writing to the appropriate
police department, the county sheriff, the agency responsible for assessing or investigating
the report, or the local welfare agency.

(b) Any report shall be of sufficient content to identify the child, any person believed
to be responsible for the maltreatment of the child if the person is known, the nature and
extent of the maltreatment, and the name and address of the reporter. The local welfare
agency or agency responsible for assessing or investigating the report shall accept a report
made under section 260E.06 notwithstanding refusal by a reporter to provide the reporter's
name or address as long as the report is otherwise sufficient under this paragraph.

new text begin (c) Notwithstanding paragraph (a), upon implementation of the provider licensing and
reporting hub, an individual who has an account with the provider licensing and reporting
hub and is required to report suspected maltreatment at a licensed program under section
260E.06, subdivision 1, may submit a written report in the hub in a manner prescribed by
the commissioner and is not required to make an oral report. A report submitted through
the provider licensing and reporting hub must be made immediately.
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. 62.

Minnesota Statutes 2022, section 270B.14, subdivision 1, is amended to read:

Subdivision 1.

Disclosure to commissioner of human services.

(a) On the request of
the commissioner of human services, the commissioner shall disclose return information
regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to the
extent provided in paragraph (b) and for the purposes set forth in paragraph (c).

(b) Data that may be disclosed are limited to data relating to the identity, whereabouts,
employment, income, and property of a person owing or alleged to be owing an obligation
of child support.

(c) The commissioner of human services may request data only for the purposes of
carrying out the child support enforcement program and to assist in the location of parents
who have, or appear to have, deserted their children. Data received may be used only as set
forth in section 256.978.

(d) The commissioner shall provide the records and information necessary to administer
the supplemental housing allowance to the commissioner of human services.

(e) At the request of the commissioner of human services, the commissioner of revenue
shall electronically match the Social Security numbers and names of participants in the
telephone assistance plan operated under sections 237.69 to 237.71, with those of property
tax refund filers, and determine whether each participant's household income is within the
eligibility standards for the telephone assistance plan.

(f) The commissioner may provide records and information collected under sections
295.50 to 295.59 to the commissioner of human services for purposes of the Medicaid
Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law
102-234. Upon the written agreement by the United States Department of Health and Human
Services to maintain the confidentiality of the data, the commissioner may provide records
and information collected under sections 295.50 to 295.59 to the Centers for Medicare and
Medicaid Services section of the United States Department of Health and Human Services
for purposes of meeting federal reporting requirements.

(g) The commissioner may provide records and information to the commissioner of
human services as necessary to administer the early refund of refundable tax credits.

(h) The commissioner may disclose information to the commissioner of human services
as necessary for income verification for eligibility and premium payment under the
MinnesotaCare program, under section 256L.05, subdivision 2, as well as the medical
assistance program under chapter 256B.

(i) The commissioner may disclose information to the commissioner of human services
necessary to verify whether applicants or recipients for the Minnesota family investment
program, general assistance, the Supplemental Nutrition Assistance Program (SNAP),
Minnesota supplemental aid program, and child care assistance have claimed refundable
tax credits under chapter 290 and the property tax refund under chapter 290A, and the
amounts of the credits.

(j) The commissioner may disclose information to the commissioner of human services
necessary to verify income for purposes of calculating parental contribution amounts under
section 252.27, subdivision 2a.

new text begin (k) At the request of the commissioner of human services and when authorized in writing
by the taxpayer, the commissioner of revenue may match the business legal name or
individual legal name, and the Minnesota tax identification number, federal Employer
Identification Number, or Social Security number of the applicant under section 245A.04,
subdivision 1; 245I.20; or 245H.03; or license or certification holder. The commissioner of
revenue may share the matching with the commissioner of human services. The matching
may only be used by the commissioner of human services to determine eligibility for provider
grant programs and to facilitate the regulatory oversight of license and certification holders
as it relates to ownership and public funds program integrity. This paragraph applies only
if the commissioner of human services and the commissioner of revenue enter into an
interagency agreement for the purposes of this paragraph.
new text end

Sec. 63. new text begin DIRECTION TO COMMISSIONER; AMENDING STAFF DISTRIBUTION
RULES FOR CHILD CARE CENTERS.
new text end

new text begin (a) Notwithstanding Minnesota Rules, part 9503.0040, subpart 2, item B, the
commissioner of human services must allow an aide to substitute for a teacher during
morning arrival and afternoon departure times in a licensed child care center if the total
arrival and departure time does not exceed 25 percent of the center's daily hours of operation.
In order for an aide to be used in this capacity, an aide must:
new text end

new text begin (1) be at least 18 years of age;
new text end

new text begin (2) have worked in the licensed child care center for a minimum of 30 days; and
new text end

new text begin (3) have completed all preservice and first-90-days training required for licensing.
new text end

new text begin (b) This section expires July 1, 2025.
new text end

ARTICLE 9

BEHAVIORAL HEALTH

Section 1.

Minnesota Statutes 2022, section 245.462, subdivision 17, is amended to read:

Subd. 17.

Mental health practitioner.

deleted text begin (a)deleted text end "Mental health practitioner" means a new text begin staff
new text end person deleted text begin providing services to adults with mental illness or children with emotional disturbance
who is qualified in at least one of the ways described in paragraphs (b) to (g). A mental
health practitioner for a child client must have training working with children. A mental
health practitioner for an adult client must have training working with adultsdeleted text end new text begin who is qualified
according to section 245I.04, subdivision 4new text end .

deleted text begin (b) For purposes of this subdivision, a practitioner is qualified through relevant
coursework if the practitioner completes at least 30 semester hours or 45 quarter hours in
behavioral sciences or related fields and:
deleted text end

deleted text begin (1) has at least 2,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, substance use disorder, or emotional disturbance; or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities and completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects;
deleted text end

deleted text begin (2) is fluent in the non-English language of the ethnic group to which at least 50 percent
of the practitioner's clients belong, completes 40 hours of training in the delivery of services
to adults with mental illness or children with emotional disturbance, and receives clinical
supervision from a mental health professional at least once a week until the requirement of
2,000 hours of supervised experience is met;
deleted text end

deleted text begin (3) is working in a day treatment program under section 245.4712, subdivision 2;
deleted text end

deleted text begin (4) has completed a practicum or internship that (i) requires direct interaction with adults
or children served, and (ii) is focused on behavioral sciences or related fields; or
deleted text end

deleted text begin (5) is in the process of completing a practicum or internship as part of a formal
undergraduate or graduate training program in social work, psychology, or counseling.
deleted text end

deleted text begin (c) For purposes of this subdivision, a practitioner is qualified through work experience
if the person:
deleted text end

deleted text begin (1) has at least 4,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, substance use disorder, or emotional disturbance; or
deleted text end

deleted text begin (2) has at least 2,000 hours of supervised experience in the delivery of services to adults
or children with:
deleted text end

deleted text begin (i) mental illness, emotional disturbance, or substance use disorder, and receives clinical
supervision as required by applicable statutes and rules from a mental health professional
at least once a week until the requirement of 4,000 hours of supervised experience is met;
or
deleted text end

deleted text begin (ii) traumatic brain injury or developmental disabilities; completes training on mental
illness, recovery from mental illness, mental health de-escalation techniques, co-occurring
mental illness and substance abuse, and psychotropic medications and side effects; and
receives clinical supervision as required by applicable statutes and rules at least once a week
from a mental health professional until the requirement of 4,000 hours of supervised
experience is met.
deleted text end

deleted text begin (d) For purposes of this subdivision, a practitioner is qualified through a graduate student
internship if the practitioner is a graduate student in behavioral sciences or related fields
and is formally assigned by an accredited college or university to an agency or facility for
clinical training.
deleted text end

deleted text begin (e) For purposes of this subdivision, a practitioner is qualified by a bachelor's or master's
degree if the practitioner:
deleted text end

deleted text begin (1) holds a master's or other graduate degree in behavioral sciences or related fields; or
deleted text end

deleted text begin (2) holds a bachelor's degree in behavioral sciences or related fields and completes a
practicum or internship that (i) requires direct interaction with adults or children served,
and (ii) is focused on behavioral sciences or related fields.
deleted text end

deleted text begin (f) For purposes of this subdivision, a practitioner is qualified as a vendor of medical
care if the practitioner meets the definition of vendor of medical care in section 256B.02,
subdivision 7, paragraphs (b) and (c), and is serving a federally recognized tribe.
deleted text end

deleted text begin (g) For purposes of medical assistance coverage of diagnostic assessments, explanations
of findings, and psychotherapy under section 256B.0625, subdivision 65, a mental health
practitioner working as a clinical trainee means that the practitioner's clinical supervision
experience is helping the practitioner gain knowledge and skills necessary to practice
effectively and independently. This may include supervision of direct practice, treatment
team collaboration, continued professional learning, and job management. The practitioner
must also:
deleted text end

deleted text begin (1) comply with requirements for licensure or board certification as a mental health
professional, according to the qualifications under Minnesota Rules, part 9505.0371, subpart
5, item A, including supervised practice in the delivery of mental health services for the
treatment of mental illness; or
deleted text end

deleted text begin (2) be a student in a bona fide field placement or internship under a program leading to
completion of the requirements for licensure as a mental health professional according to
the qualifications under Minnesota Rules, part 9505.0371, subpart 5, item A.
deleted text end

deleted text begin (h) For purposes of this subdivision, "behavioral sciences or related fields" has the
meaning given in section 256B.0623, subdivision 5, paragraph (d).
deleted text end

deleted text begin (i) Notwithstanding the licensing requirements established by a health-related licensing
board, as defined in section 214.01, subdivision 2, this subdivision supersedes any other
statute or rule.
deleted text end

Sec. 2.

Minnesota Statutes 2022, section 245.4663, subdivision 1, is amended to read:

Subdivision 1.

Grant program established.

The commissioner shall award grants to
licensed or certified mental health providers that meet the criteria in subdivision 2 to fund
supervision of new text begin or preceptorships for students, new text end internsnew text begin ,new text end and clinical trainees who are working
toward becoming mental health professionals deleted text begin anddeleted text end new text begin ;new text end to subsidize the costs of licensing
applications and examination fees for clinical traineesnew text begin ; and to fund training for workers to
become supervisorsnew text end . For purposes of this section, an intern may include an individual who
is working toward an undergraduate degree in the behavioral sciences or related field at an
accredited educational institution.

Sec. 3.

Minnesota Statutes 2022, section 245.4889, subdivision 1, is amended to read:

Subdivision 1.

Establishment and authority.

(a) The commissioner is authorized to
make grants from available appropriations to assist:

(1) counties;

(2) Indian tribes;

(3) children's collaboratives under section 124D.23 or 245.493; or

(4) mental health service providers.

(b) The following services are eligible for grants under this section:

(1) services to children with emotional disturbances as defined in section 245.4871,
subdivision 15, and their families;

(2) transition services under section 245.4875, subdivision 8, for young adults under
age 21 and their families;

(3) respite care services for children with emotional disturbances or severe emotional
disturbances who are at risk of out-of-home placement or already in out-of-home placement
in family foster settings as defined in chapter 245A and at risk of change in out-of-home
placement or placement in a residential facility or other higher level of care. Allowable
activities and expenses for respite care services are defined under subdivision 4. A child is
not required to have case management services to receive respite care services;

(4) children's mental health crisis services;

new text begin (5) child-, youth-, and family-specific mobile response and stabilization services models;
new text end

deleted text begin (5)deleted text end new text begin (6)new text end mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;

deleted text begin (6)deleted text end new text begin (7)new text end children's mental health screening and follow-up diagnostic assessment and
treatment;

deleted text begin (7)deleted text end new text begin (8)new text end services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;

deleted text begin (8)deleted text end new text begin (9)new text end school-linked mental health services under section 245.4901;

deleted text begin (9)deleted text end new text begin (10)new text end building evidence-based mental health intervention capacity for children birth
to age five;

deleted text begin (10)deleted text end new text begin (11)new text end suicide prevention and counseling services that use text messaging statewide;

deleted text begin (11)deleted text end new text begin (12)new text end mental health first aid training;

deleted text begin (12)deleted text end new text begin (13)new text end training for parents, collaborative partners, and mental health providers on the
impact of adverse childhood experiences and trauma and development of an interactive
website to share information and strategies to promote resilience and prevent trauma;

deleted text begin (13)deleted text end new text begin (14)new text end transition age services to develop or expand mental health treatment and
supports for adolescents and young adults 26 years of age or younger;

deleted text begin (14)deleted text end new text begin (15)new text end early childhood mental health consultation;

deleted text begin (15)deleted text end new text begin (16)new text end evidence-based interventions for youth at risk of developing or experiencing
a first episode of psychosis, and a public awareness campaign on the signs and symptoms
of psychosis;

deleted text begin (16)deleted text end new text begin (17)new text end psychiatric consultation for primary care practitioners; and

deleted text begin (17)deleted text end new text begin (18)new text end providers to begin operations and meet program requirements when establishing
a new children's mental health program. These may be start-up grants.

(c) Services under paragraph (b) must be designed to help each child to function and
remain with the child's family in the community and delivered consistent with the child's
treatment plan. Transition services to eligible young adults under this paragraph must be
designed to foster independent living in the community.

(d) As a condition of receiving grant funds, a grantee shall obtain all available third-party
reimbursement sources, if applicable.

new text begin (e) The commissioner may establish and design a pilot program to expand the mobile
response and stabilization services model for children, youth, and families. The commissioner
may use grant funding to consult with a qualified expert entity to assist in the formulation
of measurable outcomes and explore and position the state to submit a Medicaid state plan
amendment to scale the model statewide.
new text end

Sec. 4.

Minnesota Statutes 2022, section 245.4901, subdivision 4, is amended to read:

Subd. 4.

Data collection and outcome measurement.

Grantees shall provide data to
the commissioner for the purpose of evaluating the effectiveness of the school-linked
behavioral health grant programnew text begin , no more frequently than twice per year. Data provided by
grantees must include only the number of clients served, client demographics, payor
information, client-related clinical and ancillary services including hours of direct client
services, and hours of ancillary support services. Qualitative data may also be collected to
demonstrate outcomes. The commissioner must consult with grantees to develop ongoing
outcome measures for program capacity and performancenew text end .

Sec. 5.

Minnesota Statutes 2022, section 245.4901, is amended by adding a subdivision
to read:

new text begin Subd. 5.new text end

new text begin Consultation; grant awards.new text end

new text begin In administering the grant program, the
commissioner shall consult with school districts that have not received grants under this
section but that wish to collaborate with a community mental health provider. The
commissioner shall also work with culturally specific providers to allow these providers to
serve students from their community in multiple schools. When awarding grants, the
commissioner shall consider the need to have consistency of providers over time among
schools and students.
new text end

Sec. 6.

new text begin [245.4903] CULTURAL AND ETHNIC MINORITY INFRASTRUCTURE
GRANT PROGRAM.
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 must establish a
cultural and ethnic minority infrastructure grant program to ensure that mental health and
substance use disorder treatment supports and services are culturally specific and culturally
responsive to meet the cultural needs of communities served.
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 licensed entity or provider from
a cultural or ethnic minority population who:
new text end

new text begin (1) provides mental health or substance use disorder treatment services and supports to
individuals from cultural and ethnic minority populations, including members of those
populations who identify as lesbian, gay, bisexual, transgender, or queer;
new text end

new text begin (2) provides, or is qualified and has the capacity to provide, clinical supervision and
support to members of culturally diverse and ethnic minority communities so they may
become qualified mental health and substance use disorder treatment providers; or
new text end

new text begin (3) has the capacity and experience to provide training for mental health and substance
use disorder treatment providers on cultural competency and cultural humility.
new text end

new text begin Subd. 3.new text end

new text begin Allowable grant activities.new text end

new text begin (a) Grantees must engage in activities and provide
supportive services to ensure and increase equitable access to culturally specific and
responsive care and build organizational and professional capacity for licensure and
certification for the communities served. Allowable grant activities include but are not
limited to:
new text end

new text begin (1) providing workforce development activities focused on recruiting, supporting,
training, and supervising mental health and substance use disorder practitioners and
professionals from diverse racial, cultural, and ethnic communities;
new text end

new text begin (2) helping members of racial and ethnic minority communities become qualified mental
health and substance use disorder professionals, practitioners, clinical supervisors, recovery
peer specialists, mental health certified peer specialists, and mental health certified family
peer specialists;
new text end

new text begin (3) providing culturally specific outreach, early intervention, trauma-informed services,
and recovery support in mental health and substance use disorder services;
new text end

new text begin (4) providing trauma-informed and culturally responsive mental health and substance
use disorder supports and services to children and families, youth, or adults who are from
cultural and ethnic minority backgrounds and are uninsured or underinsured;
new text end

new text begin (5) expanding mental health and substance use disorder services, particularly in greater
Minnesota;
new text end

new text begin (6) training mental health and substance use disorder treatment providers on cultural
competency and cultural humility;
new text end

new text begin (7) providing activities that increase the availability of culturally responsive mental
health and substance use disorder services for children and families, youth, or adults, or
that increase the availability of substance use disorder services for individuals from cultural
and ethnic minorities in the state;
new text end

new text begin (8) providing interpreter services at intensive residential treatment facilities, children's
residential treatment centers, or psychiatric residential treatment facilities in order for
children or adults with limited English proficiency or children or adults who are fluent in
another language to be able to access treatment; and
new text end

new text begin (9) paying for case-specific consultation between a mental health professional and the
appropriate diverse mental health professional in order to facilitate the provision of services
that are culturally appropriate to a client's needs.
new text end

new text begin (b) The commissioner must assist grantees with meeting third-party credentialing
requirements, and grantees must obtain all available third-party reimbursement sources as
a condition of receiving grant money. Grantees must serve individuals from cultural and
ethnic minority communities regardless of health coverage status or ability to pay.
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 regular data summaries
to the commissioner for purposes of evaluating the effectiveness of the cultural and ethnic
minority infrastructure grant program. The commissioner must use identified culturally
appropriate outcome measures instruments to evaluate outcomes and must evaluate program
activities by analyzing whether the program:
new text end

new text begin (1) increased access to culturally specific services for individuals from cultural and
ethnic minority communities across the state;
new text end

new text begin (2) increased the number of individuals from cultural and ethnic minority communities
served by grantees;
new text end

new text begin (3) increased cultural responsiveness and cultural competency of mental health and
substance use disorder treatment providers;
new text end

new text begin (4) increased the number of mental health and substance use disorder treatment providers
and clinical supervisors from cultural and ethnic minority communities;
new text end

new text begin (5) increased the number of mental health and substance use disorder treatment
organizations owned, managed, or led by individuals who are Black, Indigenous, or people
of color;
new text end

new text begin (6) reduced health disparities through improved clinical and functional outcomes for
those accessing services; and
new text end

new text begin (7) led to an overall increase in culturally specific mental health and substance use
disorder service availability.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 7.

Minnesota Statutes 2022, section 245I.04, subdivision 14, is amended to read:

Subd. 14.

Mental health rehabilitation worker qualifications.

(a) A mental health
rehabilitation worker must:

(1) have a high school diploma or equivalent; deleted text begin and
deleted text end

new text begin (2) have the training required under section 245I.05, subdivision 3, paragraph (c); and
new text end

deleted text begin (2)deleted text end new text begin (3)new text end meet one of the following qualification requirements:

(i) be fluent in the non-English language or competent in the culture of the ethnic group
to which at least 20 percent of the mental health rehabilitation worker's clients belong;

(ii) have an associate of arts degree;

(iii) have two years of full-time postsecondary education or a total of 15 semester hours
or 23 quarter hours in behavioral sciences or related fields;

(iv) be a registered nurse;

(v) have, within the previous ten years, three years of personal life experience with
mental illness;

(vi) have, within the previous ten years, three years of life experience as a primary
caregiver to an adult with a mental illness, traumatic brain injury, substance use disorder,
or developmental disability; or

(vii) have, within the previous ten years, 2,000 hours of work experience providing
health and human services to individuals.

(b) A mental health rehabilitation worker who is new text begin exclusively new text end scheduled as an overnight
staff person deleted text begin and works alonedeleted text end is exempt from the additional qualification requirements in
paragraph (a), clause deleted text begin (2)deleted text end new text begin (3)new text end .

Sec. 8.

Minnesota Statutes 2022, section 245I.04, subdivision 16, is amended to read:

Subd. 16.

Mental health behavioral aide qualifications.

(a) A level 1 mental health
behavioral aide must havenew text begin the training required under section 245I.05, subdivision 3,
paragraph (c), andnew text end : (1) a high school diploma or equivalent; or (2) two years of experience
as a primary caregiver to a child with mental illness within the previous ten years.

(b) A level 2 mental health behavioral aide mustdeleted text begin : (1)deleted text end havenew text begin the training required under
section 245I.05, subdivision 3, paragraph (c), andnew text end an associate or bachelor's degreedeleted text begin ; or (2)
be certified by a program under section 256B.0943, subdivision 8adeleted text end .

Sec. 9.

Minnesota Statutes 2022, section 245I.05, subdivision 3, is amended to read:

Subd. 3.

Initial training.

(a) A staff person must receive training about:

(1) vulnerable adult maltreatment under section 245A.65, subdivision 3; and

(2) the maltreatment of minor reporting requirements and definitions in chapter 260E
within 72 hours of first providing direct contact services to a client.

(b) Before providing direct contact services to a client, a staff person must receive training
about:

(1) client rights and protections under section 245I.12;

(2) the Minnesota Health Records Act, including client confidentiality, family engagement
under section 144.294, and client privacy;

(3) emergency procedures that the staff person must follow when responding to a fire,
inclement weather, a report of a missing person, and a behavioral or medical emergency;

(4) specific activities and job functions for which the staff person is responsible, including
the license holder's program policies and procedures applicable to the staff person's position;

(5) professional boundaries that the staff person must maintain; and

(6) specific needs of each client to whom the staff person will be providing direct contact
services, including each client's developmental status, cognitive functioning, and physical
and mental abilities.

(c) Before providing direct contact services to a client, a mental health rehabilitation
worker, mental health behavioral aide, or mental health practitioner required to receive the
training according to section 245I.04, subdivision 4, must receive 30 hours of training about:

(1) mental illnesses;

(2) client recovery and resiliency;

(3) mental health de-escalation techniques;

(4) co-occurring mental illness and substance use disorders; and

(5) psychotropic medications and medication side effects.

(d) Within 90 days of first providing direct contact services to an adult client, deleted text begin a clinical
trainee,deleted text end mental health practitioner, mental health certified peer specialist, or mental health
rehabilitation worker must receive training about:

(1) trauma-informed care and secondary trauma;

(2) person-centered individual treatment plans, including seeking partnerships with
family and other natural supports;

(3) co-occurring substance use disorders; and

(4) culturally responsive treatment practices.

(e) Within 90 days of first providing direct contact services to a child client, deleted text begin a clinical
trainee,deleted text end mental health practitioner, mental health certified family peer specialist, mental
health certified peer specialist, or mental health behavioral aide must receive training about
the topics in clauses (1) to (5). This training must address the developmental characteristics
of each child served by the license holder and address the needs of each child in the context
of the child's family, support system, and culture. Training topics must include:

(1) trauma-informed care and secondary trauma, including adverse childhood experiences
(ACEs);

(2) family-centered treatment plan development, including seeking partnership with a
child client's family and other natural supports;

(3) mental illness and co-occurring substance use disorders in family systems;

(4) culturally responsive treatment practices; and

(5) child development, including cognitive functioning, and physical and mental abilities.

(f) For a mental health behavioral aide, the training under paragraph (e) must include
parent team training using a curriculum approved by the commissioner.

Sec. 10.

Minnesota Statutes 2022, section 245I.08, subdivision 2, is amended to read:

Subd. 2.

Documentation standards.

A license holder must ensure that all documentation
required by this chapter:

(1) is legible;

(2) identifies the applicable client new text begin name on each page of the client file new text end and staff personnew text begin
namenew text end on each pagenew text begin of the personnel filenew text end ; and

(3) is signed and dated by the staff persons who provided services to the client or
completed the documentation, including the staff persons' credentials.

Sec. 11.

Minnesota Statutes 2022, section 245I.08, subdivision 3, is amended to read:

Subd. 3.

Documenting approval.

A license holder must ensure that all diagnostic
assessments, functional assessments, level of care assessments, and treatment plans completed
by a clinical trainee or mental health practitioner contain documentation of approval by a
treatment supervisor within deleted text begin fivedeleted text end new text begin tennew text end business days of initial completion by the staff person
under treatment supervision.

Sec. 12.

Minnesota Statutes 2022, section 245I.08, subdivision 4, is amended to read:

Subd. 4.

Progress notes.

A license holder must use a progress note to document each
occurrence of a mental health service that a staff person provides to a client. A progress
note must include the following:

(1) the type of service;

(2) the date of service;

(3) the start and stop time of the service unless the license holder is licensed as a
residential program;

(4) the location of the service;

(5) the scope of the service, including: (i) the targeted goal and objective; (ii) the
intervention that the staff person provided to the client and the methods that the staff person
used; (iii) the client's response to the intervention;new text begin andnew text end (iv) the staff person's plan to take
future actions, including changes in treatment that the staff person will implement if the
intervention was ineffective; deleted text begin and (v) the service modality;
deleted text end

(6) the signature and credentials of the staff person who provided the service to the
client;

(7) the mental health provider travel documentation required by section 256B.0625, if
applicable; and

(8) significant observations by the staff person, if applicable, including: (i) the client's
current risk factors; (ii) emergency interventions by staff persons; (iii) consultations with
or referrals to other professionals, family, or significant others; and (iv) changes in the
client's mental or physical symptoms.

Sec. 13.

Minnesota Statutes 2022, section 245I.10, subdivision 2, is amended to read:

Subd. 2.

Generally.

(a) A license holder must use a client's diagnostic assessment or
crisis assessment to determine a client's eligibility for mental health services, except as
provided in this section.

(b) Prior to completing a client's initial diagnostic assessment, a license holder may
provide a client with the following services:

(1) an explanation of findings;

(2) neuropsychological testing, neuropsychological assessment, and psychological
testing;

(3) any combination of psychotherapy sessions, family psychotherapy sessions, and
family psychoeducation sessions not to exceed three sessions;

(4) crisis assessment services according to section 256B.0624; and

(5) ten days of intensive residential treatment services according to the assessment and
treatment planning standards in section 245I.23, subdivision 7.

(c) Based on the client's needs that a crisis assessment identifies under section 256B.0624,
a license holder may provide a client with the following services:

(1) crisis intervention and stabilization services under section 245I.23 or 256B.0624;
and

(2) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization.

(d) Based on the client's needs in the client's brief diagnostic assessment, a license holder
may provide a client with any combination of psychotherapy sessions, group psychotherapy
sessions, family psychotherapy sessions, and family psychoeducation sessions not to exceed
ten sessions within a 12-month period without prior authorization for any new client or for
an existing client who the license holder projects will need fewer than ten sessions during
the next 12 months.

(e) Based on the client's needs that a hospital's medical history and presentation
examination identifies, a license holder may provide a client with:

(1) any combination of psychotherapy sessions, group psychotherapy sessions, family
psychotherapy sessions, and family psychoeducation sessions not to exceed ten sessions
within a 12-month period without prior authorization for any new client or for an existing
client who the license holder projects will need fewer than ten sessions during the next 12
months; and

(2) up to five days of day treatment services or partial hospitalization.

(f) A license holder must complete a new standard diagnostic assessment of a clientnew text begin or
an update to an assessment as permitted under paragraph (g)new text end :

(1) when the client requires services of a greater number or intensity than the services
that paragraphs (b) to (e) describe;

(2) deleted text begin at least annually following the client's initial diagnostic assessmentdeleted text end if the client needs
additional mental health services and the client does not meet the criteria for a brief
assessment;

(3) when the client's mental health condition has changed markedly since the client's
most recent diagnostic assessment; deleted text begin or
deleted text end

(4) when the client's current mental health condition does not meet the criteria of the
client's current diagnosisdeleted text begin .deleted text end new text begin ; or
new text end

new text begin (5) upon the client's request.
new text end

(g) For deleted text begin an existingdeleted text end new text begin a new text end clientnew text begin who is already engaged in services and has a prior assessmentnew text end ,
the license holder must deleted text begin ensure that a new standard diagnostic assessment includesdeleted text end new text begin completenew text end
a written update containing all significant new or changed information about the client,new text begin
removal of outdated or inaccurate information,new text end and an update regarding what information
has not significantly changed, including a discussion with the client about changes in the
client's life situation, functioning, presenting problems, and progress with achieving treatment
goals since the client's last diagnostic assessment was completed.

Sec. 14.

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

Subd. 3.

Continuity of services.

(a) For any client with a diagnostic assessment
completed under Minnesota Rules, parts 9505.0370 to 9505.0372, before July 1, 2022, or
upon federal approval, whichever is later, the diagnostic assessment is valid for authorizing
the client's treatment and billing for one calendar year after the date that the assessment was
completed.

(b) For any client with an individual treatment plan completed under section 256B.0622,
256B.0623, 256B.0943, 256B.0946, or 256B.0947 or Minnesota Rules, parts 9505.0370 to
9505.0372, the client's treatment plan is valid for authorizing treatment and billing until the
treatment plan's expiration date.

Sec. 15.

Minnesota Statutes 2022, section 245I.10, subdivision 5, is amended to read:

Subd. 5.

Brief diagnostic assessment; required elements.

(a) Only a mental health
professional or clinical trainee may complete a brief diagnostic assessment of a client. deleted text begin A
license holder may only use a brief diagnostic assessment for a client who is six years of
age or older.
deleted text end

(b) When conducting a brief diagnostic assessment of a client, the assessor must complete
a face-to-face interview with the client and a written evaluation of the client. The assessor
must gather and document initial components of the client's standard diagnostic assessment,
including the client's:

(1) age;

(2) description of symptoms, including the reason for the client's referral;

(3) history of mental health treatment;

(4) cultural influences on the client; and

(5) mental status examination.

(c) Based on the initial components of the assessment, the assessor must develop a
provisional diagnostic formulation about the client. The assessor may use the client's
provisional diagnostic formulation to address the client's immediate needs and presenting
problems.

(d) A mental health professional or clinical trainee may use treatment sessions with the
client authorized by a brief diagnostic assessment to gather additional information about
the client to complete the client's standard diagnostic assessment if the number of sessions
will exceed the coverage limits in subdivision 2.

Sec. 16.

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

Subd. 6.

Standard diagnostic assessment; required elements.

(a) Only a mental health
professional or a clinical trainee may complete a standard diagnostic assessment of a client.
A standard diagnostic assessment of a client must include a face-to-face interview with a
client and a written evaluation of the client. The assessor must complete a client's standard
diagnostic assessment within the client's cultural context.

(b) When completing a standard diagnostic assessment of a client, the assessor must
gather and document information about the client's current life situation, including the
following information:

(1) the client's age;

(2) the client's current living situation, including the client's housing status and household
members;

(3) the status of the client's basic needs;

(4) the client's education level and employment status;

(5) the client's current medications;

(6) any immediate risks to the client's health and safety;

(7) the client's perceptions of the client's condition;

(8) the client's description of the client's symptoms, including the reason for the client's
referral;

(9) the client's history of mental health treatment; and

(10) cultural influences on the client.

(c) If the assessor cannot obtain the information that this paragraph requires without
retraumatizing the client or harming the client's willingness to engage in treatment, the
assessor must identify which topics will require further assessment during the course of the
client's treatment. The assessor must gather and document information related to the following
topics:

(1) the client's relationship with the client's family and other significant personal
relationships, including the client's evaluation of the quality of each relationship;

(2) the client's strengths and resources, including the extent and quality of the client's
social networks;

(3) important developmental incidents in the client's life;

(4) maltreatment, trauma, potential brain injuries, and abuse that the client has suffered;

(5) the client's history of or exposure to alcohol and drug usage and treatment; and

(6) the client's health history and the client's family health history, including the client's
physical, chemical, and mental health history.

(d) When completing a standard diagnostic assessment of a client, an assessor must use
a recognized diagnostic framework.

(1) When completing a standard diagnostic assessment of a client who is five years of
age or younger, the assessor must use the current edition of the DC: 0-5 Diagnostic
Classification of Mental Health and Development Disorders of Infancy and Early Childhood
published by Zero to Three.

(2) When completing a standard diagnostic assessment of a client who is six years of
age or older, the assessor must use the current edition of the Diagnostic and Statistical
Manual of Mental Disorders published by the American Psychiatric Association.

deleted text begin (3) When completing a standard diagnostic assessment of a client who is five years of
deleted text end deleted text begin age or younger, an assessor must administer the Early Childhood Service Intensity Instrument
deleted text end deleted text begin (ECSII) to the client and include the results in the client's assessment.
deleted text end

deleted text begin (4) When completing a standard diagnostic assessment of a client who is six to 17 years
deleted text end deleted text begin of age, an assessor must administer the Child and Adolescent Service Intensity Instrument
deleted text end deleted text begin (CASII) to the client and include the results in the client's assessment.
deleted text end

deleted text begin (5)deleted text end new text begin (3)new text end When completing a standard diagnostic assessment of a client who is 18 years
of age or older, an assessor must use either (i) the CAGE-AID Questionnaire or (ii) the
criteria in the most recent edition of the Diagnostic and Statistical Manual of Mental
Disorders published by the American Psychiatric Association to screen and assess the client
for a substance use disorder.

(e) When completing a standard diagnostic assessment of a client, the assessor must
include and document the following components of the assessment:

(1) the client's mental status examination;

(2) the client's baseline measurements; symptoms; behavior; skills; abilities; resources;
vulnerabilities; safety needs, including client information that supports the assessor's findings
after applying a recognized diagnostic framework from paragraph (d); and any differential
diagnosis of the client;

(3) an explanation of: (i) how the assessor diagnosed the client using the information
from the client's interview, assessment, psychological testing, and collateral information
about the client; (ii) the client's needs; (iii) the client's risk factors; (iv) the client's strengths;
and (v) the client's responsivity factors.

(f) When completing a standard diagnostic assessment of a client, the assessor must
consult the client and the client's family about which services that the client and the family
prefer to treat the client. The assessor must make referrals for the client as to services required
by law.

new text begin (g) Information from other providers and prior assessments may be used to complete
the diagnostic assessment if the source of the information is documented in the diagnostic
assessment.
new text end

Sec. 17.

Minnesota Statutes 2022, section 245I.10, subdivision 7, is amended to read:

Subd. 7.

Individual treatment plan.

A license holder must follow each client's written
individual treatment plan when providing services to the client with the following exceptions:

(1) services that do not require that a license holder completes a standard diagnostic
assessment of a client before providing services to the client;

(2) when developing a new text begin treatment or new text end service plan; and

(3) when a client re-engages in services under subdivision 8, paragraph (b).

Sec. 18.

Minnesota Statutes 2022, section 245I.10, subdivision 8, is amended to read:

Subd. 8.

Individual treatment plan; required elements.

(a) After completing a client's
diagnostic assessment new text begin or reviewing a client's diagnostic assessment received from a different
provider new text end and before providing services to the clientnew text begin beyond those permitted under subdivision
7new text end , the license holder must complete the client's individual treatment plan. The license holder
must:

(1) base the client's individual treatment plan on the client's diagnostic assessment and
baseline measurements;

(2) for a child client, use a child-centered, family-driven, and culturally appropriate
planning process that allows the child's parents and guardians to observe and participate in
the child's individual and family treatment services, assessments, and treatment planning;

(3) for an adult client, use a person-centered, culturally appropriate planning process
that allows the client's family and other natural supports to observe and participate in the
client's treatment services, assessments, and treatment planning;

(4) identify the client's treatment goals, measureable treatment objectives, a schedule
for accomplishing the client's treatment goals and objectives, a treatment strategy, and the
individuals responsible for providing treatment services and supports to the client. The
license holder must have a treatment strategy to engage the client in treatment if the client:

(i) has a history of not engaging in treatment; and

(ii) is ordered by a court to participate in treatment services or to take neuroleptic
medications;

(5) identify the participants involved in the client's treatment planning. The client must
be a participant in the client's treatment planning. If applicable, the license holder must
document the reasons that the license holder did not involve the client's family or other
natural supports in the client's treatment planning;

(6) review the client's individual treatment plan every 180 days and update the client's
individual treatment plan with the client's treatment progress, new treatment objectives and
goals or, if the client has not made treatment progress, changes in the license holder's
approach to treatment; and

(7) ensure that the client approves of the client's individual treatment plan unless a court
orders the client's treatment plan under chapter 253B.

(b) If the client disagrees with the client's treatment plan, the license holder must
document in the client file the reasons why the client does not agree with the treatment plan.
If the license holder cannot obtain the client's approval of the treatment plan, a mental health
professional must make efforts to obtain approval from a person who is authorized to consent
on the client's behalf within 30 days after the client's previous individual treatment plan
expired. A license holder may not deny a client service during this time period solely because
the license holder could not obtain the client's approval of the client's individual treatment
plan. A license holder may continue to bill for the client's otherwise eligible services when
the client re-engages in services.

Sec. 19.

Minnesota Statutes 2022, section 245I.11, subdivision 3, is amended to read:

Subd. 3.

Storing and accounting for medications.

(a) If a license holder stores client
medications, the license holder must:

(1) store client medications in original containers in a locked location;

(2) store refrigerated client medications in special trays or containers that are separate
from food;

(3) store client medications marked "for external use only" in a compartment that is
separate from other client medications;

(4) store Schedule II deleted text begin to IVdeleted text end drugs listed in section 152.02, deleted text begin subdivisionsdeleted text end new text begin subdivision new text end 3 deleted text begin to
5deleted text end , in a compartment that is locked separately from other medications;

(5) ensure that only authorized staff persons have access to stored client medications;

(6) follow a documentation procedure deleted text begin on each shiftdeleted text end to account for all deleted text begin scheduleddeleted text end new text begin Schedule
II to Vnew text end drugsnew text begin listed in section 152.02, subdivisions 3 to 6new text end ; and

(7) record each incident when a staff person accepts a supply of client medications and
destroy discontinued, outdated, or deteriorated client medications.

(b) If a license holder is licensed as a residential program, the license holder must allow
clients who self-administer medications to keep a private medication supply. The license
holder must ensure that the client stores all private medication in a locked container in the
client's private living area, unless the private medication supply poses a health and safety
risk to any clients. A client must not maintain a private medication supply of a prescription
medication without a written medication order from a licensed prescriber and a prescription
label that includes the client's name.

Sec. 20.

Minnesota Statutes 2022, section 245I.11, subdivision 4, is amended to read:

Subd. 4.

Medication orders.

(a) If a license holder stores, prescribes, or administers
medications or observes a client self-administer medications, the license holder must:

(1) ensure that a licensed prescriber writes all orders to accept, administer, or discontinue
client medications;

(2) accept nonwritten orders to administer client medications in emergency circumstances
only;

(3) establish a timeline and process for obtaining a written order with the licensed
prescriber's signature when the license holder accepts a nonwritten order to administer client
medications;new text begin and
new text end

deleted text begin (4) obtain prescription medication renewals from a licensed prescriber for each client
every 90 days for psychotropic medications and annually for all other medications; and
deleted text end

deleted text begin (5)deleted text end new text begin (4)new text end maintain the client's right to privacy and dignity.

(b) If a license holder employs a licensed prescriber, the license holder must inform the
client about potential medication effects and side effects and obtain and document the client's
informed consent before the licensed prescriber prescribes a medication.

Sec. 21.

Minnesota Statutes 2022, section 245I.20, subdivision 5, is amended to read:

Subd. 5.

Treatment supervision specified.

deleted text begin (a)deleted text end A mental health professional must remain
responsible for each client's case. The certification holder must document the name of the
mental health professional responsible for each case and the dates that the mental health
professional is responsible for the client's case from beginning date to end date. The
certification holder must assign each client's case for assessment, diagnosis, and treatment
services to a treatment team member who is competent in the assigned clinical service, the
recommended treatment strategy, and in treating the client's characteristics.

deleted text begin (b) Treatment supervision of mental health practitioners and clinical trainees required
by section 245I.06 must include case reviews as described in this paragraph. Every two
months, a mental health professional must complete and document a case review of each
client assigned to the mental health professional when the client is receiving clinical services
from a mental health practitioner or clinical trainee. The case review must include a
consultation process that thoroughly examines the client's condition and treatment, including:
(1) a review of the client's reason for seeking treatment, diagnoses and assessments, and
the individual treatment plan; (2) a review of the appropriateness, duration, and outcome
of treatment provided to the client; and (3) treatment recommendations.
deleted text end

Sec. 22.

Minnesota Statutes 2022, section 245I.20, subdivision 6, is amended to read:

Subd. 6.

Additional policy and procedure requirements.

(a) In addition to the policies
and procedures required by section 245I.03, the certification holder must establish, enforce,
and maintain the policies and procedures required by this subdivision.

(b) The certification holder must have a clinical evaluation procedure to identify and
document each treatment team member's areas of competence.

(1) outline the client intake process;

(2) describe how the mental health clinic determines the appropriateness of accepting a
client into treatment by reviewing the client's condition and need for treatment, the clinical
services that the mental health clinic offers to clients, and other available resources; and

(3) contain a process for assigning a client's case to a mental health professional who is
responsible for the client's case and other treatment team members.

new text begin (d) Notwithstanding the requirements under section 245I.10, subdivisions 5 to 9, for the
required elements of a diagnostic assessment and a treatment plan, psychiatry billed as
evaluation and management services must be documented in accordance with the most
recent current procedural terminology as published by the American Medical Association.
new text end

Sec. 23.

Minnesota Statutes 2022, section 254B.02, subdivision 5, is amended to read:

Subd. 5.

deleted text begin Administrative adjustmentdeleted text end new text begin Local agency allocationnew text end .

The commissioner may
make payments to local agencies from money allocated under this section to support
deleted text begin administrative activities under sections 254B.03 and 254B.04deleted text end new text begin individuals with substance
use disordersnew text end . The deleted text begin administrativedeleted text end payment must not deleted text begin exceed the lesser of: (1) five percent
of the first $50,000, four percent of the next $50,000, and three percent of the remaining
payments for services from the special revenue account according to subdivision 1; or (2)deleted text end new text begin
be less than 133 percent ofnew text end the local agency deleted text begin administrativedeleted text end payment for the fiscal year ending
June 30, 2009, adjusted in proportion to the statewide change in the appropriation for this
chapter.

new text begin EFFECTIVE DATE.new text end

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

Sec. 24.

Minnesota Statutes 2022, section 254B.05, subdivision 1, is amended to read:

Subdivision 1.

Licensure required.

(a) Programs licensed by the commissioner are
eligible vendors. Hospitals may apply for and receive licenses to be eligible vendors,
notwithstanding the provisions of section 245A.03. American Indian programs that provide
substance use disorder treatment, extended care, transitional residence, or outpatient treatment
services, and are licensed by tribal government are eligible vendors.

(b) A licensed professional in private practice as defined in section 245G.01, subdivision
17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible
vendor of a comprehensive assessment and assessment summary provided according to
section 245G.05, and treatment services provided according to sections 245G.06 and
245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses
(1) to (6).

(c) A county is an eligible vendor for a comprehensive assessment and assessment
summary when provided by an individual who meets the staffing credentials of section
245G.11, subdivisions 1 and 5, and completed according to the requirements of section
245G.05. A county is an eligible vendor of care coordination services when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and
provided according to the requirements of section 245G.07, subdivision 1, paragraph (a),
clause (5).

(d) A recovery community organization that meets certification requirements identified
by the commissioner is an eligible vendor of peer support services.

(e) Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, are not eligible vendors. Programs that are not licensed as a residential or
nonresidential substance use disorder treatment or withdrawal management program by the
commissioner or by tribal government or do not meet the requirements of subdivisions 1a
and 1b are not eligible vendors.

new text begin (f) Hospitals, federally qualified health centers, and rural health clinics are eligible
vendors of a comprehensive assessment when the comprehensive assessment is completed
according to section 245G.05 and by an individual who meets the criteria of an alcohol and
drug counselor according to section 245G.11, subdivision 5. The alcohol and drug counselor
must be individually enrolled with the commissioner and reported on the claim as the
individual who provided the service.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 25.

Minnesota Statutes 2022, section 254B.05, subdivision 1a, is amended to read:

Subd. 1a.

Room and board provider requirements.

(a) deleted text begin Effective January 1, 2000,deleted text end
Vendors of room and board are eligible for behavioral health fund payment if the vendor:

(1) has rules prohibiting residents bringing chemicals into the facility or using chemicals
while residing in the facility and provide consequences for infractions of those rules;

(2) is determined to meet applicable health and safety requirements;

(3) is not a jail or prison;

(4) is not concurrently receiving funds under chapter 256I for the recipient;

(5) admits individuals who are 18 years of age or older;

(6) is registered as a board and lodging or lodging establishment according to section
157.17;

(7) has awake staff on site 24 hours per day;

(8) has staff who are at least 18 years of age and meet the requirements of section
245G.11, subdivision 1, paragraph (b);

(9) has emergency behavioral procedures that meet the requirements of section 245G.16;

(10) meets the requirements of section 245G.08, subdivision 5, if administering
medications to clients;

(11) meets the abuse prevention requirements of section 245A.65, including a policy on
fraternization and the mandatory reporting requirements of section 626.557;

(12) documents coordination with the treatment provider to ensure compliance with
section 254B.03, subdivision 2;

(13) protects client funds and ensures freedom from exploitation by meeting the
provisions of section 245A.04, subdivision 13;

(14) has a grievance procedure that meets the requirements of section 245G.15,
subdivision 2; and

(15) has sleeping and bathroom facilities for men and women separated by a door that
is locked, has an alarm, or is supervised by awake staff.

(b) Programs licensed according to Minnesota Rules, chapter 2960, are exempt from
paragraph (a), clauses (5) to (15).

(c) Programs providing children's mental health crisis admissions and stabilization under
section 245.4882, subdivision 6, are eligible vendors of room and board.

new text begin (d) Programs providing children's residential services under section 245.4882, except
services for individuals who have a placement under chapter 260C or 260D, are eligible
vendors of room and board.
new text end

deleted text begin (d)deleted text end new text begin (e)new text end Licensed programs providing intensive residential treatment services or residential
crisis stabilization services pursuant to section 256B.0622 or 256B.0624 are eligible vendors
of room and board and are exempt from paragraph (a), clauses (6) to (15).

new text begin EFFECTIVE DATE.new text end

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

Sec. 26.

Minnesota Statutes 2022, section 256.478, subdivision 1, is amended to read:

Subdivision 1.

Purposenew text begin and establishmentnew text end .

(a) The commissioner shall establish the
transition to community initiative to award grants to serve individualsnew text begin who are not eligible
for medical assistance ornew text end for whom new text begin goods, new text end supportsnew text begin ,new text end and services not covered by medical
assistance would allow them to:

(1) live in the least restrictive setting and as independently as possible;

new text begin (2) access services that support short- and long-term needs for developmental growth
or individualized treatment needs;
new text end

deleted text begin (2)deleted text end new text begin (3)new text end build or maintain relationships with family and friends; and

deleted text begin (3)deleted text end new text begin (4)new text end participate in community life.

(b) Grantees must ensure that individuals are engaged in a process that involves
person-centered planning and informed choice decision-making. The informed choice
decision-making process must provide accessible written information and be experiential
whenever possiblenew text begin , and must engage family members, legal guardians, or natural supports,
as appropriate and whenever possiblenew text end .

Sec. 27.

Minnesota Statutes 2022, section 256.478, subdivision 2, is amended to read:

Subd. 2.

Eligibility.

An individual is eligible for the transition to community initiative
if the individual deleted text begin does not meet eligibility criteria for the medical assistance program under
section deleted text end deleted text begin or deleted text end deleted text begin , but whodeleted text end new text begin can demonstrate that current services are not capable
of meeting individual treatment and service needs that can be met in the community with
support, and the individualnew text end meets at least one of the following criteria:

(1) the person deleted text begin otherwisedeleted text end meets the criteria under section 256B.092, subdivision 13, or
256B.49, subdivision 24;

(2) the person has met treatment objectives and no longer requires a hospital-level carenew text begin ,
residential-level care,new text end or a secure treatment setting, but the person's discharge from the
Anoka Metro Regional Treatment Center, the Minnesota deleted text begin Security Hospitaldeleted text end new text begin Forensic Mental
Health Program, the Child and Adolescent Behavioral Health Hospital program, a psychiatric
residential treatment facility under section 256B.0941, intensive residential treatment services
under section 256B.0622, children's residential services under section 245.4882new text end , new text begin juvenile
detention facility, county supervised building, new text end or a deleted text begin community behavioral healthdeleted text end hospital
would be substantially delayed without additional resources available through the transitions
to community initiative;

deleted text begin (3) the person is in a community hospital, but alternative community living options
would be appropriate for the person, and the person has received approval from the
commissioner; or
deleted text end

deleted text begin (4)(i)deleted text end new text begin (3)new text end the person new text begin (i) new text end is receiving customized living services reimbursed under section
256B.4914, 24-hour customized living services reimbursed under section 256B.4914, or
community residential services reimbursed under section 256B.4914; (ii) deleted text begin the persondeleted text end expresses
a desire to move; and (iii) deleted text begin the persondeleted text end has received approval from the commissionerdeleted text begin .deleted text end new text begin ; or
new text end

new text begin (4) the person can demonstrate that the person's needs are beyond the scope of current
service designs and grant funding can support the inclusion of additional supports for the
person to access appropriate treatment and services in the least restrictive environment.
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. 28.

Minnesota Statutes 2022, section 256B.0622, subdivision 7b, is amended to read:

Subd. 7b.

Assertive community treatment program size and opportunities.

(a) Each
ACT team shall maintain an annual average caseload that does not exceed 100 clients.
Staff-to-client ratios shall be based on team size as follows:

(1) a small ACT team must:

(i) employ at least six but no more than seven full-time treatment team staff, excluding
the program assistant and the psychiatric care provider;

(ii) serve an annual average maximum of no more than 50 clients;

(iii) ensure at least one full-time equivalent position for every eight clients served;

(iv) schedule ACT team staff deleted text begin for at least eight-hour shift coveragedeleted text end on weekdays and
on-call duty to provide crisis services and deliver services after hours when staff are not
working;

(v) provide crisis services during business hours if the small ACT team does not have
sufficient staff numbers to operate an after-hours on-call system. During all other hours,
the ACT team may arrange for coverage for crisis assessment and intervention services
through a reliable crisis-intervention provider as long as there is a mechanism by which the
ACT team communicates routinely with the crisis-intervention provider and the on-call
ACT team staff are available to see clients face-to-face when necessary or if requested by
the crisis-intervention services provider;

(vi) adjust schedules and provide staff to carry out the needed service activities in the
evenings or on weekend days or holidays, when necessary;

(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team's psychiatric
care provider during all hours is not feasible, alternative psychiatric prescriber backup must
be arranged and a mechanism of timely communication and coordination established in
writing; and

(viii) be composed of, at minimum, one full-time team leader, at least 16 hours each
week per 50 clients of psychiatric provider time, or equivalent if fewer clients, one full-time
equivalent nursing, one full-time co-occurring disorder specialist, one full-time equivalent
mental health certified peer specialist, one full-time vocational specialist, one full-time
program assistant, and at least one additional full-time ACT team member who has mental
health professional, certified rehabilitation specialist, clinical trainee, or mental health
practitioner status; and

(2) a midsize ACT team shall:

(i) be composed of, at minimum, one full-time team leader, at least 16 hours of psychiatry
time for 51 clients, with an additional two hours for every six clients added to the team, 1.5
to two full-time equivalent nursing staff, one full-time co-occurring disorder specialist, one
full-time equivalent mental health certified peer specialist, one full-time vocational specialist,
one full-time program assistant, and at least 1.5 to two additional full-time equivalent ACT
members, with at least one dedicated full-time staff member with mental health professional
status. Remaining team members may have mental health professional, certified rehabilitation
specialist, clinical trainee, or mental health practitioner status;

(ii) employ seven or more treatment team full-time equivalents, excluding the program
assistant and the psychiatric care provider;

(iii) serve an annual average maximum caseload of 51 to 74 clients;

(iv) ensure at least one full-time equivalent position for every nine clients served;

(v) schedule ACT team staff for a minimum of ten-hour shift coverage on weekdays
and six- to eight-hour shift coverage on weekends and holidays. In addition to these minimum
specifications, staff are regularly scheduled to provide the necessary services on a
client-by-client basis in the evenings and on weekends and holidays;

(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working;

(vii) have the authority to arrange for coverage for crisis assessment and intervention
services through a reliable crisis-intervention provider as long as there is a mechanism by
which the ACT team communicates routinely with the crisis-intervention provider and the
on-call ACT team staff are available to see clients face-to-face when necessary or if requested
by the crisis-intervention services provider; and

(viii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the psychiatric care provider
during all hours is not feasible, alternative psychiatric prescriber backup must be arranged
and a mechanism of timely communication and coordination established in writing;

(3) a large ACT team must:

(i) be composed of, at minimum, one full-time team leader, at least 32 hours each week
per 100 clients, or equivalent of psychiatry time, three full-time equivalent nursing staff,
one full-time co-occurring disorder specialist, one full-time equivalent mental health certified
peer specialist, one full-time vocational specialist, one full-time program assistant, and at
least two additional full-time equivalent ACT team members, with at least one dedicated
full-time staff member with mental health professional status. Remaining team members
may have mental health professional or mental health practitioner status;

(ii) employ nine or more treatment team full-time equivalents, excluding the program
assistant and psychiatric care provider;

(iii) serve an annual average maximum caseload of 75 to 100 clients;

(iv) ensure at least one full-time equivalent position for every nine individuals served;

(v) schedule staff to work two eight-hour shifts, with a minimum of two staff on the
second shift providing services at least 12 hours per day weekdays. For weekends and
holidays, the team must operate and schedule ACT team staff to work one eight-hour shift,
with a minimum of two staff each weekend day and every holiday;

(vi) schedule ACT team staff on-call duty to provide crisis services and deliver services
when staff are not working; and

(vii) arrange for and provide psychiatric backup during all hours the psychiatric care
provider is not regularly scheduled to work. If availability of the ACT team psychiatric care
provider during all hours is not feasible, alternative psychiatric backup must be arranged
and a mechanism of timely communication and coordination established in writing.

(b) An ACT team of any size may have a staff-to-client ratio that is lower than the
requirements described in paragraph (a) upon approval by the commissioner, but may not
exceed a one-to-ten staff-to-client ratio.

Sec. 29.

Minnesota Statutes 2022, section 256B.0622, subdivision 7c, is amended to read:

Subd. 7c.

Assertive community treatment program organization and communication
requirements.

(a) An ACT team shall provide at least 75 percent of all services in the
community in non-office-based or non-facility-based settings.

(b) ACT team members must know all clients receiving services, and interventions must
be carried out with consistency and follow empirically supported practice.

(c) Each ACT team client shall be assigned an individual treatment team that is
determined by a variety of factors, including team members' expertise and skills, rapport,
and other factors specific to the individual's preferences. The majority of clients shall see
at least three ACT team members in a given month.

(d) The ACT team shall have the capacity to rapidly increase service intensity to a client
when the client's status requires it, regardless of geography, new text begin and new text end provide flexible service in
an individualized mannerdeleted text begin , and see clients on average three times per week for at least 120
minutes per weekdeleted text end new text begin at a frequency that meets the client's needsnew text end . Services must be available
at times that meet client needs.

(e) ACT teams shall make deliberate efforts to assertively engage clients in services.
Input of family members, natural supports, and previous and subsequent treatment providers
is required in developing engagement strategies. ACT teams shall include the client, identified
family, and other support persons in the admission, initial assessment, and planning process
as primary stakeholders, meet with the client in the client's environment at times of the day
and week that honor the client's preferences, and meet clients at home and in jails or prisons,
streets, homeless shelters, or hospitals.

(f) ACT teams shall ensure that a process is in place for identifying individuals in need
of more or less assertive engagement. Interventions are monitored to determine the success
of these techniques and the need to adapt the techniques or approach accordingly.

(g) ACT teams shall conduct daily team meetings to systematically update clinically
relevant information, briefly discuss the status of assertive community treatment clients
over the past 24 hours, problem solve emerging issues, plan approaches to address and
prevent crises, and plan the service contacts for the following 24-hour period or weekend.
All team members scheduled to work shall attend this meeting.

(h) ACT teams shall maintain a clinical log that succinctly documents important clinical
information and develop a daily team schedule for the day's contacts based on a central file
of the clients' weekly or monthly schedules, which are derived from interventions specified
within the individual treatment plan. The team leader must have a record to ensure that all
assigned contacts are completed.

Sec. 30.

Minnesota Statutes 2022, section 256B.0623, subdivision 4, is amended to read:

Subd. 4.

Provider entity standards.

(a) The provider entity must be certified by the
state following the certification process and procedures developed by the commissioner.

(b) The certification process is a determination as to whether the entity meets the standards
in this section and chapter 245I, as required in section 245I.011, subdivision 5. The
certification must specify which adult rehabilitative mental health services the entity is
qualified to provide.

deleted text begin (c) A noncounty provider entity must obtain additional certification from each county
in which it will provide services. The additional certification must be based on the adequacy
of the entity's knowledge of that county's local health and human service system, and the
ability of the entity to coordinate its services with the other services available in that county.
A county-operated entity must obtain this additional certification from any other county in
which it will provide services.
deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end State-level recertification must occur at least every three years.

deleted text begin (e)deleted text end new text begin (d)new text end The commissioner may intervene at any time and decertify providers with cause.
The decertification is subject to appeal to the state. A county board may recommend that
the state decertify a provider for cause.

deleted text begin (f)deleted text end new text begin (e) new text end The adult rehabilitative mental health services provider entity must meet the
following standards:

(1) have capacity to recruit, hire, manage, and train qualified staff;

(2) have adequate administrative ability to ensure availability of services;

(3) ensure that staff are skilled in the delivery of the specific adult rehabilitative mental
health services provided to the individual eligible recipient;

(4) ensure enough flexibility in service delivery to respond to the changing and
intermittent care needs of a recipient as identified by the recipient and the individual treatment
plan;

(5) assist the recipient in arranging needed crisis assessment, intervention, and
stabilization services;

(6) ensure that services are coordinated with other recipient mental health services
providers and the county mental health authority and the federally recognized American
Indian authority and necessary others after obtaining the consent of the recipient. Services
must also be coordinated with the recipient's case manager or care coordinator if the recipient
is receiving case management or care coordination services;

(7) keep all necessary records required by law;

(8) deliver services as required by section 245.461;

(9) be an enrolled Medicaid provider; and

(10) maintain a quality assurance plan to determine specific service outcomes and the
recipient's satisfaction with services.

Sec. 31.

Minnesota Statutes 2022, section 256B.0624, subdivision 5, is amended to read:

Subd. 5.

Crisis assessment and intervention staff qualifications.

(a) Qualified
individual staff of a qualified provider entity must provide crisis assessment and intervention
services to a recipient. A staff member providing crisis assessment and intervention services
to a recipient must be qualified as a:

(1) mental health professional;

(2) clinical trainee;

(3) mental health practitioner;

(4) mental health certified family peer specialist; or

(5) mental health certified peer specialist.

(b) When crisis assessment and intervention services are provided to a recipient in the
community, a mental health professional, clinical trainee, or mental health practitioner must
lead the response.

(c) The 30 hours of ongoing training required by section 245I.05, subdivision 4, paragraph
(b), must be specific to providing crisis services to children and adults and include training
about evidence-based practices identified by the commissioner of health to reduce the
recipient's risk of suicide and self-injurious behavior.

new text begin (d) At least six hours of the ongoing training under paragraph (c) must be specific to
working with families and providing crisis stabilization services to children and include the
following topics:
new text end

new text begin (1) developmental tasks of childhood and adolescence;
new text end

new text begin (2) family relationships;
new text end

new text begin (3) child and youth engagement and motivation, including motivational interviewing;
new text end

new text begin (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
queer youth;
new text end

new text begin (5) positive behavior support;
new text end

new text begin (6) crisis intervention for youth with developmental disabilities;
new text end

new text begin (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
new text end

new text begin (8) youth substance use.
new text end

deleted text begin (d)deleted text end new text begin (e)new text end Team members must be experienced in crisis assessment, crisis intervention
techniques, treatment engagement strategies, working with families, and clinical
decision-making under emergency conditions and have knowledge of local services and
resources.

Sec. 32.

Minnesota Statutes 2022, section 256B.0624, subdivision 8, is amended to read:

Subd. 8.

Crisis stabilization staff qualifications.

(a) Mental health crisis stabilization
services must be provided by qualified individual staff of a qualified provider entity. A staff
member providing crisis stabilization services to a recipient must be qualified as a:

(1) mental health professional;

(2) certified rehabilitation specialist;

(3) clinical trainee;

(4) mental health practitioner;

(5) mental health certified family peer specialist;

(6) mental health certified peer specialist; or

(7) mental health rehabilitation worker.

(b) The 30 hours of ongoing training required in section 245I.05, subdivision 4, paragraph
(b), must be specific to providing crisis services to children and adults and include training
about evidence-based practices identified by the commissioner of health to reduce a recipient's
risk of suicide and self-injurious behavior.

new text begin (c) For providers who deliver care to children 21 years of age and younger, at least six
hours of the ongoing training under this subdivision must be specific to working with families
and providing crisis stabilization services to children and include the following topics:
new text end

new text begin (1) developmental tasks of childhood and adolescence;
new text end

new text begin (2) family relationships;
new text end

new text begin (3) child and youth engagement and motivation, including motivational interviewing;
new text end

new text begin (4) culturally responsive care, including care for lesbian, gay, bisexual, transgender, and
queer youth;
new text end

new text begin (5) positive behavior support;
new text end

new text begin (6) crisis intervention for youth with developmental disabilities;
new text end

new text begin (7) child traumatic stress, trauma-informed care, and trauma-focused cognitive behavioral
therapy; and
new text end

new text begin (8) youth substance use.
new text end

new text begin This paragraph does not apply to adult residential crisis stabilization service providers
licensed according to section 245I.23.
new text end

Sec. 33.

Minnesota Statutes 2022, section 256B.0757, subdivision 4c, is amended to read:

Subd. 4c.

Behavioral health home services staff qualifications.

(a) A behavioral health
home services provider must maintain staff with required professional qualifications
appropriate to the setting.

(b) If behavioral health home services are offered in a mental health setting, the
integration specialist must be a deleted text begin registereddeleted text end new text begin licensednew text end nurse deleted text begin licensed under the Minnesota Nurse
Practice Act, sections 148.171 to 148.285deleted text end new text begin , as defined in section 148.171, subdivision 9new text end .

(c) If behavioral health home services are offered in a primary care setting, the integration
specialist must be a mental health professional who is qualified according to section 245I.04,
subdivision 2.

(d) If behavioral health home services are offered in either a primary care setting or
mental health setting, the systems navigator must be a mental health practitioner who is
qualified according to section 245I.04, subdivision 4, or a community health worker as
defined in section 256B.0625, subdivision 49.

(e) If behavioral health home services are offered in either a primary care setting or
mental health setting, the qualified health home specialist must be one of the following:

(1) a mental health certified peer specialist who is qualified according to section 245I.04,
subdivision 10;

(2) a mental health certified family peer specialist who is qualified according to section
245I.04, subdivision 12;

(3) a case management associate as defined in section 245.462, subdivision 4, paragraph
(g), or 245.4871, subdivision 4, paragraph (j);

(4) a mental health rehabilitation worker who is qualified according to section 245I.04,
subdivision 14;

(5) a community paramedic as defined in section 144E.28, subdivision 9;

(6) a peer recovery specialist as defined in section 245G.07, subdivision 1, clause (5);
or

(7) a community health worker as defined in section 256B.0625, subdivision 49.

Sec. 34.

Minnesota Statutes 2022, section 256B.0941, subdivision 2a, is amended to read:

Subd. 2a.

Sleeping hours.

During normal sleeping hours, a psychiatric residential
treatment facility provider must provide at least one staff person for every six residents
present within a living unit. A provider must adjust sleeping-hour staffing levels based on
the clinical needs of the residents in the facility.new text begin Sleeping hours must include at least one
staff trained and certified to provide emergency medical response. During normal sleeping
hours, a registered nurse must be available on call to assess a child's needs and must be
available within 60 minutes.
new text end

Sec. 35.

Minnesota Statutes 2022, section 256B.0941, is amended by adding a subdivision
to read:

new text begin Subd. 2b.new text end

new text begin Shared site.new text end

new text begin Related services that have a bright-line separation from psychiatric
residential treatment facility service operations may be delivered in the same facility,
including under the same structural roof. In shared site settings, staff must provide services
only to programs they are affiliated to through NETStudy 2.0.
new text end

Sec. 36.

Minnesota Statutes 2022, section 256B.0941, is amended by adding a subdivision
to read:

new text begin Subd. 5.new text end

new text begin Start-up and capacity-building grants.new text end

new text begin (a) The commissioner shall establish
start-up and capacity-building grants for psychiatric residential treatment facility sites.
Start-up grants to prospective psychiatric residential treatment facility sites may be used
for:
new text end

new text begin (1) administrative expenses;
new text end

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

new text begin (3) Health Insurance Portability and Accountability Act of 1996 compliance;
new text end

new text begin (4) therapeutic resources, including evidence-based, culturally appropriate curriculums
and training programs for staff and clients;
new text end

new text begin (5) allowable physical renovations to the property; and
new text end

new text begin (6) emergency workforce shortage uses, as determined by the commissioner.
new text end

new text begin (b) Start-up and capacity-building grants to prospective and current psychiatric residential
treatment facilities may be used to support providers who treat and accept individuals with
complex support needs, including but not limited to:
new text end

new text begin (1) neurocognitive disorders;
new text end

new text begin (2) co-occurring intellectual developmental disabilities;
new text end

new text begin (3) schizophrenia spectrum disorders;
new text end

new text begin (4) manifested or labeled aggressive behaviors; and
new text end

new text begin (5) manifested sexually inappropriate behaviors.
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. 37.

Minnesota Statutes 2022, section 256B.0946, subdivision 4, is amended to read:

Subd. 4.

Service delivery payment requirements.

(a) To be eligible for payment under
this section, a provider must develop and practice written policies and procedures for
children's intensive behavioral health services, consistent with subdivision 1, paragraph (b),
and comply with the following requirements in paragraphs (b) to (n).

(b) Each previous and current mental health, school, and physical health treatment
provider must be contacted to request documentation of treatment and assessments that the
eligible client has received. This information must be reviewed and incorporated into the
standard diagnostic assessment and team consultation and treatment planning review process.

(c) Each client receiving treatment must be assessed for a trauma history, and the client's
treatment plan must document how the results of the assessment will be incorporated into
treatment.

(d) The level of care assessment as defined in section 245I.02, subdivision 19, and
functional assessment as defined in section 245I.02, subdivision 17, must be updated at
least every deleted text begin 90deleted text end new text begin 180new text end days or prior to discharge from the service, whichever comes first.

(e) Each client receiving treatment services must have an individual treatment plan that
is reviewed, evaluated, and approved every deleted text begin 90deleted text end new text begin 180new text end days using the team consultation and
treatment planning process.

(f) Clinical care consultation must be provided in accordance with the client's individual
treatment plan.

(g) Each client must have a crisis plan within ten days of initiating services and must
have access to clinical phone support 24 hours per day, seven days per week, during the
course of treatment. The crisis plan must demonstrate coordination with the local or regional
mobile crisis intervention team.

(h) Services must be delivered and documented at least three days per week, equaling
at least six hours of treatment per week. If the mental health professional, client, and family
agree, service units may be temporarily reduced for a period of no more than 60 days in
order to meet the needs of the client and family, or as part of transition or on a discharge
plan to another service or level of care. The reasons for service reduction must be identified,
documented, and included in the treatment plan. Billing and payment are prohibited for
days on which no services are delivered and documented.

(i) Location of service delivery must be in the client's home, day care setting, school, or
other community-based setting that is specified on the client's individualized treatment plan.

(j) Treatment must be developmentally and culturally appropriate for the client.

(k) Services must be delivered in continual collaboration and consultation with the
client's medical providers and, in particular, with prescribers of psychotropic medications,
including those prescribed on an off-label basis. Members of the service team must be aware
of the medication regimen and potential side effects.

(l) Parents, siblings, foster parents, legal guardians, and members of the child's
permanency plan must be involved in treatment and service delivery unless otherwise noted
in the treatment plan.

(m) Transition planning for the child must be conducted starting with the first treatment
plan and must be addressed throughout treatment to support the child's permanency plan
and postdischarge mental health service needs.

(n) In order for a provider to receive the daily per-client encounter rate, at least one of
the services listed in subdivision 1, paragraph (b), clauses (1) to (3), must be provided. The
services listed in subdivision 1, paragraph (b), clauses (4) and (5), may be included as part
of the daily per-client encounter rate.

Sec. 38. new text begin DIRECTION TO COMMISSIONER; CHANGES TO RESIDENTIAL
ADULT MENTAL HEALTH PROGRAM LICENSING REQUIREMENTS.
new text end

new text begin (a) The commissioner of human services must consult with stakeholders to determine
the changes to residential adult mental health program licensing requirements in Minnesota
Rules, parts 9520.0500 to 9520.0670, necessary to:
new text end

new text begin (1) update requirements for category I programs to align with current mental health
practices, client rights for similar services, and health and safety needs of clients receiving
services;
new text end

new text begin (2) remove category II classification and requirements; and
new text end

new text begin (3) add licensing requirements to the rule for the Forensic Mental Health Program.
new text end

new text begin (b) The commissioner must use existing authority in Minnesota Statutes, chapter 245A,
to amend Minnesota Rules, parts 9520.0500 to 9520.0670, based on the stakeholder
consultation in paragraph (a) and additional changes as determined by the commissioner.
new text end

Sec. 39. new text begin LOCAL AGENCY SUBSTANCE USE DISORDER ALLOCATION.
new text end

new text begin The commissioner of human services shall evaluate the ongoing need for local agency
substance use disorder allocations under Minnesota Statutes, section 254B.02. The evaluation
must include recommendations on whether local agency allocations should continue, and
if so, must recommend what the purpose of the allocations should be and propose an updated
allocation methodology that aligns with the purpose and person-centered outcomes for
people experiencing substance use disorders and behavioral health conditions. The
commissioner may contract with a vendor to support this evaluation through research and
actuarial analysis.
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. 40. new text begin RATE INCREASE FOR MENTAL HEALTH ADULT DAY TREATMENT.
new text end

new text begin The commissioner of human services must increase the reimbursement rate for adult
day treatment under Minnesota Statutes, section 256B.0671, subdivision 3, by 50 percent
over the reimbursement rate in effect as of June 30, 2023.
new text end

new text begin EFFECTIVE DATE.new text end

Sec. 41. new text begin ROOM AND BOARD COSTS IN CHILDREN'S RESIDENTIAL
FACILITIES.
new text end

new text begin The commissioner of human services must update the behavioral health fund room and
board rate schedule to include services provided under Minnesota Statutes, section 245.4882,
for individuals who do not have a placement under Minnesota Statutes, chapter 260C or
260D. The commissioner must establish room and board rates commensurate with current
room and board rates for adolescent programs licensed under Minnesota Statutes, section
245G.18.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 42. new text begin SCHOOL-LINKED BEHAVIORAL HEALTH GRANT CONTRACT
DATES.
new text end

new text begin (a) The commissioner of human services shall ensure that contracts executed during
fiscal year 2024 with school-linked behavioral health grantees have a start date retroactive
to July 1, 2023, to provide consistency in services and payments for services. Any such
contracts executed after July 1, 2023, and any payments made subject to such contracts
shall not be considered to violate Minnesota Statutes, section 16A.15, 16B.98, or 16C.05.
new text end

new text begin (b) This section expires on July 1, 2024.
new text end

new text begin EFFECTIVE DATE.new text end

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

ARTICLE 10

ECONOMIC ASSISTANCE

Section 1.

Minnesota Statutes 2022, section 119B.011, subdivision 3, is amended to read:

Subd. 3.

Application.

"Application" means the submission to a county agency, by or
on behalf of a family, of a completed, signed, and dated:

(1) child care assistance universal application form; or

(2) child care addendum form in combination with a combined application form for
MFIPdeleted text begin , DWP,deleted text end or Supplemental Nutrition Assistance Program (SNAP) benefits.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 2.

Minnesota Statutes 2022, section 119B.011, subdivision 15, is amended to read:

Subd. 15.

Income.

"Income" means earned income as defined under section 256P.01,
subdivision 3, unearned income as defined under section 256P.01, subdivision 8, and public
assistance cash benefits, including the Minnesota family investment program, deleted text begin diversionary
work program,deleted text end work benefit, Minnesota supplemental aid, general assistance, refugee cash
assistance, at-home infant child care subsidy payments, and child support and maintenance
distributed to the family under section 256.741, subdivision 2a.

The following are deducted from income: funds used to pay for health insurance
premiums for family members, and child or spousal support paid to or on behalf of a person
or persons who live outside of the household. Income sources not included in this subdivision
and section 256P.06, subdivision 3, are not countednew text begin as incomenew text end .

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 3.

Minnesota Statutes 2022, section 119B.02, subdivision 4, is amended to read:

Subd. 4.

Universal application form.

The commissioner must develop and make
available to all counties a universal application form for child care assistance under this
chapter. The commissioner may develop and make available to all counties a child care
addendum form to be used to supplement the combined application form for MFIPdeleted text begin , DWP,deleted text end
or Supplemental Nutrition Assistance Program (SNAP) benefits or to supplement other
statewide application forms for public assistance programs for families applying for one of
these programs in addition to child care assistance. The application must provide notice of
eligibility requirements for assistance and penalties for wrongfully obtaining assistance.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 4.

Minnesota Statutes 2022, section 119B.025, subdivision 4, is amended to read:

Subd. 4.

Changes in eligibility.

(a) The county shall process a change in eligibility
factors according to paragraphs (b) to (g).

(b) A family is subject to the reporting requirements in section 256P.07new text begin , subdivision 6new text end .

(c) If a family reports a change or a change is known to the agency before the family's
regularly scheduled redetermination, the county must act on the change. The commissioner
shall establish standards for verifying a change.

(d) A change in income occurs on the day the participant received the first payment
reflecting the change in income.

(e) During a family's 12-month eligibility period, if the family's income increases and
remains at or below 85 percent of the state median income, adjusted for family size, there
is no change to the family's eligibility. The county shall not request verification of the
change. The co-payment fee shall not increase during the remaining portion of the family's
12-month eligibility period.

(f) During a family's 12-month eligibility period, if the family's income increases and
exceeds 85 percent of the state median income, adjusted for family size, the family is not
eligible for child care assistance. The family must be given 15 calendar days to provide
verification of the change. If the required verification is not returned or confirms ineligibility,
the family's eligibility ends following a subsequent 15-day adverse action notice.

(g) Notwithstanding Minnesota Rules, parts 3400.0040, subpart 3, and 3400.0170,
subpart 1, if an applicant or participant reports that employment ended, the agency may
accept a signed statement from the applicant or participant as verification that employment
ended.

new text begin EFFECTIVE DATE.new text end

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

Sec. 5.

Minnesota Statutes 2022, section 119B.03, subdivision 3, is amended to read:

Subd. 3.

Eligible participants.

Families that meet the eligibility requirements under
sections 119B.09 and 119B.10, except MFIP participantsdeleted text begin , diversionary work program,deleted text end and
transition year families are eligible for child care assistance under the basic sliding fee
program. Families enrolled in the basic sliding fee program shall be continued until they
are no longer eligible. Child care assistance provided through the child care fund is considered
assistance to the parent.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 6.

Minnesota Statutes 2022, section 119B.03, subdivision 4a, is amended to read:

Subd. 4a.

Temporary reprioritization.

(a) Notwithstanding subdivision 4, priority for
child care assistance under the basic sliding fee assistance program shall be determined
according to this subdivision beginning July 1, 2021, through May 31, 2024.

(b) First priority must be given to eligible non-MFIP families who do not have a high
school diploma or commissioner of education-selected high school equivalency certification
or who need remedial and basic skill courses in order to pursue employment or to pursue
education leading to employment and who need child care assistance to participate in the
education program. This includes student parents as defined under section 119B.011,
subdivision 19b. Within this priority, the following subpriorities must be used:

(1) child care needs of minor parents;

(2) child care needs of parents under 21 years of age; and

(3) child care needs of other parents within the priority group described in this paragraph.

(c) Second priority must be given to families in which at least one parent is a veteran,
as defined under section 197.447.

(d) Third priority must be given to eligible families who do not meet the specifications
of paragraph (b), (c), (e), or (f).

(e) Fourth priority must be given to families who are eligible for portable basic sliding
fee assistance through the portability pool under subdivision 9.

(f) Fifth priority must be given to eligible families receiving services under section
119B.011, subdivision 20a, if the parents have completed their MFIP deleted text begin or DWPdeleted text end transition
yeardeleted text begin , or if the parents are no longer receiving or eligible for DWP supportsdeleted text end .

(g) Families under paragraph (f) must be added to the basic sliding fee waiting list on
the date they complete their transition year under section 119B.011, subdivision 20.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 7.

Minnesota Statutes 2022, section 119B.05, subdivision 1, is amended to read:

Subdivision 1.

Eligible participants.

Families eligible for child care assistance under
the MFIP child care program are:

(1) MFIP participants who are employed or in job search and meet the requirements of
section 119B.10;

(2) persons who are members of transition year families under section 119B.011,
subdivision 20, and meet the requirements of section 119B.10;

deleted text begin (3) families who are participating in employment orientation or job search, or other
employment or training activities that are included in an approved employability development
plan under section 256J.95;
deleted text end

deleted text begin (4)deleted text end new text begin (3)new text end MFIP families who are participating in work job search, job support, employment,
or training activities as required in their employment plan, or in appeals, hearings,
assessments, or orientations according to chapter 256J;

deleted text begin (5)deleted text end new text begin (4)new text end MFIP families who are participating in social services activities under chapter
256J as required in their employment plan approved according to chapter 256J;

deleted text begin (6)deleted text end new text begin (5)new text end families who are participating in services or activities that are included in an
approved family stabilization plan under section 256J.575;

deleted text begin (7)deleted text end new text begin (6)new text end families who are participating in programs as required in tribal contracts under
section 119B.02, subdivision 2, or 256.01, subdivision 2;

deleted text begin (8)deleted text end new text begin (7)new text end families who are participating in the transition year extension under section
119B.011, subdivision 20a;

deleted text begin (9)deleted text end new text begin (8)new text end student parents as defined under section 119B.011, subdivision 19b; and

deleted text begin (10)deleted text end new text begin (9)new text end student parents who turn 21 years of age and who continue to meet the other
requirements under section 119B.011, subdivision 19b. A student parent continues to be
eligible until the student parent is approved for basic sliding fee child care assistance or
until the student parent's redetermination, whichever comes first. At the student parent's
redetermination, if the student parent was not approved for basic sliding fee child care
assistance, a student parent's eligibility ends following a 15-day adverse action notice.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 8.

Minnesota Statutes 2022, section 119B.09, subdivision 7, is amended to read:

Subd. 7.

Date of eligibility for assistance.

(a) The date of eligibility for child care
assistance under this chapter is the later of the date the application was received by the
county; the beginning date of employment, education, or training; the date the infant is born
for applicants to the at-home infant care program; or the date a determination has been made
that the applicant is a participant in employment and training services under Minnesota
Rules, part 3400.0080, or chapter 256J.

(b) Payment ceases for a family under the at-home infant child care program when a
family has used a total of 12 months of assistance as specified under section 119B.035.
Payment of child care assistance for employed persons on MFIP is effective the date of
employment or the date of MFIP eligibility, whichever is later. Payment of child care
assistance for MFIP deleted text begin or DWPdeleted text end participants in employment and training services is effective
the date of commencement of the services or the date of MFIP deleted text begin or DWPdeleted text end eligibility, whichever
is later. Payment of child care assistance for transition year child care must be made
retroactive to the date of eligibility for transition year child care.

(c) Notwithstanding paragraph (b), payment of child care assistance for participants
eligible under section 119B.05 may only be made retroactive for a maximum of three months
from the date of application for child care assistance.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 9.

Minnesota Statutes 2022, section 119B.095, subdivision 2, is amended to read:

Subd. 2.

Maintain steady child care authorizations.

(a) Notwithstanding Minnesota
Rules, chapter 3400, the amount of child care authorized under section 119B.10 for
employment, education, or an MFIP deleted text begin or DWPdeleted text end employment plan shall continue at the same
number of hours or more hours until redetermination, including:

(1) when the other parent moves in and is employed or has an education plan under
section 119B.10, subdivision 3, or has an MFIP deleted text begin or DWPdeleted text end employment plan; or

(2) when the participant's work hours are reduced or a participant temporarily stops
working or attending an approved education program. Temporary changes include, but are
not limited to, a medical leave, seasonal employment fluctuations, or a school break between
semesters.

(b) The county may increase the amount of child care authorized at any time if the
participant verifies the need for increased hours for authorized activities.

(c) The county may reduce the amount of child care authorized if a parent requests a
reduction or because of a change in:

(1) the child's school schedule;

(2) the custody schedule; or

(3) the provider's availability.

(d) The amount of child care authorized for a family subject to subdivision 1, paragraph
(b), must change when the participant's activity schedule changes. Paragraph (a) does not
apply to a family subject to subdivision 1, paragraph (b).

(e) When a child reaches 13 years of age or a child with a disability reaches 15 years of
age, the amount of child care authorized shall continue at the same number of hours or more
hours until redetermination.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 10.

Minnesota Statutes 2022, section 119B.095, subdivision 3, is amended to read:

Subd. 3.

Assistance for persons who are homeless.

An applicant who is homeless and
eligible for child care assistance is exempt from the activity participation requirements under
this chapter for three months. The applicant under this subdivision is eligible for 60 hours
of child care assistance per service period for three months from the date the county receives
the application. Additional hours may be authorized as needed based on the applicant's
participation in employment, education, or MFIP deleted text begin or DWPdeleted text end employment plan. To continue
receiving child care assistance after the initial three months, the applicant must verify that
the applicant meets eligibility and activity requirements for child care assistance under this
chapter.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 11.

Minnesota Statutes 2022, section 119B.10, subdivision 1, is amended to read:

Subdivision 1.

Assistance for persons seeking and retaining employment.

(a) Persons
who are seeking employment and who are eligible for assistance under this section are
eligible to receive up to 240 hours of child care assistance per calendar year.

(b) At application and redetermination, employed persons who work at least an average
of 20 hours and full-time students who work at least an average of ten hours a week and
receive at least a minimum wage for all hours worked are eligible for child care assistance
for employment. For purposes of this section, work-study programs must be counted as
employment. An employed person with an MFIP deleted text begin or DWPdeleted text end employment plan shall receive
child care assistance as specified in the person's employment plan. Child care assistance
during employment must be authorized as provided in paragraphs (c) and (d).

(c) When the person works for an hourly wage and the hourly wage is equal to or greater
than the applicable minimum wage, child care assistance shall be provided for the hours of
employment, break, and mealtime during the employment and travel time up to two hours
per day.

(d) When the person does not work for an hourly wage, child care assistance must be
provided for the lesser of:

(1) the amount of child care determined by dividing gross earned income by the applicable
minimum wage, up to one hour every eight hours for meals and break time, plus up to two
hours per day for travel time; or

(2) the amount of child care equal to the actual amount of child care used during
employment, including break and mealtime during employment, and travel time up to two
hours per day.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 12.

Minnesota Statutes 2022, section 119B.10, subdivision 3, is amended to read:

Subd. 3.

Assistance for persons attending an approved education or training
program.

(a) Money for an eligible person according to sections 119B.03, subdivision 3,
and 119B.05, subdivision 1, shall be used to reduce child care costs for a student. The county
shall not limit the duration of child care subsidies for a person in an employment or
educational program unless the person is ineligible for child care funds. Any other limitation
must be based on county policies included in the approved child care fund plan.

(b) To be eligible, the student must be in good standing and be making satisfactory
progress toward the degree. The maximum length of time a student is eligible for child care
assistance under the child care fund for education and training is no more than the time
necessary to complete the credit requirements for an associate's or baccalaureate degree as
determined by the educational institution. Time limitations for child care assistance do not
apply to basic or remedial educational programs needed for postsecondary education or
employment. Basic or remedial educational programs include high school, commissioner
of education-selected high school equivalency, and English as a second language programs.
A program exempt from this time limit must not run concurrently with a postsecondary
program.

(c) If a student meets the conditions of paragraphs (a) and (b), child care assistance must
be authorized for all hours of class time and credit hours, including independent study and
internships, and up to two hours of travel time per day. A postsecondary student shall receive
four hours of child care assistance per credit hour for study time and academic appointments
per service period.

(d) For an MFIP deleted text begin or DWPdeleted text end participant, child care assistance must be authorized according
to the person's approved employment plan. If an MFIP deleted text begin or DWPdeleted text end participant receiving MFIP
deleted text begin or DWPdeleted text end child care assistance under this chapter moves to another county, continues to
participate in an authorized educational or training program, and remains eligible for MFIP
deleted text begin or DWPdeleted text end child care assistance, the participant must receive continued child care assistance
from the county responsible for the person's current employment plan under section 256G.07.

(e) If a person with an approved education program under section 119B.03, subdivision
3, or 119B.05, subdivision 1, begins receiving MFIP deleted text begin or DWPdeleted text end assistance, the person continues
to receive child care assistance for the approved education program until the person's
education is included in an approved MFIP deleted text begin or DWPdeleted text end employment plan or until
redetermination, whichever occurs first.

(f) If a person's MFIP deleted text begin or DWPdeleted text end assistance ends and the approved MFIP deleted text begin or DWPdeleted text end
employment plan included education, the person continues to be eligible for child care
assistance for education under transition year child care assistance until the person's education
is included in an approved education plan or until redetermination.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 13.

Minnesota Statutes 2022, section 119B.105, subdivision 2, is amended to read:

Subd. 2.

Extended eligibility and redetermination.

(a) If the family received three
months of extended eligibility and redetermination is not due, to continue receiving child
care assistance the participant must be employed or have an education plan that meets the
requirements of section 119B.10, subdivision 3, or have an MFIP deleted text begin or DWPdeleted text end employment
plan. If child care assistance continues, the amount of child care authorized shall continue
at the same number or more hours until redetermination, unless a condition in section
119B.095, subdivision 2, paragraph (c), applies. A family subject to section 119B.095,
subdivision 1, paragraph (b), shall have child care authorized based on a verified activity
schedule.

(b) If the family's redetermination occurs before the end of the three-month extended
eligibility period to continue receiving child care assistance, the participant must verify that
the participant meets eligibility and activity requirements for child care assistance under
this chapter. If child care assistance continues, the amount of child care authorized is based
on section 119B.10. A family subject to section 119B.095, subdivision 1, paragraph (b),
shall have child care authorized based on a verified activity schedule.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 14.

Minnesota Statutes 2022, section 168B.07, subdivision 3, is amended to read:

Subd. 3.

Retrieval of contents.

(a) For purposes of this subdivision:

(1) "contents" does not include any permanently affixed mechanical or nonmechanical
automobile parts; automobile body parts; or automobile accessories, including audio or
video players; and

(2) "relief based on need" includes, but is not limited to, receipt of MFIP deleted text begin and Diversionary
Work Programdeleted text end , medical assistance, general assistance, emergency general assistance,
Minnesota supplemental aid, MSA-emergency assistance, MinnesotaCare, Supplemental
Security Income, energy assistance, emergency assistance, Supplemental Nutrition Assistance
Program (SNAP) benefits, earned income tax credit, or Minnesota working family tax credit.

(b) A unit of government or impound lot operator shall establish reasonable procedures
for retrieval of vehicle contents, and may establish reasonable procedures to protect the
safety and security of the impound lot and its personnel.

(c) At any time before the expiration of the waiting periods provided in section 168B.051,
a registered owner who provides documentation from a government or nonprofit agency or
legal aid office that the registered owner is homeless, receives relief based on need, or is
eligible for legal aid services, has the unencumbered right to retrieve any and all contents
without charge and regardless of whether the registered owner pays incurred charges or
fees, transfers title, or reclaims the vehicle.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 15.

Minnesota Statutes 2022, section 256.046, subdivision 1, is amended to read:

Subdivision 1.

Hearing authority.

A local agency must initiate an administrative fraud
disqualification hearing for individuals accused of wrongfully obtaining assistance or
intentional program violations, in lieu of a criminal action when it has not been pursued, in
the Minnesota family investment program and any affiliated program to include deleted text begin the
diversionary work program anddeleted text end the work participation cash benefit program, child care
assistance programs, general assistance, family general assistance program formerly codified
in section 256D.05, subdivision 1, clause (15), Minnesota supplemental aid, the Supplemental
Nutrition Assistance Program (SNAP), MinnesotaCare for adults without children, and
upon federal approval, all categories of medical assistance and remaining categories of
MinnesotaCare except for children through age 18. The Department of Human Services, in
lieu of a local agency, may initiate an administrative fraud disqualification hearing when
the state agency is directly responsible for administration or investigation of the program
for which benefits were wrongfully obtained. The hearing is subject to the requirements of
sections 256.045 and 256.0451 and the requirements in Code of Federal Regulations, title
7, section 273.16.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026, and applies to acts of
wrongfully obtaining assistance and intentional program violations that occur on or after
that date.
new text end

Sec. 16.

Minnesota Statutes 2022, section 256.98, subdivision 8, is amended to read:

Subd. 8.

Disqualification from program.

(a) Any person found to be guilty of
wrongfully obtaining assistance by a federal or state court or by an administrative hearing
determination, or waiver thereof, through a disqualification consent agreement, or as part
of any approved diversion plan under section 401.065, or any court-ordered stay which
carries with it any probationary or other conditions, in the Minnesota family investment
program and any affiliated program to include deleted text begin the diversionary work program anddeleted text end the work
participation cash benefit program, the Supplemental Nutrition Assistance Program (SNAP),
the general assistance program, housing support under chapter 256I, or the Minnesota
supplemental aid program shall be disqualified from that program. In addition, any person
disqualified from the Minnesota family investment program shall also be disqualified from
SNAP. The needs of that individual shall not be taken into consideration in determining the
grant level for that assistance unit:

(1) for one year after the first offense;

(2) for two years after the second offense; and

(3) permanently after the third or subsequent offense.

The period of program disqualification shall begin on the date stipulated on the advance
notice of disqualification without possibility of postponement for administrative stay or
administrative hearing and shall continue through completion unless and until the findings
upon which the sanctions were imposed are reversed by a court of competent jurisdiction.
The period for which sanctions are imposed is not subject to review. The sanctions provided
under this subdivision are in addition to, and not in substitution for, any other sanctions that
may be provided for by law for the offense involved. A disqualification established through
hearing or waiver shall result in the disqualification period beginning immediately unless
the person has become otherwise ineligible for assistance. If the person is ineligible for
assistance, the disqualification period begins when the person again meets the eligibility
criteria of the program from which they were disqualified and makes application for that
program.

(b) A family receiving assistance through child care assistance programs under chapter
119B with a family member who is found to be guilty of wrongfully obtaining child care
assistance by a federal court, state court, or an administrative hearing determination or
waiver, through a disqualification consent agreement, as part of an approved diversion plan
under section 401.065, or a court-ordered stay with probationary or other conditions, is
disqualified from child care assistance programs. The disqualifications must be for periods
of one year and two years for the first and second offenses, respectively. Subsequent
violations must result in permanent disqualification. During the disqualification period,
disqualification from any child care program must extend to all child care programs and
must be immediately applied.

(c) A provider caring for children receiving assistance through child care assistance
programs under chapter 119B is disqualified from receiving payment for child care services
from the child care assistance program under chapter 119B when the provider is found to
have wrongfully obtained child care assistance by a federal court, state court, or an
administrative hearing determination or waiver under section 256.046, through a
disqualification consent agreement, as part of an approved diversion plan under section
401.065, or a court-ordered stay with probationary or other conditions. The disqualification
must be for a period of three years for the first offense. Any subsequent violation must result
in permanent disqualification. The disqualification period must be imposed immediately
after a determination is made under this paragraph. During the disqualification period, the
provider is disqualified from receiving payment from any child care program under chapter
119B.

(d) Any person found to be guilty of wrongfully obtaining MinnesotaCare for adults
without children and upon federal approval, all categories of medical assistance and
remaining categories of MinnesotaCare, except for children through age 18, by a federal or
state court or by an administrative hearing determination, or waiver thereof, through a
disqualification consent agreement, or as part of any approved diversion plan under section
401.065, or any court-ordered stay which carries with it any probationary or other conditions,
is disqualified from that program. The period of disqualification is one year after the first
offense, two years after the second offense, and permanently after the third or subsequent
offense. The period of program disqualification shall begin on the date stipulated on the
advance notice of disqualification without possibility of postponement for administrative
stay or administrative hearing and shall continue through completion unless and until the
findings upon which the sanctions were imposed are reversed by a court of competent
jurisdiction. The period for which sanctions are imposed is not subject to review. The
sanctions provided under this subdivision are in addition to, and not in substitution for, any
other sanctions that may be provided for by law for the offense involved.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026, and applies to acts of
wrongfully obtaining assistance that occur on or after that date.
new text end

Sec. 17.

Minnesota Statutes 2022, section 256.987, subdivision 4, is amended to read:

Subd. 4.

Disqualification.

(a) Any person found to be guilty of purchasing tobacco
products or alcoholic beverages with their EBT debit card by a federal or state court or by
an administrative hearing determination, or waiver thereof, through a disqualification consent
agreement, or as part of any approved diversion plan under section 401.065, or any
court-ordered stay which carries with it any probationary or other conditions, in the: (1)
Minnesota family investment program and any affiliated program to include deleted text begin the diversionary
work program anddeleted text end the work participation cash benefit program under chapter 256J; (2)
general assistance program under chapter 256D; or (3) Minnesota supplemental aid program
under chapter 256D, shall be disqualified from all of the listed programs.

(b) The needs of the disqualified individual shall not be taken into consideration in
determining the grant level for that assistance unit: (1) for one year after the first offense;
(2) for two years after the second offense; and (3) permanently after the third or subsequent
offense.

(c) The period of program disqualification shall begin on the date stipulated on the
advance notice of disqualification without possibility for postponement for administrative
stay or administrative hearing and shall continue through completion unless and until the
findings upon which the sanctions were imposed are reversed by a court of competent
jurisdiction. The period for which sanctions are imposed is not subject to review.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026, and applies to purchases
made on or after that date.
new text end

Sec. 18.

Minnesota Statutes 2022, section 256D.01, subdivision 1a, is amended to read:

Subd. 1a.

Standards.

(a) A principal objective in providing general assistance is to
provide for single adults, childless couples, or children as defined in section 256D.02,
subdivision 6, ineligible for federal programs who are unable to provide for themselves.
The minimum standard of assistance determines the total amount of the general assistance
grant without separate standards for shelter, utilities, or other needs.

(b) The deleted text begin commissioner shall set thedeleted text end standard of assistance for an assistance unit consisting
of deleted text begin an adultdeleted text end new text begin anew text end recipient who is childless and unmarried or living apart from children and
spouse and who does not live with a parent or parents or a legal custodiannew text begin , or consisting of
a childless couple, is $350 per month effective October 1, 2024, and must be adjusted by a
percentage equal to the change in the consumer price index as of January 1 every year,
beginning October 1, 2025new text end . deleted text begin When the other standards specified in this subdivision increase,
this standard must also be increased by the same percentage.
deleted text end

(c) For an assistance unit consisting of a single adult who lives with a parent or parents,
the general assistance standard of assistance is deleted text begin the amount that the aid to families with
dependent children standard of assistance, in effect on July 16, 1996, would increase if the
recipient were added as an additional minor child to an assistance unit consisting of the
recipient's parent and all of that parent's family members, except that the standard may not
exceed the standard for a general assistance recipient living alonedeleted text end new text begin $350 per month effective
October 1, 2023, and must be adjusted by a percentage equal to the change in the consumer
price index as of January 1 every year, beginning October 1, 2025new text end . Benefits received by a
responsible relative of the assistance unit under the Supplemental Security Income program,
a workers' compensation program, the Minnesota supplemental aid program, or any other
program based on the responsible relative's disability, and any benefits received by a
responsible relative of the assistance unit under the Social Security retirement program,
may not be counted in the determination of eligibility or benefit level for the assistance unit.
Except as provided below, the assistance unit is ineligible for general assistance if the
available resources or the countable income of the assistance unit and the parent or parents
with whom the assistance unit lives are such that a family consisting of the assistance unit's
parent or parents, the parent or parents' other family members and the assistance unit as the
only or additional minor child would be financially ineligible for general assistance. For
the purposes of calculating the countable income of the assistance unit's parent or parents,
the calculation methods must follow the provisions under section 256P.06.

deleted text begin (d) For an assistance unit consisting of a childless couple, the standards of assistance
are the same as the first and second adult standards of the aid to families with dependent
children program in effect on July 16, 1996. If one member of the couple is not included in
the general assistance grant, the standard of assistance for the other is the second adult
standard of the aid to families with dependent children program as of July 16, 1996.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 19.

Minnesota Statutes 2022, section 256D.024, subdivision 1, is amended to read:

Subdivision 1.

Person convicted of drug offenses.

(a) deleted text begin Ifdeleted text end An deleted text begin applicant or recipientdeleted text end new text begin
individual whonew text end has been convicted of a new text begin felony-level new text end drug offense deleted text begin after July 1, 1997, the
assistance unit is ineligible for benefits under this chapter until five years after the applicant
has completed terms of the court-ordered sentence, unless the person is participating in a
drug treatment program, has successfully completed a drug treatment program, or has been
assessed by the county and determined not to be in need of a drug treatment program. Persons
subject to the limitations of this subdivision who become eligible for assistance under this
chapter shalldeleted text end new text begin during the previous ten years from the date of application or recertification
maynew text end be subject to random drug testing deleted text begin as a condition of continued eligibility and shall lose
eligibility for benefits for five years beginning the month following:deleted text end new text begin . The county must
provide information about substance use disorder treatment programs to a person who tests
positive for an illegal controlled substance.
new text end

deleted text begin (1) Any positive test result for an illegal controlled substance; or
deleted text end

deleted text begin (2) discharge of sentence after conviction for another drug felony.
deleted text end

(b) For the purposes of this subdivision, "drug offense" means a conviction that occurred
deleted text begin after July 1, 1997,deleted text end new text begin during the previous ten years from the date of application or recertificationnew text end
of sections 152.021 to 152.025, 152.0261, 152.0262, or 152.096. Drug offense also means
a conviction in another jurisdiction of the possession, use, or distribution of a controlled
substance, or conspiracy to commit any of these offenses, if the deleted text begin offensedeleted text end new text begin convictionnew text end occurred
deleted text begin after July 1, 1997,deleted text end new text begin during the previous ten years from the date of application or recertificationnew text end
and the conviction is a felony offense in that jurisdiction, or in the case of New Jersey, a
high misdemeanor.

new text begin EFFECTIVE DATE.new text end

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

Sec. 20.

Minnesota Statutes 2022, section 256D.03, is amended by adding a subdivision
to read:

new text begin Subd. 2b.new text end

new text begin Budgeting and reporting.new text end

new text begin Every county agency shall determine eligibility
and calculate benefit amounts for general assistance according to chapter 256P.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 21.

Minnesota Statutes 2022, section 256D.06, subdivision 5, is amended to read:

Subd. 5.

Eligibility; requirements.

(a) Any applicant, otherwise eligible for general
assistance and possibly eligible for maintenance benefits from any other source shall (1)
make application for those benefits within deleted text begin 30deleted text end new text begin 90new text end days of the general assistance application;
and (2) execute an interim assistance agreement on a form as directed by the commissioner.

(b) The commissioner shall review a denial of an application for other maintenance
benefits and may require a recipient of general assistance to file an appeal of the denial if
appropriate. If found eligible for benefits from other sources, and a payment received from
another source relates to the period during which general assistance was also being received,
the recipient shall be required to reimburse the county agency for the interim assistance
paid. Reimbursement shall not exceed the amount of general assistance paid during the time
period to which the other maintenance benefits apply and shall not exceed the state standard
applicable to that time period.

(c) The commissioner may contract with the county agencies, qualified agencies,
organizations, or persons to provide advocacy and support services to process claims for
federal disability benefits for applicants or recipients of services or benefits supervised by
the commissioner using money retained under this section.

(d) The commissioner may provide methods by which county agencies shall identify,
refer, and assist recipients who may be eligible for benefits under federal programs for
people with a disability.

(e) The total amount of interim assistance recoveries retained under this section for
advocacy, support, and claim processing services shall not exceed 35 percent of the interim
assistance recoveries in the prior fiscal year.

new text begin EFFECTIVE DATE.new text end

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

Sec. 22.

Minnesota Statutes 2022, section 256D.44, subdivision 5, is amended to read:

Subd. 5.

Special needs.

(a) In addition to the state standards of assistance established
in subdivisions 1 to 4, payments are allowed for the following special needs of recipients
of Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
center, or a setting authorized to receive housing support payments under chapter 256I.

(b) The county agency shall pay a monthly allowance for medically prescribed diets if
the cost of those additional dietary needs cannot be met through some other maintenance
benefit. The need for special diets or dietary items must be prescribed by a licensed physician,
advanced practice registered nurse, or physician assistant. Costs for special diets shall be
determined as percentages of the allotment for a one-person household under the thrifty
food plan as defined by the United States Department of Agriculture. The types of diets and
the percentages of the thrifty food plan that are covered are as follows:

(1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;

(2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent of
thrifty food plan;

(3) controlled protein diet, less than 40 grams and requires special products, 125 percent
of thrifty food plan;

(4) low cholesterol diet, 25 percent of thrifty food plan;

(5) high residue diet, 20 percent of thrifty food plan;

(6) pregnancy and lactation diet, 35 percent of thrifty food plan;

(7) gluten-free diet, 25 percent of thrifty food plan;

(8) lactose-free diet, 25 percent of thrifty food plan;

(9) antidumping diet, 15 percent of thrifty food plan;

(10) hypoglycemic diet, 15 percent of thrifty food plan; or

(11) ketogenic diet, 25 percent of thrifty food plan.

(c) Payment for nonrecurring special needs must be allowed for necessary home repairs
or necessary repairs or replacement of household furniture and appliances using the payment
standard of the AFDC program in effect on July 16, 1996, for these expenses, as long as
other funding sources are not available.

(d) A fee for guardian or conservator service is allowed at a reasonable rate negotiated
by the county or approved by the court. This rate shall not exceed five percent of the
assistance unit's gross monthly income up to a maximum of $100 per month. If the guardian
or conservator is a member of the county agency staff, no fee is allowed.

(e) The county agency shall continue to pay a monthly allowance of $68 for restaurant
meals for a person who was receiving a restaurant meal allowance on June 1, 1990, and
who eats two or more meals in a restaurant daily. The allowance must continue until the
person has not received Minnesota supplemental aid for one full calendar month or until
the person's living arrangement changes and the person no longer meets the criteria for the
restaurant meal allowance, whichever occurs first.

(f) A fee deleted text begin of ten percent of the recipient's gross income or $25, whichever is less,deleted text end new text begin equal
to the maximum monthly amount allowed by the Social Security Administrationnew text end is allowed
for representative payee services provided by an agency that meets the requirements under
SSI regulations to charge a fee for representative payee services. This special need is available
to all recipients of Minnesota supplemental aid regardless of their living arrangement.

(g)(1) Notwithstanding the language in this subdivision, an amount equal to one-half of
the maximum federal Supplemental Security Income payment amount for a single individual
which is in effect on the first day of July of each year will be added to the standards of
assistance established in subdivisions 1 to 4 for adults under the age of 65 who qualify as
in need of housing assistance and are:

(i) relocating from an institution, a setting authorized to receive housing support under
chapter 256I, or an adult mental health residential treatment program under section
256B.0622;

(ii) eligible for personal care assistance under section 256B.0659; or

(iii) home and community-based waiver recipients living in their own home or rented
or leased apartment.

(2) Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter
needy benefit under this paragraph is considered a household of one. An eligible individual
who receives this benefit prior to age 65 may continue to receive the benefit after the age
of 65.

(3) "Housing assistance" means that the assistance unit incurs monthly shelter costs that
exceed 40 percent of the assistance unit's gross income before the application of this special
needs standard. "Gross income" for the purposes of this section is the applicant's or recipient's
income as defined in section 256D.35, subdivision 10, or the standard specified in subdivision
3, paragraph (a) or (b), whichever is greater. A recipient of a federal or state housing subsidy,
that limits shelter costs to a percentage of gross income, shall not be considered in need of
housing assistance for purposes of this paragraph.

new text begin EFFECTIVE DATE.new text end

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

Sec. 23.

Minnesota Statutes 2022, section 256D.63, subdivision 2, is amended to read:

Subd. 2.

SNAP reporting requirements.

The commissioner of human services shall
implement simplified reporting as permitted under the Food and Nutrition Act of 2008, as
amended, and the SNAP regulations in Code of Federal Regulations, title 7, part 273. SNAP
benefit recipient households required to report periodically shall not be required to report
more often than one time every six months. deleted text begin This provision shall not apply to households
receiving food benefits under the Minnesota family investment program waiver.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 24.

new text begin [256D.65] SUPPLEMENTAL NUTRITION ASSISTANCE OUTREACH
PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin SNAP outreach program.new text end

new text begin The commissioner of human services shall
implement a Supplemental Nutrition Assistance Program (SNAP) outreach program to
inform low-income households about the availability, eligibility requirements, application
procedures, and benefits of SNAP that meets the requirements of the United States
Department of Agriculture.
new text end

new text begin Subd. 2.new text end

new text begin Duties of commissioner.new text end

new text begin In addition to any other duties imposed by federal
law, the commissioner shall:
new text end

new text begin (1) supervise the administration of the SNAP outreach program according to guidance
provided by the United States Department of Agriculture;
new text end

new text begin (2) submit the SNAP outreach plan and budget to the United States Department of
Agriculture;
new text end

new text begin (3) accept any funds provided by the federal government or other sources for SNAP
outreach;
new text end

new text begin (4) administer the request-for-proposals process and establish contracts with grantees
to ensure SNAP outreach services are available to inform low-income households statewide;
new text end

new text begin (5) approve budgets from grantees to ensure that activities are eligible for federal
reimbursement;
new text end

new text begin (6) monitor grantees, review invoices, and reimburse grantees for allowable costs that
are eligible for federal reimbursement;
new text end

new text begin (7) provide technical assistance to grantees to ensure that projects support SNAP outreach
goals and project costs are eligible for federal reimbursement;
new text end

new text begin (8) work in partnership with counties, Tribal Nations, and community organizations to
enhance the reach and services of a statewide SNAP outreach program; and
new text end

new text begin (9) identify and leverage eligible nonfederal funds to earn federal reimbursement for
SNAP outreach.
new text end

new text begin Subd. 3.new text end

new text begin Program funding.new text end

new text begin (a) Grantees must submit allowable costs for approved
SNAP outreach activities to the commissioner in order to receive federal reimbursement.
new text end

new text begin (b) The commissioner shall disburse federal reimbursement funds for allowable costs
for approved SNAP outreach activities to the state agency or grantee that incurred the costs
being reimbursed.
new text end

Sec. 25.

Minnesota Statutes 2022, section 256E.34, subdivision 4, is amended to read:

Subd. 4.

Use of money.

At least 96 percent of the money distributed to Hunger Solutions
under this section must be distributed to food shelf programs to purchase, transport, and
coordinate the distribution of nutritious food to needy individuals and families. new text begin The money
distributed to food shelf programs may also be used to purchase personal hygiene products,
including but not limited to diapers and toilet paper. new text end No more than four percent of the money
may be expended for other expenses, such as rent, salaries, and other administrative expenses
of Hunger Solutions.

Sec. 26.

new text begin [256E.342] AMERICAN INDIAN FOOD SOVEREIGNTY FUNDING
PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The American Indian food sovereignty funding program
is established to improve access and equity to food security programs within Tribal and
American Indian communities. The program shall assist Tribal Nations and American Indian
communities in achieving self-determination and improve collaboration and partnership
building between American Indian communities and the state. The commissioner of human
services shall administer the program and provide outreach, technical assistance, and program
development support to increase food security for American Indians.
new text end

new text begin Subd. 2.new text end

new text begin Distribution of funding.new text end

new text begin (a) The commissioner shall provide funding to support
food system changes and provide equitable access to existing and new methods of food
support for American Indian communities. The commissioner shall determine the timing
and form of the application for the program.
new text end

new text begin (b) Eligible recipients of funding under this section include:
new text end

new text begin (1) federally recognized American Indian Tribes or bands in Minnesota as defined in
section 10.65; or
new text end

new text begin (2) nonprofit organizations or fiscal sponsors with a majority American Indian board of
directors.
new text end

new text begin (c) Funding for American Indian Tribes or Bands must be allocated by a formula
determined by the commissioner. Funding for nonprofit organizations or fiscal sponsors
must be awarded through a competitive grant process.
new text end

new text begin Subd. 3.new text end

new text begin Allowable uses of money.new text end

new text begin Recipients shall use money provided under this
section to promote food security for American Indian communities by:
new text end

new text begin (1) planning for sustainable food systems;
new text end

new text begin (2) implementing food security programs, including but not limited to technology to
facilitate no-contact or low-contact food distribution and outreach models;
new text end

new text begin (3) providing culturally relevant training for building food access;
new text end

new text begin (4) purchasing, producing, processing, transporting, storing, and coordinating the
distribution of food, including culturally relevant food; and
new text end

new text begin (5) purchasing seeds, plants, equipment, or materials to preserve, procure, or grow food.
new text end

new text begin Subd. 4.new text end

new text begin Reporting.new text end

new text begin Recipients shall report on the use of American Indian food
sovereignty funding program money under this section to the commissioner.
new text end

new text begin The commissioner shall determine the timing and form required for the reports.
new text end

Sec. 27.

Minnesota Statutes 2022, section 256E.35, subdivision 1, is amended to read:

Subdivision 1.

Establishment.

The Minnesota family assets for independence initiative
is established to provide incentives for low-income families to accrue assets for education,
housing, vehicles, new text begin emergencies, new text end and economic development purposes.

Sec. 28.

Minnesota Statutes 2022, section 256E.35, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) The definitions in this subdivision apply to this section.

(b) "Eligible educational institution" means the following:

(1) an institution of higher education described in section 101 or 102 of the Higher
Education Act of 1965; or

(2) an area vocational education school, as defined in subparagraph (C) or (D) of United
States Code, title 20, chapter 44, section 2302 (3) (the Carl D. Perkins Vocational and
Applied Technology Education Act), which is located within any state, as defined in United
States Code, title 20, chapter 44, section 2302 (30). This clause is applicable only to the
extent section 2302 is in effect on August 1, 2008.

(c) "Family asset account" means a savings account opened by a household participating
in the Minnesota family assets for independence initiative.

(d) "Fiduciary organization" means:

(1) a community action agency that has obtained recognition under section 256E.31;

(2) a federal community development credit union deleted text begin serving the seven-county metropolitan
areadeleted text end ; deleted text begin or
deleted text end

(3) a women-oriented economic development agency deleted text begin serving the seven-county
metropolitan area.deleted text end new text begin ;
new text end

new text begin (4) a federally recognized Tribal Nation; or
new text end

new text begin (5) a nonprofit organization as defined under section 501(c)(3) of the Internal Revenue
Code.
new text end

(e) "Financial coach" means a person who:

(1) has completed an intensive financial literacy training workshop that includes
curriculum on budgeting to increase savings, debt reduction and asset building, building a
good credit rating, and consumer protection;

(2) participates in ongoing statewide family assets for independence in Minnesota (FAIM)
network training meetings under FAIM program supervision; and

(3) provides financial coaching to program participants under subdivision 4a.

(f) "Financial institution" means a bank, bank and trust, savings bank, savings association,
or credit union, the deposits of which are insured by the Federal Deposit Insurance
Corporation or the National Credit Union Administration.

(g) "Household" means all individuals who share use of a dwelling unit as primary
quarters for living and eating separate from other individuals.

(h) "Permissible use" means:

(1) postsecondary educational expenses at an eligible educational institution as defined
in paragraph (b), including books, supplies, and equipment required for courses of instruction;

(2) acquisition costs of acquiring, constructing, or reconstructing a residence, including
any usual or reasonable settlement, financing, or other closing costs;

(3) business capitalization expenses for expenditures on capital, plant, equipment, working
capital, and inventory expenses of a legitimate business pursuant to a business plan approved
by the fiduciary organization;

(4) acquisition costs of a principal residence within the meaning of section 1034 of the
Internal Revenue Code of 1986 which do not exceed 100 percent of the average area purchase
price applicable to the residence determined according to section 143(e)(2) and (3) of the
Internal Revenue Code of 1986; deleted text begin and
deleted text end

(5) acquisition costs of a personal vehicle only if approved by the fiduciary organizationdeleted text begin .deleted text end new text begin ;
new text end

new text begin (6) contributions to an emergency savings account; and
new text end

new text begin (7) contributions to a Minnesota 529 savings plan.
new text end

Sec. 29.

Minnesota Statutes 2022, section 256E.35, subdivision 3, is amended to read:

Subd. 3.

Grants awarded.

The commissioner shall allocate funds to participating
fiduciary organizations to provide family asset services. Grant awards must be based on a
plan submitted by a statewide organization representing fiduciary organizations. The
statewide organization must ensure that any interested unrepresented fiduciary organization
have input into the development of the plan. The plan must equitably distribute funds to
achieve geographic balance and document the capacity of participating fiduciary
organizations to manage the program.new text begin A portion of funds appropriated for this section may
be expended on the evaluation of the Minnesota family assets for independence initiative.
new text end

Sec. 30.

Minnesota Statutes 2022, section 256E.35, subdivision 4a, is amended to read:

Subd. 4a.

Financial coaching.

A financial coach shall provide the following to program
participants:

(1) financial education relating to budgeting, debt reduction, asset-specific training,
new text begin credit building, new text end and financial stability activities;

(2) asset-specific training related to buying a home or vehicle, acquiring postsecondary
education, deleted text begin ordeleted text end starting or expanding a small businessnew text begin , saving for emergencies, or saving for
a child's educationnew text end ; and

(3) financial stability education and training to improve and sustain financial security.

Sec. 31.

Minnesota Statutes 2022, section 256E.35, subdivision 6, is amended to read:

Subd. 6.

Withdrawal; matching; permissible uses.

(a) To receive a match, a
participating household must transfer funds withdrawn from a family asset account to its
matching fund custodial account held by the fiscal agent, according to the family asset
agreement. The fiscal agent must determine if the match request is for a permissible use
consistent with the household's family asset agreement.

(b) The fiscal agent must ensure the household's custodial account contains the applicable
matching funds to match the balance in the household's account, including interest, on at
least a quarterly basis and at the time of an approved withdrawal. Matches must be a
contribution of $3 from state grant or TANF funds for every $1 of funds withdrawn from
the family asset account not to exceed a deleted text begin $6,000deleted text end new text begin $12,000new text end lifetime limit.

(c) Notwithstanding paragraph (b), if funds are appropriated for the Federal Assets for
Independence Act of 1998, and a participating fiduciary organization is awarded a grant
under that act, participating households with that fiduciary organization must be provided
matches as follows:

(1) from state grant and TANF funds, a matching contribution of $1.50 for every $1 of
funds withdrawn from the family asset account not to exceed a deleted text begin $3,000deleted text end new text begin $6,000new text end lifetime limit;
and

(2) from nonstate funds, a matching contribution of not less than $1.50 for every $1 of
funds withdrawn from the family asset account not to exceed a deleted text begin $3,000deleted text end new text begin $6,000new text end lifetime limit.

(d) Upon receipt of transferred custodial account funds, the fiscal agent must make a
direct payment to the vendor of the goods or services for the permissible use.

Sec. 32.

Minnesota Statutes 2022, section 256E.35, subdivision 7, is amended to read:

Subd. 7.

Program reporting.

The fiscal agent on behalf of each fiduciary organization
participating in a family assets for independence initiative must report quarterly to the
commissioner of human services identifying the participants with accountsdeleted text begin ,deleted text end new text begin ;new text end the number of
accountsdeleted text begin ,deleted text end new text begin ;new text end the amount of savings and matches for each participant's accountdeleted text begin ,deleted text end new text begin ;new text end the uses of
the accountdeleted text begin , anddeleted text end new text begin ;new text end the number of businesses, homes, vehicles, and educational services paid
for with money from the accountdeleted text begin ,deleted text end new text begin ; and the amount of contributions to Minnesota 529 savings
plans and emergency savings accounts,new text end as well as other information that may be required
for the commissioner to administer the program and meet federal TANF reporting
requirements.

Sec. 33.

Minnesota Statutes 2022, section 256I.03, subdivision 7, is amended to read:

Subd. 7.

Countable income.

new text begin (a) new text end "Countable income" means all income received by an
applicant or recipient as described under section 256P.06, less any applicable exclusions or
disregards. deleted text begin For a recipient of any cash benefit from the SSI program, countable income
means the SSI benefit limit in effect at the time the person is a recipient of housing support,
less the medical assistance personal needs allowance under section 256B.35. If the SSI limit
or benefit is reduced for a person due to events other than receipt of additional income,
countable income means actual income less any applicable exclusions and disregards.
deleted text end

new text begin (b) For a recipient of any cash benefit from the SSI program who does not live in a
setting described in section 256I.04, subdivision 2a, paragraph (b), clause (2), countable
income equals the SSI benefit limit in effect at the time that the person is a recipient of
housing support, less the personal needs allowance under section 256B.35. If the SSI limit
or benefit is reduced for a person due to events other than the receipt of additional income,
countable income equals actual income less any applicable exclusions and disregards.
new text end

new text begin (c) For a recipient of any cash benefit from the SSI program who lives in a setting as
described in section 256I.04, subdivision 2a, paragraph (b), clause (2), countable income
equals 30 percent of the SSI benefit limit in effect at the time that a person is a recipient of
housing support. If the SSI limit or benefit is reduced for a person due to events other than
the receipt of additional income, countable income equals 30 percent of the actual income
less any applicable exclusions and disregards. For recipients under this paragraph, the
personal needs allowance described in section 256B.35 does not apply.
new text end

new text begin (d) Notwithstanding the earned income disregard described in section 256P.03, for a
recipient of unearned income as defined in section 256P.06, subdivision 3, clause (2), other
than SSI and the general assistance personal needs allowance, who lives in a setting described
in section 256I.04, subdivision 2a, paragraph (b), clause (2), countable income equals 30
percent of the recipient's total income after applicable exclusions and disregards. Total
income includes any unearned income as defined in section 256P.06 and any earned income
in the month that the person is a recipient of housing support. For recipients under this
paragraph, the personal needs allowance described in section 256B.35 does not apply.
new text end

new text begin (e) For a recipient who lives in a setting as described in section 256I.04, subdivision 2a,
paragraph (b), clause (2), and receives general assistance, the personal needs allowance
described in section 256B.35 is not countable unearned income.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 34.

Minnesota Statutes 2022, section 256I.03, subdivision 13, is amended to read:

Subd. 13.

Prospective budgeting.

"Prospective budgeting" deleted text begin means estimating the amount
of monthly income a person will have in the payment monthdeleted text end new text begin has the meaning given in
section 256P.01, subdivision 9new text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 35.

Minnesota Statutes 2022, section 256I.06, subdivision 6, is amended to read:

Subd. 6.

Reports.

Recipients must report changes in circumstances according to section
256P.07 deleted text begin that affect eligibility or housing support payment amounts, other than changes in
earned income, within ten days of the changedeleted text end . Recipients with countable earned income
must complete a household report form deleted text begin at leastdeleted text end once every six monthsnew text begin according to section
256P.10new text end . deleted text begin If the report form is not received before the end of the month in which it is due,
the county agency must terminate eligibility for housing support payments. The termination
shall be effective on the first day of the month following the month in which the report was
due. If a complete report is received within the month eligibility was terminated, the
individual is considered to have continued an application for housing support payment
effective the first day of the month the eligibility was terminated.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 36.

Minnesota Statutes 2022, section 256I.06, is amended by adding a subdivision
to read:

new text begin Subd. 6a.new text end

new text begin When to terminate assistance.new text end

new text begin An agency must terminate benefits when the
assistance unit fails to submit the household report form before the end of the month in
which the household report form is due. The termination shall be effective on the first day
of the month following the month in which the household report form was due. If the
assistance unit submits the household report form within 30 days of the termination of
benefits and remains eligible, benefits must be reinstated and made available retroactively
for the full benefit month.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 37.

Minnesota Statutes 2022, section 256I.06, subdivision 8, is amended to read:

Subd. 8.

Amount of housing support payment.

(a) The amount of a room and board
payment to be made on behalf of an eligible individual is determined by subtracting the
individual's countable income under section 256I.04, subdivision 1, for a whole calendar
month from the room and board rate for that same month. The housing support payment is
determined by multiplying the housing support rate times the period of time the individual
was a resident or temporarily absent under section 256I.05, subdivision 2a.

(b) For an individual with earned income under paragraph (a), prospective budgeting
new text begin according to section 256P.09 new text end must be used deleted text begin to determine the amount of the individual's
payment for the following six-month period. An increase in income shall not affect an
individual's eligibility or payment amount until the month following the reporting month.
A decrease in income shall be effective the first day of the month after the month in which
the decrease is reporteddeleted text end .

(c) For an individual who receives housing support payments under section 256I.04,
subdivision 1, paragraph (c), the amount of the housing support payment is determined by
multiplying the housing support rate times the period of time the individual was a resident.

new text begin EFFECTIVE DATE.new text end

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

Sec. 38.

Minnesota Statutes 2022, section 256J.01, subdivision 1, is amended to read:

Subdivision 1.

Implementation of Minnesota family investment program
(MFIP).

deleted text begin Except for section 256J.95,deleted text end This chapter and chapter 256K may be cited as the
Minnesota family investment program (MFIP). MFIP is the statewide implementation of
components of the Minnesota family investment plan (MFIP) authorized and formerly
codified in section 256.031 and Minnesota family investment plan-Ramsey County (MFIP-R)
formerly codified in section 256.047.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 39.

Minnesota Statutes 2022, section 256J.02, subdivision 2, is amended to read:

Subd. 2.

Use of money.

State money appropriated for purposes of this section and TANF
block grant money must be used for:

(1) financial assistance to or on behalf of any minor child who is a resident of this state
under section 256J.12;

(2) the health care and human services training and retention program under chapter
116L, for costs associated with families with children with incomes below 200 percent of
the federal poverty guidelines;

(3) the pathways program under section 116L.04, subdivision 1a;

(4) welfare to work transportation authorized under Public Law 105-178;

(5) reimbursements for the federal share of child support collections passed through to
the custodial parent;

(6) program administration under this chapter;

deleted text begin (7) the diversionary work program under section 256J.95;
deleted text end

deleted text begin (8)deleted text end new text begin (7)new text end the MFIP consolidated fund under section 256J.626; and

deleted text begin (9)deleted text end new text begin (8)new text end the Minnesota Department of Health consolidated fund under Laws 2001, First
Special Session chapter 9, article 17, section 3, subdivision 2.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 40.

Minnesota Statutes 2022, section 256J.08, subdivision 65, is amended to read:

Subd. 65.

Participant.

(a) "Participant" includes any of the following:

(1) a person who is currently receiving cash assistance or the food portion available
through MFIP;

(2) a person who withdraws a cash or food assistance payment by electronic transfer or
receives and cashes an MFIP assistance check or food coupons and is subsequently
determined to be ineligible for assistance for that period of time is a participant, regardless
whether that assistance is repaid;

(3) the caregiver relative and the minor child whose needs are included in the assistance
payment;

(4) a person in an assistance unit who does not receive a cash and food assistance payment
because the case has been suspended from MFIP;new text begin and
new text end

deleted text begin (5) a person who receives cash payments under the diversionary work program under
section 256J.95 is a participant; and
deleted text end

deleted text begin (6)deleted text end new text begin (5)new text end a person who receives cash payments under family stabilization services under
section 256J.575.

(b) "Participant" does not include a person who fails to withdraw or access electronically
any portion of the person's cash and food assistance payment by the end of the payment
month, who makes a written request for closure before the first of a payment month and
repays cash and food assistance electronically issued for that payment month within that
payment month, or who returns any uncashed assistance check and food coupons and
withdraws from the program.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 41.

Minnesota Statutes 2022, section 256J.08, subdivision 71, is amended to read:

Subd. 71.

Prospective budgeting.

"Prospective budgeting" deleted text begin means a method of
determining the amount of the assistance payment in which the budget month and payment
month are the samedeleted text end new text begin has the meaning given in section 256P.01, subdivision 9new text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 42.

Minnesota Statutes 2022, section 256J.08, subdivision 79, is amended to read:

Subd. 79.

Recurring income.

"Recurring income" means a form of income which is:

(1) received periodically, and may be received irregularly when receipt can be anticipated
even though the date of receipt cannot be predicted; and

(2) from the same source or of the same type that is received and budgeted in a
prospective month deleted text begin and is received in one or both of the first two retrospective monthsdeleted text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 43.

Minnesota Statutes 2022, section 256J.09, subdivision 10, is amended to read:

Subd. 10.

Ineligibility for MFIP deleted text begin or the diversionary work programdeleted text end .

When an applicant
is not eligible for MFIP deleted text begin or the diversionary work program under section 256J.95deleted text end because
the applicant does not meet eligibility requirements, the county agency must determine
whether the applicant is eligible for SNAPdeleted text begin ,deleted text end or health care programs. The county must also
inform applicants about resources available through the county or other agencies to meet
short-term emergency needs.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 44.

Minnesota Statutes 2022, section 256J.11, subdivision 1, is amended to read:

Subdivision 1.

General citizenship requirements.

(a) To be eligible for MFIP, a member
of the assistance unit must be a citizen of the United States, a qualified noncitizen as defined
in section 256J.08, or a noncitizen who is otherwise residing lawfully in the United States.

(b) A qualified noncitizen who entered the United States on or after August 22, 1996,
is eligible for MFIP. However, TANF dollars cannot be used to fund the MFIP benefits for
an individual under this paragraph for a period of five years after the date of entry unless
the qualified noncitizen meets one of the following criteria:

(1) was admitted to the United States as a refugee under United States Code, title 8,
section 1157;

(2) was granted asylum under United States Code, title 8, section 1158;

(3) was granted withholding of deportation under the United States Code, title 8, section
1253(h);

(4) is a veteran of the United States armed forces with an honorable discharge for a
reason other than noncitizen status, or is a spouse or unmarried minor dependent child of
the same; or

(5) is an individual on active duty in the United States armed forces, other than for
training, or is a spouse or unmarried minor dependent child of the same.

(c) A person who is not a qualified noncitizen but who is otherwise residing lawfully in
the United States is eligible for MFIP. However, TANF dollars cannot be used to fund the
MFIP benefits for an individual under this paragraph.

(d) For purposes of this subdivision, a nonimmigrant in one or more of the classes listed
in United States Code, title 8, section 1101(a)(15)new text begin (A)-(S) and (V)new text end , or an undocumented
immigrant who resides in the United States without the approval or acquiescence of the
United States Citizenship and Immigration Services, is not eligible for MFIP.

new text begin EFFECTIVE DATE.new text end

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

Sec. 45.

Minnesota Statutes 2022, section 256J.21, subdivision 3, is amended to read:

Subd. 3.

Initial income test.

new text begin (a) new text end The agency shall determine initial eligibility by
considering all earned and unearned income as defined in section 256P.06. To be eligible
for MFIP, the assistance unit's countable income minus the earned income disregards in
paragraph (a) and section 256P.03 must be below the family wage level according to section
256J.24, subdivision 7, for that size assistance unit.

deleted text begin (a)deleted text end new text begin (b)new text end The initial eligibility determination must disregard the following items:

(1) the earned income disregard as determined in section 256P.03;

(2) dependent care costs must be deducted from gross earned income for the actual
amount paid for dependent care up to a maximum of $200 per month for each child less
than two years of age, and $175 per month for each child two years of age and older;

(3) all payments made according to a court order for spousal support or the support of
children not living in the assistance unit's household shall be disregarded from the income
of the person with the legal obligation to pay support; and

(4) an allocation for the unmet need of an ineligible spouse or an ineligible child under
the age of 21 for whom the caregiver is financially responsible and who lives with the
caregiver according to section 256J.36.

deleted text begin (b) After initial eligibility is established,deleted text end new text begin (c) The income test is for a six-month period.new text end
The assistance payment calculation is based on deleted text begin the monthly income testdeleted text end new text begin prospective budgeting
according to section 256P.09new text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 46.

Minnesota Statutes 2022, section 256J.21, subdivision 4, is amended to read:

Subd. 4.

deleted text begin Monthlydeleted text end Income test and determination of assistance payment.

deleted text begin The county
agency shall determine ongoing eligibility and the assistance payment amount according
to the monthly income test.deleted text end To be eligible for MFIP, the result of the computations in
paragraphs (a) to (e) new text begin applied to prospective budgeting new text end must be at least $1.

(a) Apply an income disregard as defined in section 256P.03, to gross earnings and
subtract this amount from the family wage level. If the difference is equal to or greater than
the MFIP transitional standard, the assistance payment is equal to the MFIP transitional
standard. If the difference is less than the MFIP transitional standard, the assistance payment
is equal to the difference. The earned income disregard in this paragraph must be deducted
every month there is earned income.

(b) All payments made according to a court order for spousal support or the support of
children not living in the assistance unit's household must be disregarded from the income
of the person with the legal obligation to pay support.

(c) An allocation for the unmet need of an ineligible spouse or an ineligible child under
the age of 21 for whom the caregiver is financially responsible and who lives with the
caregiver must be made according to section 256J.36.

(d) Subtract unearned income dollar for dollar from the MFIP transitional standard to
determine the assistance payment amount.

(e) When income is both earned and unearned, the amount of the assistance payment
must be determined by first treating gross earned income as specified in paragraph (a). After
determining the amount of the assistance payment under paragraph (a), unearned income
must be subtracted from that amount dollar for dollar to determine the assistance payment
amount.

deleted text begin (f) When the monthly income is greater than the MFIP transitional standard after
deductions and the income will only exceed the standard for one month, the county agency
must suspend the assistance payment for the payment month.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 47.

Minnesota Statutes 2022, section 256J.26, subdivision 1, is amended to read:

Subdivision 1.

Person convicted of drug offenses.

(a) An individual who has been
convicted of a felony level drug offense deleted text begin committeddeleted text end during the previous ten years from the
date of application or recertification is subject to the following:

(1) Benefits for the entire assistance unit must be paid in vendor form for shelter and
utilities during any time the applicant is part of the assistance unit.

(2) The convicted applicant or participant deleted text begin shalldeleted text end new text begin maynew text end be subject to random drug testing
deleted text begin as a condition of continued eligibility anddeleted text end new text begin .new text end Following any positive test for an illegal controlled
substance deleted text begin is subject to the following sanctions:deleted text end new text begin , the county must provide information about
substance use disorder treatment programs to the applicant or participant.
new text end

deleted text begin (i) for failing a drug test the first time, the residual amount of the participant's grant after
making vendor payments for shelter and utility costs, if any, must be reduced by an amount
equal to 30 percent of the MFIP standard of need for an assistance unit of the same size.
When a sanction under this subdivision is in effect, the job counselor must attempt to meet
with the person face-to-face. During the face-to-face meeting, the job counselor must explain
the consequences of a subsequent drug test failure and inform the participant of the right to
appeal the sanction under section 256J.40. If a face-to-face meeting is not possible, the
county agency must send the participant a notice of adverse action as provided in section
256J.31, subdivisions 4 and 5, and must include the information required in the face-to-face
meeting; or
deleted text end

deleted text begin (ii) for failing a drug test two times, the participant is permanently disqualified from
receiving MFIP assistance, both the cash and food portions. The assistance unit's MFIP
grant must be reduced by the amount which would have otherwise been made available to
the disqualified participant. Disqualification under this item does not make a participant
ineligible for the Supplemental Nutrition Assistance Program (SNAP). Before a
disqualification under this provision is imposed, the job counselor must attempt to meet
with the participant face-to-face. During the face-to-face meeting, the job counselor must
identify other resources that may be available to the participant to meet the needs of the
family and inform the participant of the right to appeal the disqualification under section
256J.40. If a face-to-face meeting is not possible, the county agency must send the participant
a notice of adverse action as provided in section 256J.31, subdivisions 4 and 5, and must
include the information required in the face-to-face meeting.
deleted text end

deleted text begin (3) A participant who fails a drug test the first time and is under a sanction due to other
MFIP program requirements is considered to have more than one occurrence of
noncompliance and is subject to the applicable level of sanction as specified under section
256J.46, subdivision 1, paragraph (d).
deleted text end

(b) Applicants requesting only SNAP benefits or participants receiving only SNAP
benefits, who have been convicted of a new text begin felony-level new text end drug offense deleted text begin that occurred after July
1, 1997,deleted text end new text begin during the previous ten years from the date of application or recertificationnew text end may,
if otherwise eligible, receive SNAP benefits deleted text begin ifdeleted text end new text begin .new text end The convicted applicant or participant deleted text begin isdeleted text end new text begin
may benew text end subject to random drug testing deleted text begin as a condition of continued eligibilitydeleted text end . Following a
positive test for an illegal controlled substance, the deleted text begin applicant is subject to the following
sanctions:deleted text end new text begin county must provide information about substance use disorder treatment programs
to the applicant or participant.
new text end

deleted text begin (1) for failing a drug test the first time, SNAP benefits shall be reduced by an amount
equal to 30 percent of the applicable SNAP benefit allotment. When a sanction under this
clause is in effect, a job counselor must attempt to meet with the person face-to-face. During
the face-to-face meeting, a job counselor must explain the consequences of a subsequent
drug test failure and inform the participant of the right to appeal the sanction under section
256J.40. If a face-to-face meeting is not possible, a county agency must send the participant
a notice of adverse action as provided in section 256J.31, subdivisions 4 and 5, and must
include the information required in the face-to-face meeting; and
deleted text end

deleted text begin (2) for failing a drug test two times, the participant is permanently disqualified from
receiving SNAP benefits. Before a disqualification under this provision is imposed, a job
counselor must attempt to meet with the participant face-to-face. During the face-to-face
meeting, the job counselor must identify other resources that may be available to the
participant to meet the needs of the family and inform the participant of the right to appeal
the disqualification under section 256J.40. If a face-to-face meeting is not possible, a county
agency must send the participant a notice of adverse action as provided in section 256J.31,
subdivisions 4 and 5, and must include the information required in the face-to-face meeting.
deleted text end

(c) For the purposes of this subdivision, "drug offense" means deleted text begin an offensedeleted text end new text begin a convictionnew text end
that occurred during the previous ten years from the date of application or recertification
of sections 152.021 to 152.025, 152.0261, 152.0262, 152.096, or 152.137. Drug offense
also means a conviction in another jurisdiction of the possession, use, or distribution of a
controlled substance, or conspiracy to commit any of these offenses, if the deleted text begin offensedeleted text end new text begin convictionnew text end
occurred during the previous ten years from the date of application or recertification and
the conviction is a felony offense in that jurisdiction, or in the case of New Jersey, a high
misdemeanor.

new text begin EFFECTIVE DATE.new text end

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

Sec. 48.

Minnesota Statutes 2022, section 256J.33, subdivision 1, is amended to read:

Subdivision 1.

Determination of eligibility.

(a) A county agency must determine MFIP
eligibility prospectively deleted text begin for a payment monthdeleted text end based on deleted text begin retrospectivelydeleted text end assessing income
and the county agency's best estimate of the circumstances that will exist in the payment
month.

(b) deleted text begin Except as described in section 256J.34, subdivision 1, when prospective eligibility
exists,deleted text end A county agency must calculate the amount of the assistance payment using
deleted text begin retrospectivedeleted text end new text begin prospectivenew text end budgeting. To determine MFIP eligibility and the assistance
payment amount, a county agency must apply countable income, described in sections
256P.06 and 256J.37, subdivisions 3 to deleted text begin 10deleted text end new text begin 9new text end , received by members of an assistance unit or
by other persons whose income is counted for the assistance unit, described under sections
256J.37, subdivisions 1 to 2, and 256P.06, subdivision 1.

(c) This income must be applied to the MFIP standard of need or family wage level
subject to this section and sections 256J.34 to 256J.36. Countable income as described in
section 256P.06, subdivision 3, received deleted text begin in a calendar monthdeleted text end must be applied to the needs
of an assistance unit.

new text begin (d) An assistance unit is not eligible when the countable income equals or exceeds the
MFIP standard of need or the family wage level for the assistance unit.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2025, except that the amendment
to paragraph (b) striking "10" and inserting "9" is effective July 1, 2024.
new text end

Sec. 49.

Minnesota Statutes 2022, section 256J.33, subdivision 2, is amended to read:

Subd. 2.

Prospective eligibility.

An agency must determine whether the eligibility
requirements that pertain to an assistance unit, including those in sections 256J.11 to 256J.15
and 256P.02, will be met prospectively for the payment deleted text begin monthdeleted text end new text begin periodnew text end . deleted text begin Except for the
provisions in section 256J.34, subdivision 1,deleted text end The income test will be applied deleted text begin retrospectivelydeleted text end new text begin
prospectivelynew text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 50.

Minnesota Statutes 2022, section 256J.35, is amended to read:

256J.35 AMOUNT OF ASSISTANCE PAYMENT.

Except as provided in paragraphs (a) to deleted text begin (d)deleted text end new text begin (e)new text end , the amount of an assistance payment is
equal to the difference between the MFIP standard of need or the Minnesota family wage
level in section 256J.24 and countable income.

(a) Beginning July 1, 2015, MFIP assistance units are eligible for an MFIP housing
assistance grant of $110 per month, unless:

(1) the housing assistance unit is currently receiving public and assisted rental subsidies
provided through the Department of Housing and Urban Development (HUD) and is subject
to section 256J.37, subdivision 3a; or

(2) the assistance unit is a child-only case under section 256J.88.

(b) new text begin On October 1 of each year, the commissioner shall adjust the MFIP housing assistance
grant in paragraph (a) for inflation based on the CPI-U for the prior calendar year.
new text end

new text begin (c) new text end When MFIP eligibility exists for the month of application, the amount of the assistance
payment for the month of application must be prorated from the date of application or the
date all other eligibility factors are met for that applicant, whichever is later. This provision
applies when an applicant loses at least one day of MFIP eligibility.

deleted text begin (c)deleted text end new text begin (d)new text end MFIP overpayments to an assistance unit must be recouped according to section
256P.08, subdivision 6.

deleted text begin (d)deleted text end new text begin (e)new text end An initial assistance payment must not be made to an applicant who is not eligible
on the date payment is made.

new text begin EFFECTIVE DATE.new text end

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

Sec. 51.

Minnesota Statutes 2022, section 256J.37, subdivision 3, is amended to read:

Subd. 3.

Earned income of wage, salary, and contractual employees.

The agency
must include gross earned income less any disregards in the initial deleted text begin and monthlydeleted text end income
test. Gross earned income received by persons employed on a contractual basis must be
prorated over the period covered by the contract even when payments are received over a
lesser period of time.

new text begin EFFECTIVE DATE.new text end

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

Sec. 52.

Minnesota Statutes 2022, section 256J.37, subdivision 3a, is amended to read:

Subd. 3a.

Rental subsidies; unearned income.

(a) Effective July 1, 2003, the agency
shall count $50 of the value of public and assisted rental subsidies provided through the
Department of Housing and Urban Development (HUD) as unearned income to the cash
portion of the MFIP grant. The full amount of the subsidy must be counted as unearned
income when the subsidy is less than $50. The income from this subsidy shall be budgeted
according to section deleted text begin 256J.34deleted text end new text begin 256P.09new text end .

(b) The provisions of this subdivision shall not apply to an MFIP assistance unit which
includes a participant who is:

(1) age 60 or older;

(2) a caregiver who is suffering from an illness, injury, or incapacity that has been
certified by a qualified professional when the illness, injury, or incapacity is expected to
continue for more than 30 days and severely limits the person's ability to obtain or maintain
suitable employment; or

(3) a caregiver whose presence in the home is required due to the illness or incapacity
of another member in the assistance unit, a relative in the household, or a foster child in the
household when the illness or incapacity and the need for the participant's presence in the
home has been certified by a qualified professional and is expected to continue for more
than 30 days.

(c) The provisions of this subdivision shall not apply to an MFIP assistance unit where
the parental caregiver is an SSI participant.

new text begin EFFECTIVE DATE.new text end

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

Sec. 53.

Minnesota Statutes 2022, section 256J.40, is amended to read:

256J.40 FAIR HEARINGS.

Caregivers receiving a notice of intent to sanction or a notice of adverse action that
includes a sanction, reduction in benefits, suspension of benefits, denial of benefits, or
termination of benefits may request a fair hearing. A request for a fair hearing must be
submitted in writing to the county agency or to the commissioner and must be mailed within
30 days after a participant or former participant receives written notice of the agency's action
or within 90 days when a participant or former participant shows good cause for not
submitting the request within 30 days. A former participant who receives a notice of adverse
action due to an overpayment may appeal the adverse action according to the requirements
in this section. Issues that may be appealed are:

(1) the amount of the assistance payment;

(2) a suspension, reduction, denial, or termination of assistance;

(3) the basis for an overpayment, the calculated amount of an overpayment, and the level
of recoupment;

(4) the eligibility for an assistance payment; and

(5) the use of protective or vendor payments under section 256J.39, subdivision 2, clauses
(1) to (3).

deleted text begin Except for benefits issued under section 256J.95,deleted text end A county agency must not reduce,
suspend, or terminate payment when an aggrieved participant requests a fair hearing prior
to the effective date of the adverse action or within ten days of the mailing of the notice of
adverse action, whichever is later, unless the participant requests in writing not to receive
continued assistance pending a hearing decision. deleted text begin An appeal request cannot extend benefits
for the diversionary work program under section 256J.95 beyond the four-month time limit.deleted text end
Assistance issued pending a fair hearing is subject to recovery under section 256P.08 when
as a result of the fair hearing decision the participant is determined ineligible for assistance
or the amount of the assistance received. A county agency may increase or reduce an
assistance payment while an appeal is pending when the circumstances of the participant
change and are not related to the issue on appeal. The commissioner's order is binding on
a county agency. No additional notice is required to enforce the commissioner's order.

A county agency shall reimburse appellants for reasonable and necessary expenses of
attendance at the hearing, such as child care and transportation costs and for the transportation
expenses of the appellant's witnesses and representatives to and from the hearing. Reasonable
and necessary expenses do not include legal fees. Fair hearings must be conducted at a
reasonable time and date by an impartial human services judge employed by the department.
The hearing may be conducted by telephone or at a site that is readily accessible to persons
with disabilities.

The appellant may introduce new or additional evidence relevant to the issues on appeal.
Recommendations of the human services judge and decisions of the commissioner must be
based on evidence in the hearing record and are not limited to a review of the county agency
action.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 54.

Minnesota Statutes 2022, section 256J.42, subdivision 5, is amended to read:

Subd. 5.

Exemption for certain families.

(a) Any cash assistance received by an
assistance unit does not count toward the 60-month limit on assistance during a month in
which the caregiver is age 60 or older.

(b) From July 1, 1997, until the date MFIP is operative in the caregiver's county of
financial responsibility, any cash assistance received by a caregiver who is complying with
Minnesota Statutes 1996, section 256.73, subdivision 5a, and Minnesota Statutes 1998,
section 256.736, if applicable, does not count toward the 60-month limit on assistance.
Thereafter, any cash assistance received by a minor caregiver who is complying with the
requirements of sections 256J.14 and 256J.54, if applicable, does not count towards the
60-month limit on assistance.

(c) Any diversionary assistance or emergency assistance received prior to July 1, 2003,
does not count toward the 60-month limit.

(d) Any cash assistance received by an 18- or 19-year-old caregiver who is complying
with an employment plan that includes an education option under section 256J.54 does not
count toward the 60-month limit.

(e) Payments provided to meet short-term emergency needs under section 256J.626 deleted text begin and
diversionary work program benefits provided under section 256J.95deleted text end do not count toward
the 60-month time limit.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 55.

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

Subdivision 1.

Eligibility.

(a) To be eligible for a hardship extension, a participant in
an assistance unit subject to the time limit under section 256J.42, subdivision 1, must deleted text begin be in
compliance in the participant's 60th counted month. For purposes of determining eligibility
for a hardship extension, a participant is in compliance in any month that the participant
has not been sanctioned. In order to maintain eligibility for any of the hardship extension
categories a participant shalldeleted text end develop and comply with either an employment plan or a
family stabilization services plan, whichever is appropriate.

(b) If one participant in a two-parent assistance unit is determined to be ineligible for a
hardship extension, the county shall give the assistance unit the option of disqualifying the
ineligible participant from MFIP. In that case, the assistance unit shall be treated as a
one-parent assistance unit.

deleted text begin (c) Prior to denying an extension, the county must review the sanction status and
determine whether the sanction is appropriate or if good cause exists under section 256J.57.
If the sanction was inappropriately applied or the participant is granted a good cause
exception before the end of month 60, the participant shall be considered for an extension.
deleted text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 1, 2026.
new text end

Sec. 56.

Minnesota Statutes 2022, section 256J.425, subdivision 4, is amended to read:

Subd. 4.

Employed participants.

(a) An assistance unit subject to the time limit under
section 256J.42, subdivision 1, is eligible to receive assistance under a hardship extension
if the participant who reached the time limit belongs to:

(1) a one-parent assistance unit in which the participant is participating in work activities
for at least 30 hours per week, of which an average of at least 25 hours per week every
month are spent participating in employment;

(2) a two-parent assistance unit in which the participants are participating in work
activities for at least 55 hours per week, of which an average of at least 45 hours per week
every month are spent participating in employment; or

(3) an assistance unit in which a participant is participating in employment for fewer
hours than those specified in clause (1), and the participant submits verification from a
qualified professional, in a form acceptable to the commissioner, stating that the number
of hours the participant may work is limited due to illness or disability, as long as the
participant is participating in employment for at least the number of hours specified by the
qualified professional. The participant must be following the treatment recommendations
of the qualified professional providing the verification. The commissioner shall develop a
form to be completed and signed by the qualified professional, documenting the diagnosis
and any additional information necessary to document the functional limitations of the
participant that limit work hours. If the participant is part of a two-parent assistance unit,
the other parent must be treated as a one-parent assistance unit for purposes of meeting the
work requirements under this subdivision.

(b) For purposes of this section, employment means:

(1) unsubsidized employment under section 256J.49, subdivision 13, clause (1);

(2) subsidized employment under section 256J.49, subdivision 13, clause (2);

(3) on-the-job training under section 256J.49, subdivision 13, clause (2);

(4) an apprenticeship under section 256J.49, subdivision 13, clause (1);

(5) supported work under section 256J.49, subdivision 13, clause (2);

(6) a combination of clauses (1) to (5); or

(7) child care under section 256J.49, subdivision 13, clause (7), if it is in combination
with paid employment.

(c) If a participant is complying with a child protection plan under chapter 260C, the
number of hours required under the child protection plan count toward the number of hours
required under this subdivision.

(d) The county shall provide the opportunity for subsidized employment to participants
needing that type of employment within available appropriations.

deleted text begin (e) To be eligible for a hardship extension for employed participants under this
subdivision, a participant must be in compliance for at least ten out of the 12 months the
participant received MFIP immediately preceding the participant's 61st month on assistance.
If ten or fewer months of eligibility for TANF assistance remain at the time the participant
from another state applies for assistance, the participant must be in compliance every month.
deleted text end

deleted text begin (f)deleted text end new text begin (e)new text end The employment plan developed under section 256J.521, subdivision 2, for
participants under this subdivision must contain at least the minimum number of hours
specified in paragraph (a) for the purpose of meeting the requirements for an extension
under this subdivision. The job counselor and the participant must sign the employment
plan to indicate agreement between the job counselor and the participant on the contents of
the plan.

deleted text begin (g)deleted text end new text begin (f)new text end Participants who fail to meet the requirements in paragraph (a), withoutnew text begin eligibility
for another hardship extension ornew text end good cause under section 256J.57, shall be deleted text begin sanctioneddeleted text end new text begin
subject to sanctionnew text end or deleted text begin permanently disqualified under subdivision 6. Good cause may only
be granted for that portion of the month for which the good cause reason appliesdeleted text end new text begin case closurenew text end .
Participants must meet all remaining requirements in the approved employment plan or be
subject to sanction or deleted text begin permanent disqualificationdeleted text end new text begin case closurenew text end .

deleted text begin (h)deleted text end new text begin (g)new text end If the noncompliance with an employment plan is due to the involuntary loss of
employment, the participant is exempt from the hourly employment requirement under this
subdivision for one month. Participants must meet all remaining requirements in the approved
employment plan or be subject to sanction or deleted text begin permanent disqualificationdeleted text end new text begin case closure if
ineligible for another hardship extensionnew text end .

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 1, 2026.
new text end

Sec. 57.

Minnesota Statutes 2022, section 256J.425, subdivision 5, is amended to read:

Subd. 5.

Accrual of certain exempt months.

(a) Participants who are not eligible for
assistance under a hardship extension under this section shall be eligible for a hardship
extension for a period of time equal to the number of months that were counted toward the
60-month time limit while the participant was a caregiver with a child or an adult in the
household who meets the disability or medical criteria for home care services under section
256B.0651, subdivision 1, paragraph (c), or a home and community-based waiver services
program under chapter 256B, or meets the criteria for severe emotional disturbance under
section 245.4871, subdivision 6, or for serious and persistent mental illness under section
245.462, subdivision 20, paragraph (c), and who was subject to the requirements in section
256J.561, subdivision 2.

(b) A participant who received MFIP assistance that counted toward the 60-month time
limit while the participant met the state time limit exemption criteria under section 256J.42,
subdivision 4 or 5, is eligible for assistance under a hardship extension for a period of time
equal to the number of months that were counted toward the 60-month time limit while the
participant met the state time limit exemption criteria under section 256J.42, subdivision 4
or 5.

(c) After the accrued months have been exhausted, the county agency must determine
if the assistance unit is eligible for an extension under another extension category in
subdivision 2, 3, or 4.

(d) At the time of the case review, a county agency must explain to the participant the
basis for receiving a hardship extension based on the accrual of exempt months. The
participant must provide documentation necessary to enable the county agency to determine
whether the participant is eligible to receive a hardship extension based on the accrual of
exempt months or authorize a county agency to verify the information.

deleted text begin (e) While receiving extended MFIP assistance under this subdivision, a participant is
subject to the MFIP policies that apply to participants during the first 60 months of MFIP,
unless the participant is a member of a two-parent family in which one parent is extended
under subdivision 3 or 4. For two-parent families in which one parent is extended under
subdivision 3 or 4, the sanction provisions in subdivision 6 shall apply.
deleted text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 1, 2026.
new text end

Sec. 58.

Minnesota Statutes 2022, section 256J.425, subdivision 7, is amended to read:

Subd. 7.

Status of deleted text begin disqualified participantsdeleted text end new text begin closed casesnew text end .

(a) An assistance unit that
deleted text begin is disqualifieddeleted text end new text begin has its case closednew text end under deleted text begin subdivision 6, paragraph (a),deleted text end new text begin section 256J.46new text end may
be approved for MFIP if the participant complies with MFIP program requirements and
demonstrates compliance for up to one month. No assistance shall be paid during this period.

(b) An assistance unit that deleted text begin is disqualifieddeleted text end new text begin has its case closednew text end under deleted text begin subdivision 6,
paragraph (a),deleted text end new text begin section 256J.46new text end and that reapplies under paragraph (a) is subject to sanction
under section 256J.46, subdivision 1, paragraph (c)deleted text begin , clause (1), for a first occurrence of
noncompliance. A subsequent occurrence of noncompliance results in a permanent
disqualificationdeleted text end .

deleted text begin (c) If one participant in a two-parent assistance unit receiving assistance under a hardship
extension under subdivision 3 or 4 is determined to be out of compliance with the
employment and training services requirements under sections 256J.521 to 256J.57, the
county shall give the assistance unit the option of disqualifying the noncompliant participant
from MFIP. In that case, the assistance unit shall be treated as a one-parent assistance unit
for the purposes of meeting the work requirements under subdivision 4. An applicant who
is disqualified from receiving assistance under this paragraph may reapply under paragraph
(a). If a participant is disqualified from MFIP under this subdivision a second time, the
participant is permanently disqualified from MFIP.
deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end Prior to a deleted text begin disqualificationdeleted text end new text begin case closurenew text end under this subdivision, a county agency
must review the participant's case to determine if the employment plan is still appropriate
and attempt to meet with the participant face-to-face. If a face-to-face meeting is not
conducted, the county agency must send the participant a notice of adverse action as provided
in section 256J.31. During the face-to-face meeting, the county agency must:

(1) determine whether the continued noncompliance can be explained and mitigated by
providing a needed preemployment activity, as defined in section 256J.49, subdivision 13,
clause (9);

(2) determine whether the participant qualifies for a good cause exception under section
256J.57;

(3) inform the participant of the family violence waiver criteria and make appropriate
referrals if the waiver is requested;

(4) inform the participant of the participant's sanction status and explain the consequences
of continuing noncompliance;

(5) identify other resources that may be available to the participant to meet the needs of
the family; and

(6) inform the participant of the right to appeal under section 256J.40.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 1, 2026.
new text end

Sec. 59.

Minnesota Statutes 2022, section 256J.46, subdivision 1, is amended to read:

Subdivision 1.

Participants not complying with program requirements.

(a) A
participant who fails without good cause under section 256J.57 to comply with the
requirements deleted text begin of this chapterdeleted text end new text begin for orientation under section 256J.45, or employment and
training services under sections 256J.515 to 256J.57new text end , and who is not subject to a sanction
under subdivision 2, shall be subject to a sanctionnew text begin or case closurenew text end as provided in this
deleted text begin subdivisiondeleted text end new text begin sectionnew text end . new text begin Good cause may only be granted for the month for which the good
cause reason applies. new text end Prior to the imposition of a sanction, a county agency shall provide a
notice of intent to sanction under section 256J.57, subdivision 2, and, when applicable, a
notice of adverse action as provided in section 256J.31new text begin , subdivision 5new text end .

(b) A sanction under this subdivision becomes effective the month following the month
in which a required notice is given. A sanction must not be imposed when a participant
comes into compliance deleted text begin with the requirements for orientation under section 256J.45deleted text end prior to
the effective date of the sanction. deleted text begin A sanction must not be imposed when a participant comes
into compliance with the requirements for employment and training services under sections
256J.515 to 256J.57 ten days prior to the effective date of the sanction.deleted text end For purposes of this
subdivision, each month that a participant fails to comply with a requirement of this chapter
shall be considered a separate occurrence of noncompliance. If both participants in a
two-parent assistance unit are out of compliance at the same time, it is considered one
occurrence of noncompliance.

deleted text begin (1) For the first occurrence of noncompliance by a participant in an assistance unit, the
assistance unit's grant shall be reduced by ten percent of the MFIP standard of need for an
assistance unit of the same size with the residual grant paid to the participant. The reduction
in the grant amount must be in effect for a minimum of one month and shall be removed in
the month following the month that the participant returns to compliance.
deleted text end

deleted text begin (2)deleted text end for deleted text begin adeleted text end new text begin the first,new text end second, third, fourth, fifth, or sixth new text begin consecutive new text end occurrence of
noncompliance by a participant in an assistance unitdeleted text begin , the assistance unit's shelter costs shall
be vendor paid up to the amount of the cash portion of the MFIP grant for which the
assistance unit is eligible. At county option, the assistance unit's utilities may also be vendor
paid up to the amount of the cash portion of the MFIP grant remaining after vendor payment
of the assistance unit's shelter costs. The residual amount of the grant after vendor payment,
if any, must be reduced by an amountdeleted text end new text begin arenew text end equal to deleted text begin 30deleted text end new text begin a reduction of fivenew text end percent of the new text begin cash
portion of the new text end MFIP deleted text begin standard of need for andeleted text end new text begin grant received by thenew text end assistance unit deleted text begin of the
same size before the residual grant is paid to the assistance unitdeleted text end . The reduction in the grant
amount must be in effect for a minimum of one month and shall be removed in the month
following the month that the participant in a one-parent assistance unit returns to compliancenew text begin ,
unless the requirements in paragraph (h) are metnew text end . In a two-parent assistance unit, the grant
reduction must be in effect for a minimum of one month and shall be removed in the month
following the month both participants return to compliancenew text begin , unless the requirements in
paragraph (h) are metnew text end . deleted text begin The vendor payment of shelter costs and, if applicable, utilities shall
be removed six months after the month in which the participant or participants return to
compliance.deleted text end new text begin When an assistance unit comes into compliance with the requirements in section
256.741, or shows good cause under section 256.741, subdivision 10, or 256J.57, the sanction
occurrences for that assistance unit shall be equal to zero sanctions.new text end If an assistance unit is
sanctioned under this clause, the participant's case file must be reviewed to determine if the
employment plan is still appropriate.

(d) For a seventh new text begin consecutive new text end occurrence of noncompliance by a participant in an
assistance unit, deleted text begin or when the participants in a two-parent assistance unit have a total of seven
occurrences of noncompliance,deleted text end the county agency shall close the MFIP assistance unit's
financial assistance case, deleted text begin bothdeleted text end new text begin includingnew text end the cash and food portions, and redetermine the
family's deleted text begin continueddeleted text end eligibility for Supplemental Nutrition Assistance Program (SNAP)
payments. The MFIP case must remain closed for a minimum of one full month. Before the
case is closed, the county agency must review the participant's case to determine if the
employment plan is still appropriate and attempt to meet with the participant face-to-face.
The participant may bring an advocate to the face-to-face meeting. If a face-to-face meeting
is not conducted, the county agency must send the participant a written notice that includes
the information required under clause (1).

(1) During the face-to-face meeting, the county agency must:

(i) determine whether the continued noncompliance can be explained and mitigated by
providing a needed preemployment activity, as defined in section 256J.49, subdivision 13,
clause (9);

(ii) determine whether the participant qualifies for a good cause exception under section
256J.57, or if the sanction is for noncooperation with child support requirements, determine
if the participant qualifies for a good cause exemption under section 256.741, subdivision
10;

(iii) determine whether the work activities in the employment plan are appropriate based
on the criteria in section 256J.521, subdivision 2 or 3;

(iv) determine whether the participant qualifies for the family violence waiver;

(v) inform the participant of the participant's sanction status and explain the consequences
of continuing noncompliance;

(vi) identify other resources that may be available to the participant to meet the needs
of the family; and

(vii) inform the participant of the right to appeal under section 256J.40.

(2) If the lack of an identified activity or service can explain the noncompliance, the
county must work with the participant to provide the identified activity.

(3) The grant must be restored to the full amount for which the assistance unit is eligible
retroactively to the first day of the month in which the participant was found to lack
preemployment activities or to qualify for a family violence waiver or for a good cause
exemption under section 256.741, subdivision 10, or 256J.57.

(e) For the purpose of applying sanctions under this section, only new text begin consecutive new text end occurrences
of noncompliance that occur deleted text begin after July 1, 2003deleted text end new text begin on or after May 1, 2026new text end , shall be considerednew text begin
when counting the number of sanction occurrences under this subdivision. Active cases
under sanction on May 1, 2026, shall be considered to have one sanction occurrencenew text end . If the
participant deleted text begin is in 30 percent sanction in the month this section takes effect, that month counts
as the first occurrence for purposes of applying the sanctions under this section, but the
sanction shall remain at 30 percent for that monthdeleted text end new text begin comes into compliance, the assistance
unit is considered to have zero sanctionsnew text end .

(f) An assistance unit whose case is closed under paragraph (d) or (g), may reapply for
MFIPnew text begin using a form prescribed by the commissionernew text end and shall be eligible if the participant
complies with MFIP program requirements and demonstrates compliance for up to one
month. No assistance shall be paid during this period.new text begin The county agency shall not start a
new certification period for a participant who has submitted the reapplication form within
30 calendar days of case closure. The county agency must process the form according to
section 256P.04, except that the county agency shall not require additional verification of
information in the case file unless the information is inaccurate, questionable, or no longer
current. If a participant does not reapply for MFIP within 30 calendar days of case closure,
a new application must be completed.
new text end

(g) An assistance unit whose case has been closed for noncompliancedeleted text begin ,deleted text end that reapplies
under paragraph (f)deleted text begin ,deleted text end is subject to sanction under paragraph (c)deleted text begin , clause (2), for a first
occurrence of noncompliance. Any subsequent occurrence of noncompliance shall result
indeleted text end new text begin andnew text end case closure under paragraph (d).

new text begin (h) If an assistance unit is in compliance by the 15th of the month in which the assistance
unit has a sanction imposed, the reduction to the assistance unit's cash grant shall be restored
retroactively for the current month and the sanction occurrences shall be equal to zero.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 1, 2026.
new text end

Sec. 60.

Minnesota Statutes 2022, section 256J.46, subdivision 2, is amended to read:

Subd. 2.

Sanctions for refusal to cooperate with support requirements.

The grant of
an MFIP caregiver who refuses to cooperate, as determined by the child support enforcement
agency, with support requirements under section 256.741, shall be subject to sanction as
specified in this subdivision and subdivision 1deleted text begin . For a first occurrence of noncooperation,
the assistance unit's grant must be reduced by 30 percent of the applicable MFIP standard
of need. Subsequent occurrences of noncooperation shall be subject to sanction under
subdivision 1, paragraphs (c), clause (2), and (d).deleted text end new text begin , paragraphs (b) to (h), except the assistance
unit's cash portion of the grant must be reduced by 25 percent of the MFIP cash received
by the assistance unit.new text end The residual amount of the grant, if any, must be paid to the caregiver.
A sanction under this subdivision becomes effective the first month following the month
in which a required notice is given. A sanction must not be imposed when a caregiver comes
into compliance with the requirements under section 256.741 prior to the effective date of
the sanction. The sanction shall be removed in the month following the month that the
caregiver cooperates with the support requirementsnew text begin , unless the requirements in subdivision
1, paragraph (h), are metnew text end . Each month that an MFIP caregiver fails to comply with the
requirements of section 256.741 must be considered a separate occurrence of noncompliance
for the purpose of applying sanctions under subdivision 1, paragraphs (c)deleted text begin , clause (2),deleted text end and
(d).

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 1, 2026.
new text end

Sec. 61.

Minnesota Statutes 2022, section 256J.46, subdivision 2a, is amended to read:

Subd. 2a.

Dual sanctions.

(a) Notwithstanding the provisions of subdivisions 1 and 2,
for a participant subject to a sanction for refusal to comply with child support requirements
under subdivision 2 and subject to a concurrent sanction for refusal to cooperate with other
program requirements under subdivision 1, sanctions shall be imposed in the manner
prescribed in this subdivision.

deleted text begin Any vendor payment of shelter costs or utilities under this subdivision must remain in
effect for six months after the month in which the participant is no longer subject to sanction
under subdivision 1.
deleted text end

deleted text begin (b) If the participant was subject to sanction for:
deleted text end

deleted text begin (1) noncompliance under subdivision 1 before being subject to sanction for
noncooperation under subdivision 2; or
deleted text end

deleted text begin (2) noncooperation under subdivision 2 before being subject to sanction for
noncompliance under subdivision 1, the participant is considered to have a second occurrence
of noncompliance and shall be sanctioned as provided in subdivision 1, paragraph (c), clause
(2). Each subsequent occurrence of noncompliance shall be considered one additional
occurrence and shall be subject to the applicable level of sanction under subdivision 1. The
requirement that the county conduct a review as specified in subdivision 1, paragraph (d),
remains in effect.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end A participant who deleted text begin firstdeleted text end becomes subject to sanction under both subdivisions 1
and 2 in the same month is subject to sanction as follows:

(1) in the first month of noncompliance and noncooperation, the participant'snew text begin cash portion
of thenew text end grant must be reduced by deleted text begin 30deleted text end new text begin 25new text end percent of the deleted text begin applicabledeleted text end MFIP deleted text begin standard of needdeleted text end new text begin cash
received by the assistance unitnew text end , with any residual amount paid to the participant;

(2) in the second and subsequent months of noncompliance and noncooperation, the
participant shall be subject to the applicable level of sanction under subdivision deleted text begin 1deleted text end new text begin 2new text end .

The requirement that the county conduct a review as specified in subdivision 1, paragraph
(d), remains in effect.

deleted text begin (d)deleted text end new text begin (c)new text end A participant remains subject to sanction under subdivision 2 if the participant:

(1) returns to compliance and is no longer subject to sanction for noncompliance with
section 256J.45 or sections 256J.515 to 256J.57; or

(2) has the sanction for noncompliance with section 256J.45 or sections 256J.515 to
256J.57 removed upon completion of the review under subdivision 1, paragraph deleted text begin (e)deleted text end new text begin (d)new text end .

A participant remains subject to the applicable level of sanction under subdivision 1 if
the participant cooperates and is no longer subject to sanction under subdivision 2.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 1, 2026.
new text end

Sec. 62.

Minnesota Statutes 2022, section 256J.49, subdivision 9, is amended to read:

Subd. 9.

Participant.

"Participant" means a recipient of MFIP assistance who participates
or is required to participate in employment and training services under sections 256J.515
to 256J.57 deleted text begin and 256J.95deleted text end .

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 63.

Minnesota Statutes 2022, section 256J.50, subdivision 1, is amended to read:

Subdivision 1.

Employment and training services component of MFIP.

(a) Each
county must develop and provide an employment and training services component which
is designed to put participants on the most direct path to unsubsidized employment.
Participation in these services is mandatory for all MFIP caregivers.

(b) A county must provide employment and training services under sections 256J.515
to 256J.74 within 30 days after the caregiver is determined eligible for MFIPdeleted text begin , or within ten
days when the caregiver participated in the diversionary work program under section 256J.95
within the past 12 monthsdeleted text end .

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 64.

Minnesota Statutes 2022, section 256J.521, subdivision 1, is amended to read:

Subdivision 1.

Assessments.

(a) For purposes of MFIP employment services, assessment
is a continuing process of gathering information related to employability for the purpose of
identifying both participant's strengths and strategies for coping with issues that interfere
with employment. The job counselor must use information from the assessment process to
develop and update the employment plan under subdivision 2 or 3, as appropriate, to
determine whether the participant qualifies for a family violence waiver including an
employment plan under subdivision 3, and to determine whether the participant should be
referred to family stabilization services under section 256J.575.

(b) The scope of assessment must cover at least the following areas:

(1) basic information about the participant's ability to obtain and retain employment,
including: a review of the participant's education level; interests, skills, and abilities; prior
employment or work experience; transferable work skills; child care and transportation
needs;

(2) identification of personal and family circumstances that impact the participant's
ability to obtain and retain employment, including: any special needs of the children, the
level of English proficiency, family violence issues, and any involvement with social services
or the legal system;

(3) the results of a mental and chemical health screening tool designed by the
commissioner and results of the brief screening tool for special learning needs. Screening
tools for mental and chemical health and special learning needs must be approved by the
commissioner and may only be administered by job counselors or county staff trained in
using such screening tools. Participants must be told of the purpose of the screens and how
the information will be used to assist the participant in identifying and overcoming barriers
to employment. Screening for mental and chemical health and special learning needs must
be completed by participants three months after development of the initial employment plan
or earlier if there is a documented need. Failure to complete the screens will result in sanction
under section 256J.46; and

(4) a comprehensive review of participation and progress for participants who have
received MFIP assistance and have not worked in unsubsidized employment during the past
12 months. The purpose of the review is to determine the need for additional services and
supports, including placement in subsidized employment or unpaid work experience under
section 256J.49, subdivision 13, or referral to family stabilization services under section
256J.575.

deleted text begin (c) Information gathered during a caregiver's participation in the diversionary work
program under section 256J.95 must be incorporated into the assessment process.
deleted text end

deleted text begin (d)deleted text end new text begin (c)new text end The job counselor may require the participant to complete a professional chemical
use assessment to be performed according to the rules adopted under section 254A.03,
subdivision 3, including provisions in the administrative rules which recognize the cultural
background of the participant, or a professional psychological assessment as a component
of the assessment process, when the job counselor has a reasonable belief, based on objective
evidence, that a participant's ability to obtain and retain suitable employment is impaired
by a medical condition. The job counselor may assist the participant with arranging services,
including child care assistance and transportation, necessary to meet needs identified by the
assessment. Data gathered as part of a professional assessment must be classified and
disclosed according to the provisions in section 13.46.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 65.

Minnesota Statutes 2022, section 256J.621, subdivision 1, is amended to read:

Subdivision 1.

Program characteristics.

(a) Within 30 days of exiting the Minnesota
family investment program with earnings, the county must assess eligibility for work
participation cash benefits of $25 per month to assist in meeting the family's basic needs as
the participant continues to move toward self-sufficiency. Payment begins effective the first
of the month following exit or termination for MFIP deleted text begin and DWPdeleted text end participants.

(b) To be eligible for work participation cash benefits, the participant shall not receive
MFIP deleted text begin or diversionary work programdeleted text end assistance during the month and the participant or
participants must meet the following work requirements:

(1) if the participant is a single caregiver and has a child under six years of age, the
participant must be employed at least 87 hours per month;

(2) if the participant is a single caregiver and does not have a child under six years of
age, the participant must be employed at least 130 hours per month; or

(3) if the household is a two-parent family, at least one of the parents must be employed
130 hours per month.

Whenever a participant deleted text begin exits the diversionary work program ordeleted text end is terminated from MFIP
and meets the other criteria in this section, work participation cash benefits are available
for up to 24 consecutive months.

(c) Expenditures on the program are maintenance of effort state funds under a separate
state program for participants under paragraph (b), clauses (1) and (2). Expenditures for
participants under paragraph (b), clause (3), are nonmaintenance of effort funds. Months in
which a participant receives work participation cash benefits under this section do not count
toward the participant's MFIP 60-month time limit.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 66.

Minnesota Statutes 2022, section 256J.626, subdivision 2, is amended to read:

Subd. 2.

Allowable expenditures.

(a) The commissioner must restrict expenditures
under the consolidated fund to benefits and services allowed under title IV-A of the federal
Social Security Act. Allowable expenditures under the consolidated fund may include, but
are not limited to:

(1) short-term, nonrecurring shelter and utility needs that are excluded from the definition
of assistance under Code of Federal Regulations, title 45, section 260.31, for families who
meet the residency requirement in section 256J.12, subdivisions 1 and 1a. Payments under
this subdivision are not considered TANF cash assistance and are not counted towards the
60-month time limit;

(2) transportation needed to obtain or retain employment or to participate in other
approved work activities or activities under a family stabilization plan;

(3) direct and administrative costs of staff to deliver employment services for MFIPdeleted text begin , the
diversionary work program,deleted text end or family stabilization services; to administer financial assistance;
and to provide specialized services intended to assist hard-to-employ participants to transition
to work or transition from family stabilization services to MFIP;

(4) costs of education and training including functional work literacy and English as a
second language;

(5) cost of work supports including tools, clothing, boots, telephone service, and other
work-related expenses;

(6) county administrative expenses as defined in Code of Federal Regulations, title 45,
section 260(b);

(7) services to parenting and pregnant teens;

(8) supported work;

(9) wage subsidies;

(10) child care needed for MFIPdeleted text begin , the diversionary work program,deleted text end or family stabilization
services participants to participate in social services;

(11) child care to ensure that families leaving MFIP deleted text begin or diversionary work programdeleted text end will
continue to receive child care assistance from the time the family no longer qualifies for
transition year child care until an opening occurs under the basic sliding fee child care
program;

(12) services to help noncustodial parents who live in Minnesota and have minor children
receiving MFIP deleted text begin or DWPdeleted text end assistance, but do not live in the same household as the child,
obtain or retain employment; and

(13) services to help families participating in family stabilization services achieve the
greatest possible degree of self-sufficiency.

(b) Administrative costs that are not matched with county funds as provided in subdivision
8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation under this
section. The commissioner shall define administrative costs for purposes of this subdivision.

(c) The commissioner may waive the cap on administrative costs for a county or tribe
that elects to provide an approved supported employment, unpaid work, or community work
experience program for a major segment of the county's or tribe's MFIP population. The
county or tribe must apply for the waiver on forms provided by the commissioner. In no
case shall total administrative costs exceed the TANF limits.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 67.

Minnesota Statutes 2022, section 256J.626, subdivision 3, is amended to read:

Subd. 3.

Eligibility for services.

Families with a minor child, a pregnant woman, or a
noncustodial parent of a minor child receiving assistance, with incomes below 200 percent
of the federal poverty guideline for a family of the applicable size, are eligible for services
funded under the consolidated fund. Counties and tribes must give priority to families
currently receiving MFIPdeleted text begin , the diversionary work program,deleted text end or family stabilization servicesdeleted text begin ,deleted text end
and families at risk of receiving MFIP deleted text begin or diversionary work programdeleted text end . A county or tribe
shall not impose a residency requirement on families, except for the residency requirement
under section 256J.12.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 68.

Minnesota Statutes 2022, section 256J.751, subdivision 2, is amended to read:

Subd. 2.

Quarterly comparison report.

(a) The commissioner shall report quarterly to
all counties on each county's performance on the following measures:

(1) percent of MFIP caseload working in paid employment;

(2) percent of MFIP caseload receiving only the food portion of assistance;

(3) number of MFIP cases that have left assistance;

(4) median placement wage rate;

(5) caseload by months of TANF assistance;

(6) percent of MFIP deleted text begin and diversionary work program (DWP)deleted text end cases off cash assistance
or working 30 or more hours per week at one-year, two-year, and three-year follow-up
points from a baseline quarter. This measure is called the self-support index. The
commissioner shall report quarterly an expected range of performance for each county,
county grouping, and tribe on the self-support index. The expected range shall be derived
by a statistical methodology developed by the commissioner in consultation with the counties
and tribes. The statistical methodology shall control differences across counties in economic
conditions and demographics of the MFIP deleted text begin and DWPdeleted text end case load; and

(7) the TANF work participation rate, defined as the participation requirements specified
under Public Law 109-171, the Deficit Reduction Act of 2005.

(b) The commissioner shall not apply the limits on vocational educational training and
education activities under Code of Federal Regulations, title 45, section 261.33(c), when
determining TANF work participation rates for individual counties under this subdivision.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 69.

Minnesota Statutes 2022, section 256P.01, is amended by adding a subdivision
to read:

new text begin Subd. 2b.new text end

new text begin Census income.new text end

new text begin "Census income" means income earned working as a census
enumerator or decennial census worker responsible for recording the housing units and
residents in a specific geographic area.
new text end

Sec. 70.

Minnesota Statutes 2022, section 256P.01, is amended by adding a subdivision
to read:

new text begin Subd. 5a.new text end

new text begin Lived-experience engagement.new text end

new text begin "Lived-experience engagement" means an
intentional engagement of people with lived experience by a federal, Tribal, state, county,
municipal, or nonprofit human services agency funded in part or in whole by federal, state,
local government, Tribal Nation, public, private, or philanthropic money to gather and share
feedback on the impact of human services programs.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 71.

Minnesota Statutes 2022, section 256P.01, is amended by adding a subdivision
to read:

new text begin Subd. 9.new text end

new text begin Prospective budgeting.new text end

new text begin "Prospective budgeting" means estimating the amount
of monthly income that an assistance unit will have in the payment month.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 72.

Minnesota Statutes 2022, section 256P.02, subdivision 1a, is amended to read:

Subd. 1a.

Exemption.

Participants who qualify for child care assistance programs under
chapter 119B are exempt from this section, except that the personal property identified in
subdivision 2 is counted toward the asset limit of the child care assistance program under
chapter 119B.new text begin Census income is not counted toward the asset limit of the child care assistance
program under chapter 119B.
new text end

Sec. 73.

Minnesota Statutes 2022, section 256P.02, subdivision 2, is amended to read:

Subd. 2.

Personal property limitations.

The equity value of an assistance unit's personal
property listed in clauses (1) to (5) must not exceed $10,000 for applicants and participants.
For purposes of this subdivision, personal property is limited to:

(1) cashnew text begin not excluded under subdivisions 4 and 6new text end ;

(2) bank accountsnew text begin not excluded under subdivision 5new text end ;

(3) liquid stocks and bonds that can be readily accessed without a financial penalty;

(4) vehicles not excluded under subdivision 3; and

(5) the full value of business accounts used to pay expenses not related to the business.

new text begin EFFECTIVE DATE.new text end

new text begin The amendment to clause (1) referencing subdivision 4 is effective
August 1, 2023.
new text end

Sec. 74.

Minnesota Statutes 2022, section 256P.02, is amended by adding a subdivision
to read:

new text begin Subd. 4.new text end

new text begin Health and human services recipient engagement income.new text end

new text begin Income received
from lived-experience engagement, as defined in section 256P.01, subdivision 5a, shall be
excluded when determining the equity value of personal property.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 75.

Minnesota Statutes 2022, section 256P.02, is amended by adding a subdivision
to read:

new text begin Subd. 5.new text end

new text begin Account exception.new text end

new text begin Family asset accounts under section 256E.35 and individual
development accounts authorized under the Assets for Independence Act, Title IV of the
Community Opportunities, Accountability, and Training and Educational Services Human
Services Reauthorization Act of 1998, Public Law 105-285, shall be excluded when
determining the equity value of personal property.
new text end

Sec. 76.

Minnesota Statutes 2022, section 256P.02, is amended by adding a subdivision
to read:

new text begin Subd. 6.new text end

new text begin Census income.new text end

new text begin Census income is excluded when determining the equity value
of personal property.
new text end

Sec. 77.

Minnesota Statutes 2022, section 256P.04, subdivision 4, is amended to read:

Subd. 4.

Factors to be verified.

(a) The agency shall verify the following at application:

(1) identity of adults;

(2) age, if necessary to determine eligibility;

(3) immigration status;

(4) income;

(5) spousal support and child support payments made to persons outside the household;

(6) vehicles;

(7) checking and savings accounts, including but not limited to any business accounts
used to pay expenses not related to the business;

(8) inconsistent information, if related to eligibility;

(9) residence;new text begin and
new text end

(10) Social Security numberdeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (11) use of nonrecurring income under section 256P.06, subdivision 3, clause (2), item
(ix), for the intended purpose for which it was given and received.
deleted text end

(b) Applicants who are qualified noncitizens and victims of domestic violence as defined
under section 256J.08, subdivision 73, clauses (8) and (9), are not required to verify the
information in paragraph (a), clause (10). When a Social Security number is not provided
to the agency for verification, this requirement is satisfied when each member of the
assistance unit cooperates with the procedures for verification of Social Security numbers,
issuance of duplicate cards, and issuance of new numbers which have been established
jointly between the Social Security Administration and the commissioner.

new text begin EFFECTIVE DATE.new text end

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

Sec. 78.

Minnesota Statutes 2022, section 256P.04, subdivision 8, is amended to read:

Subd. 8.

Recertification.

The agency shall recertify eligibility annually. During
recertificationnew text begin and reporting under section 256P.10new text end , the agency shall verify the following:

(1) income, unless excluded, including self-employment earnings;

(2) assets when the value is within $200 of the asset limit; and

(3) inconsistent information, if related to eligibility.

new text begin EFFECTIVE DATE.new text end

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

Sec. 79.

Minnesota Statutes 2022, section 256P.06, subdivision 3, is amended to read:

Subd. 3.

Income inclusions.

The following must be included in determining the income
of an assistance unit:

(1) earned income; and

(2) unearned income, which includes:

(i) interest and dividends from investments and savings;

(ii) capital gains as defined by the Internal Revenue Service from any sale of real property;

(iii) proceeds from rent and contract for deed payments in excess of the principal and
interest portion owed on property;

(iv) income from trusts, excluding special needs and supplemental needs trusts;

(v) interest income from loans made by the participant or household;

(vi) cash prizes and winnings;

(vii) unemployment insurance income that is received by an adult member of the
assistance unit unless the individual receiving unemployment insurance income is:

(A) 18 years of age and enrolled in a secondary school; or

(B) 18 or 19 years of age, a caregiver, and is enrolled in school at least half-time;

(viii) new text begin for the purposes of programs under chapters 256D and 256I, new text end retirement, survivors,
and disability insurance payments;

(ix) deleted text begin nonrecurring income over $60 per quarter unless the nonrecurring income is: (A)
from tax refunds, tax rebates, or tax credits; (B) a reimbursement, rebate, award, grant, or
refund of personal or real property or costs or losses incurred when these payments are
made by: a public agency; a court; solicitations through public appeal; a federal, state, or
local unit of government; or a disaster assistance organization; (C) provided as an in-kind
benefit; or (D) earmarked and used for the purpose for which it was intended, subject to
verification requirements under section ;
deleted text end

deleted text begin (x)deleted text end retirement benefits;

deleted text begin (xi)deleted text end new text begin (x)new text end cash assistance benefits, as defined by each program in chapters 119B, 256D,
256I, and 256J;

deleted text begin (xii) Tribal per capita payments unless excluded by federal and state law;
deleted text end

deleted text begin (xiii)deleted text end new text begin (xi)new text end income from members of the United States armed forces unless excluded from
income taxes according to federal or state law;

deleted text begin (xiv)deleted text end new text begin (xii) for the purposes of programs under chapters 119B, 256D, and 256I, new text end all child
support payments deleted text begin for programs under chapters 119B, 256D, and 256Ideleted text end ;

deleted text begin (xv)deleted text end new text begin (xiii) for the purposes of programs under chapter 256J, new text end the amount of child support
received that exceeds $100 for assistance units with one child and $200 for assistance units
with two or more children deleted text begin for programs under chapter 256Jdeleted text end ;

deleted text begin (xvi)deleted text end new text begin (xiv)new text end spousal support; deleted text begin and
deleted text end

deleted text begin (xvii)deleted text end new text begin (xv)new text end workers' compensationdeleted text begin .deleted text end new text begin ; and
new text end

new text begin (xvi) for the purposes of programs under chapters 119B and 256J, the amount of
retirement, survivors, and disability insurance payments that exceeds the applicable monthly
federal maximum Supplemental Security Income payments.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective September 1, 2024, except the removal
of item (ix) related to nonrecurring income is effective July 1, 2024, and the removal of
item (xii) related to Tribal per capita payments are effective January 1, 2024.
new text end

Sec. 80.

Minnesota Statutes 2022, section 256P.06, is amended by adding a subdivision
to read:

new text begin Subd. 4.new text end

new text begin Recipient engagement income.new text end

new text begin Income received from lived-experience
engagement, as defined in section 256P.01, subdivision 5a, must not be counted as income
for purposes of determining or redetermining eligibility or benefits.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 81.

Minnesota Statutes 2022, section 256P.06, is amended by adding a subdivision
to read:

new text begin Subd. 5.new text end

new text begin Census income.new text end

new text begin Census income does not count as income for purposes of
determining or redetermining eligibility or benefits.
new text end

Sec. 82.

Minnesota Statutes 2022, section 256P.07, subdivision 1, is amended to read:

Subdivision 1.

Exempted programs.

Participants who new text begin receive Supplemental Security
Income and new text end qualify for Minnesota supplemental aid under chapter 256D deleted text begin anddeleted text end new text begin ornew text end for housing
support under chapter 256I deleted text begin on the basis of eligibility for Supplemental Security Incomedeleted text end are
exempt from deleted text begin this sectiondeleted text end new text begin reporting income under this chapternew text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 83.

Minnesota Statutes 2022, section 256P.07, is amended by adding a subdivision
to read:

new text begin Subd. 1a.new text end

new text begin Child care assistance programs.new text end

new text begin Participants who qualify for child care
assistance programs under chapter 119B are exempt from this section except the reporting
requirements in subdivision 6.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 84.

Minnesota Statutes 2022, section 256P.07, subdivision 2, is amended to read:

Subd. 2.

Reporting requirements.

An applicant or participant must provide information
on an application and any subsequent reporting forms about the assistance unit's
circumstances that affect eligibility or benefits. An applicant or assistance unit must report
changes new text begin that affect eligibility or benefits as new text end identified in deleted text begin subdivisiondeleted text end new text begin subdivisionsnew text end 3new text begin , 4, 5,
7, 8, and 9 during the application period or by the tenth of the month following the month
that the assistance unit's circumstances changednew text end . When information is not accurately reported,
both an overpayment and a referral for a fraud investigation may result. When information
or documentation is not provided, the receipt of any benefit may be delayed or denied,
depending on the type of information required and its effect on eligibility.

new text begin EFFECTIVE DATE.new text end

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

Sec. 85.

Minnesota Statutes 2022, section 256P.07, subdivision 3, is amended to read:

Subd. 3.

Changes that must be reported.

deleted text begin An assistance unit must report the changes
or anticipated changes specified in clauses (1) to (12) within ten days of the date they occur,
at the time of recertification of eligibility under section 256P.04, subdivisions 8 and 9, or
within eight calendar days of a reporting period, whichever occurs first. An assistance unit
must report other changes at the time of recertification of eligibility under section 256P.04,
subdivisions 8 and 9, or at the end of a reporting period, as applicable. When an agency
could have reduced or terminated assistance for one or more payment months if a delay in
reporting a change specified under clauses (1) to (12) had not occurred, the agency must
determine whether a timely notice could have been issued on the day that the change
occurred. When a timely notice could have been issued, each month's overpayment
subsequent to that notice must be considered a client error overpayment under section
119B.11, subdivision 2a, or 256P.08. Changes in circumstances that must be reported within
ten days must also be reported for the reporting period in which those changes occurred.
Within ten days, an assistance unit must report:
deleted text end

deleted text begin (1) a change in earned income of $100 per month or greater with the exception of a
program under chapter 119B;
deleted text end

deleted text begin (2) a change in unearned income of $50 per month or greater with the exception of a
program under chapter 119B;
deleted text end

deleted text begin (3) a change in employment status and hours with the exception of a program under
chapter 119B;
deleted text end

deleted text begin (4) a change in address or residence;
deleted text end

deleted text begin (5) a change in household composition with the exception of programs under chapter
256I;
deleted text end

deleted text begin (6) a receipt of a lump-sum payment with the exception of a program under chapter
119B;
deleted text end

deleted text begin (7) an increase in assets if over $9,000 with the exception of programs under chapter
119B;
deleted text end

deleted text begin (8) a change in citizenship or immigration status;
deleted text end

deleted text begin (9) a change in family status with the exception of programs under chapter 256I;
deleted text end

deleted text begin (10) a change in disability status of a unit member, with the exception of programs under
chapter 119B;
deleted text end

deleted text begin (11) a new rent subsidy or a change in rent subsidy with the exception of a program
under chapter 119B; and
deleted text end

deleted text begin (12) a sale, purchase, or transfer of real property with the exception of a program under
chapter 119B.
deleted text end

new text begin (a) An assistance unit must report changes or anticipated changes as described in this
section.
new text end

new text begin (b) An assistance unit must report:
new text end

new text begin (1) a change in eligibility for Supplemental Security Income, Retirement Survivors
Disability Insurance, or another federal income support;
new text end

new text begin (2) a change in address or residence;
new text end

new text begin (3) a change in household composition with the exception of programs under chapter
256I;
new text end

new text begin (4) cash prizes and winnings according to guidance provided for the Supplemental
Nutrition Assistance Program;
new text end

new text begin (5) a change in citizenship or immigration status;
new text end

new text begin (6) a change in family status with the exception of programs under chapter 256I; and
new text end

new text begin (7) a change that makes the value of the assistance unit's assets at or above the asset
limit.
new text end

new text begin (c) When an agency could have reduced or terminated assistance for one or more payment
months if a delay in reporting a change specified under paragraph (b) had not occurred, the
agency must determine whether the agency could have issued a timely notice on the day
that the change occurred. When a timely notice could have been issued, each month's
overpayment subsequent to the notice must be considered a client error overpayment under
section 256P.08.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2025, except that the amendment
striking clause (6) is effective July 1, 2024.
new text end

Sec. 86.

Minnesota Statutes 2022, section 256P.07, subdivision 4, is amended to read:

Subd. 4.

MFIP-specific reporting.

In addition to subdivision 3, an assistance unit under
chapter 256Jdeleted text begin , within ten days of the change,deleted text end must report:

(1) a pregnancy not resulting in birth when there are no other minor children; deleted text begin and
deleted text end

(2) a change in school attendance of a parent under 20 years of age deleted text begin or of an employed
child.deleted text end new text begin ; and
new text end

new text begin (3) an individual in the household who is 18 or 19 years of age attending high school
who graduates or drops out of school.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 87.

Minnesota Statutes 2022, section 256P.07, subdivision 6, is amended to read:

Subd. 6.

Child care assistance programs-specific reporting.

(a) deleted text begin In addition to
subdivision 3,deleted text end An assistance unit under chapter 119B, within ten days of the change, must
report:

(1) a change in a parentally responsible individual's custody schedule for any child
receiving child care assistance program benefits;

(2) a permanent end in a parentally responsible individual's authorized activity; deleted text begin and
deleted text end

(3) if the unit's family's annual included income exceeds 85 percent of the state median
income, adjusted for family sizedeleted text begin .deleted text end new text begin ;
new text end

new text begin (4) a change in address or residence;
new text end

new text begin (5) a change in household composition;
new text end

new text begin (6) a change in citizenship or immigration status; and
new text end

new text begin (7) a change in family status.
new text end

(b) An assistance unit subject to section 119B.095, subdivision 1, paragraph (b), must
report a change in the unit's authorized activity status.

(c) An assistance unit must notify the county when the unit wants to reduce the number
of authorized hours for children in the unit.

new text begin EFFECTIVE DATE.new text end

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

Sec. 88.

Minnesota Statutes 2022, section 256P.07, subdivision 7, is amended to read:

Subd. 7.

Minnesota supplemental aid-specific reporting.

new text begin (a) new text end In addition to subdivision
3, an assistance unit participating in the Minnesota supplemental aid program under deleted text begin section
256D.44, subdivision 5, paragraph (g), within ten days of the change,deleted text end new text begin chapter 256D and not
receiving Supplemental Security Incomenew text end must report deleted text begin shelter expenses.deleted text end new text begin :
new text end

new text begin (1) a change in unearned income of $50 per month or greater; and
new text end

new text begin (2) a change in earned income of $100 per month or greater.
new text end

new text begin (b) An assistance unit receiving housing assistance under section 256D.44, subdivision
5, paragraph (g), including an assistance unit that also receives Supplemental Security
Income, must report:
new text end

new text begin (1) a change in shelter expenses; and
new text end

new text begin (2) a new rent subsidy or a change in rent subsidy.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 89.

Minnesota Statutes 2022, section 256P.07, is amended by adding a subdivision
to read:

new text begin Subd. 8.new text end

new text begin Housing support-specific reporting.new text end

new text begin (a) In addition to subdivision 3, an
assistance unit participating in the housing support program under chapter 256I and not
receiving Supplemental Security Income must report:
new text end

new text begin (1) a change in unearned income of $50 per month or greater; and
new text end

new text begin (2) a change in earned income of $100 per month or greater, unless the assistance unit
is already subject to six-month reporting requirements in section 256P.10.
new text end

new text begin (b) Notwithstanding the exemptions in subdivisions 1 and 3, an assistance unit receiving
housing support under chapter 256I, including an assistance unit that receives Supplemental
Security Income, must report:
new text end

new text begin (1) a new rent subsidy or a change in rent subsidy;
new text end

new text begin (2) a change in the disability status of a unit member; and
new text end

new text begin (3) a change in household composition if the assistance unit is a participant in housing
support under section 256I.04, subdivision 3, paragraph (a), clause (3).
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 90.

Minnesota Statutes 2022, section 256P.07, is amended by adding a subdivision
to read:

new text begin Subd. 9.new text end

new text begin General assistance-specific reporting.new text end

new text begin In addition to subdivision 3, an
assistance unit participating in the general assistance program under chapter 256D must
report:
new text end

new text begin (1) a change in unearned income of $50 per month or greater;
new text end

new text begin (2) a change in earned income of $100 per month or greater, unless the assistance unit
is already subject to six-month reporting requirements in section 256P.10; and
new text end

new text begin (3) changes in any condition that would result in the loss of basis for eligibility in section
256D.05, subdivision 1, paragraph (a).
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 91.

new text begin [256P.09] PROSPECTIVE BUDGETING OF BENEFITS.
new text end

new text begin Subdivision 1.new text end

new text begin Exempted programs.new text end

new text begin Assistance units that qualify for child care
assistance programs under chapter 119B, assistance units that receive housing support under
chapter 256I and are not subject to reporting under section 256P.10, and assistance units
that qualify for Minnesota supplemental aid under chapter 256D are exempt from this
section.
new text end

new text begin Subd. 2.new text end

new text begin Prospective budgeting of benefits.new text end

new text begin An agency subject to this chapter must use
prospective budgeting to calculate the assistance payment amount.
new text end

new text begin Subd. 3.new text end

new text begin Initial income.new text end

new text begin For the purpose of determining an assistance unit's level of
benefits, an agency must take into account the income already received by the assistance
unit during or anticipated to be received during the application period. Income anticipated
to be received only in the initial month of eligibility must only be counted in the initial
month.
new text end

new text begin Subd. 4.new text end

new text begin Income determination.new text end

new text begin An agency must use prospective budgeting to determine
the amount of the assistance unit's benefit for the eligibility period based on the best
information available at the time of approval. An agency shall only count anticipated income
when the participant and the agency are reasonably certain of the amount of the payment
and the month in which the payment will be received. If the exact amount of the income is
not known, the agency shall consider only the amounts that can be anticipated as income.
new text end

new text begin Subd. 5.new text end

new text begin Income changes.new text end

new text begin An increase in income shall not affect an assistance unit's
eligibility or benefit amount until the next review unless otherwise required to be reported
in section 256P.07. A decrease in income shall be effective on the date that the change
occurs if the change is reported by the tenth of the month following the month when the
change occurred. If the assistance unit does not report the change in income by the tenth of
the month following the month when the change occurred, the change in income shall be
effective on the date that the change was reported.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 92.

new text begin [256P.10] SIX-MONTH REPORTING.
new text end

new text begin Subdivision 1.new text end

new text begin Exempted programs.new text end

new text begin Assistance units that qualify for child care
assistance programs under chapter 119B, assistance units that qualify for Minnesota
supplemental aid under chapter 256D, and assistance units that qualify for housing support
under chapter 256I and also receive Supplemental Security Income are exempt from this
section.
new text end

new text begin Subd. 2.new text end

new text begin Reporting.new text end

new text begin (a) Every six months, an assistance unit that qualifies for the
Minnesota family investment program under chapter 256J, an assistance unit that qualifies
for general assistance under chapter 256D with an earned income of $100 per month or
greater, or an assistance unit that qualifies for housing support under chapter 256I with an
earned income of $100 per month or greater is subject to six-month reviews. The initial
reporting period may be shorter than six months in order to align with other programs'
reporting periods.
new text end

new text begin (b) An assistance unit that qualifies for the Minnesota family investment program or an
assistance unit that qualifies for general assistance with an earned income of $100 per month
or greater must complete household report forms as required by the commissioner for
redetermination of benefits.
new text end

new text begin (c) An assistance unit that qualifies for housing support with an earned income of $100
per month or greater must complete household report forms as prescribed by the
commissioner to provide information about earned income.
new text end

new text begin (d) An assistance unit that qualifies for housing support and also receives assistance
through the Minnesota family investment program is subject to the requirements of this
section for purposes of the Minnesota family investment program but not for housing support.
new text end

new text begin (e) An assistance unit covered by this section must submit a household report form in
compliance with the provisions in section 256P.04, subdivision 11.
new text end

new text begin (f) An assistance unit covered by this section may choose to report changes under this
section at any time.
new text end

new text begin Subd. 3.new text end

new text begin When to terminate assistance.new text end

new text begin (a) An agency must terminate benefits when
the assistance unit fails to submit the household report form before the end of the six-month
review period. If the assistance unit submits the household report form within 30 days of
the termination of benefits and remains eligible, benefits must be reinstated and made
available retroactively for the full benefit month.
new text end

new text begin (b) When an assistance unit is determined to be ineligible for assistance according to
this section and chapter 256D, 256I, or 256J, the agency must terminate assistance.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 93.

Minnesota Statutes 2022, section 261.063, is amended to read:

261.063 TAX LEVY FOR SOCIAL SERVICES; BOARD DUTY; PENALTY.

(a) The board of county commissioners of each county shall annually levy taxes and fix
a rate sufficient to produce the full amount required for poor relief, general assistance,
Minnesota family investment program, deleted text begin diversionary work program,deleted text end county share of county
and state supplemental aid to Supplemental Security Income applicants or recipients, and
any other Social Security measures wherein there is now or may hereafter be county
participation, sufficient to produce the full amount necessary for each such item, including
administrative expenses, for the ensuing year, within the time fixed by law in addition to
all other tax levies and tax rates, however fixed or determined, and any commissioner who
shall fail to comply herewith shall be guilty of a gross misdemeanor and shall be immediately
removed from office by the governor. For the purposes of this paragraph, "poor relief"
means county services provided under sections 261.035 and 261.21 to 261.231.

(b) Nothing within the provisions of this section shall be construed as requiring a county
agency to provide income support or cash assistance to needy persons when they are no
longer eligible for assistance under general assistance, chapter 256J, or Minnesota
supplemental aid.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 94.

Minnesota Statutes 2022, section 514.972, subdivision 5, is amended to read:

Subd. 5.

Access to certain items.

(a) Any occupant may remove from the self-storage
facility personal papers and health aids upon demand made to any of the persons listed in
section 514.976, subdivision 1.

(b) An occupant who provides documentation from a government or nonprofit agency
or legal aid office that the occupant is a recipient of relief based on need, is eligible for legal
aid services, or is a survivor of domestic violence or sexual assault may remove, in addition
to the items provided in paragraph (a), personal clothing of the occupant and the occupant's
dependents and tools of the trade that are necessary for the livelihood of the occupant that
has a market value not to exceed $125 per item.

(c) The occupant shall present a list of the items and may remove the items during the
facility's ordinary business hours prior to the sale authorized by section 514.973. If the
owner unjustifiably denies the occupant access for the purpose of removing the items
specified in this subdivision, the occupant is entitled to request relief from the court for an
order allowing access to the storage space for removal of the specified items. The self-service
storage facility is liable to the occupant for the costs, disbursements, and attorney fees
expended by the occupant to obtain this order.

(d) For the purposes of this subdivision, "relief based on need" includes but is not limited
to receipt of a benefit from the Minnesota family investment program deleted text begin and diversionary
work programdeleted text end , medical assistance, general assistance, emergency general assistance,
Minnesota supplemental aid, Minnesota supplemental aid housing assistance, MinnesotaCare,
Supplemental Security Income, energy assistance, emergency assistance, Supplemental
Nutrition Assistance Program benefits, earned income tax credit, or Minnesota working
family tax credit. Relief based on need can also be proven by providing documentation from
a legal aid organization that the individual is receiving legal aid assistance, or by providing
documentation from a government agency, nonprofit, or housing assistance program that
the individual is receiving assistance due to domestic violence or sexual assault.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 95.

Minnesota Statutes 2022, section 609B.425, subdivision 2, is amended to read:

Subd. 2.

Benefit eligibility.

(a) new text begin For general assistance benefits and Minnesota
supplemental aid under chapter 256D, new text end a person convicted of a new text begin felony-level new text end drug offense
deleted text begin after July 1, 1997, is ineligible for general assistance benefits and Supplemental Security
Income under chapter 256D until:deleted text end new text begin during the previous ten years from the date of application
or recertification may be subject to random drug testing. The county must provide information
about substance use disorder treatment programs to a person who tests positive for an illegal
controlled substance.
new text end

deleted text begin (1) five years after completing the terms of a court-ordered sentence; or
deleted text end

deleted text begin (2) unless the person is participating in a drug treatment program, has successfully
completed a program, or has been determined not to be in need of a drug treatment program.
deleted text end

deleted text begin (b) A person who becomes eligible for assistance under chapter 256D is subject to
random drug testing and shall lose eligibility for benefits for five years beginning the month
following:
deleted text end

deleted text begin (1) any positive test for an illegal controlled substance; or
deleted text end

deleted text begin (2) discharge of sentence for conviction of another drug felony.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end Parole violators and fleeing felons are ineligible for benefits and persons
fraudulently misrepresenting eligibility are also ineligible to receive benefits for ten years.

new text begin EFFECTIVE DATE.new text end

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

Sec. 96.

Minnesota Statutes 2022, section 609B.435, subdivision 2, is amended to read:

Subd. 2.

Drug offenders; random testing; sanctions.

A person who is an applicant for
benefits from the Minnesota family investment program or MFIP, the vehicle for temporary
assistance for needy families or TANF, and who has been convicted of a new text begin felony-level new text end drug
offense deleted text begin shalldeleted text end new text begin maynew text end be subject to deleted text begin certain conditions, includingdeleted text end random drug testingdeleted text begin , in order
to receive MFIP benefitsdeleted text end . Following any positive test for a controlled substance, the deleted text begin convicted
applicant or participant is subject to the following sanctions:deleted text end new text begin county must provide information
about substance use disorder treatment programs to the applicant or participant.
new text end

deleted text begin (1) a first time drug test failure results in a reduction of benefits in an amount equal to
30 percent of the MFIP standard of need; and
deleted text end

deleted text begin (2) a second time drug test failure results in permanent disqualification from receiving
MFIP assistance.
deleted text end

deleted text begin A similar disqualification sequence occurs if the applicant is receiving Supplemental Nutrition
Assistance Program (SNAP) benefits.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 97. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes shall remove from Minnesota Statutes, sections 550.143,
subdivision 3c; 550.37, subdivision 14; 551.05, subdivision 1d; 571.72, subdivision 10;
571.912, subdivision 3; and 571.925, the terms "MFIP Diversionary Work Program" and
"MFIP diversionary work program." The revisor shall also make any necessary grammatical
changes related to the removal of terms.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective March 1, 2026.
new text end

Sec. 98. new text begin REPEALER.
new text end

new text begin (a)new text end new text begin Minnesota Statutes 2022, sections 256.9864; 256J.08, subdivisions 10, 61, 81, and
83; 256J.30, subdivisions 5, 7, and 8; 256J.33, subdivisions 3, 4, and 5; and 256J.34,
subdivisions 1, 2, 3, and 4,new text end new text begin are repealed.
new text end

new text begin (b)new text end new text begin Minnesota Statutes 2022, section 256J.425, subdivision 6,new text end new text begin is repealed.
new text end

new text begin (c)new text end new text begin Minnesota Statutes 2022, sections 119B.011, subdivision 10a; 256J.08, subdivision
24b; 256J.95, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, and 19;
and 256P.07, subdivision 5,new text end new text begin are repealed.
new text end

new text begin (d)new text end new text begin Minnesota Statutes 2022, section 256D.63, subdivision 1,new text end new text begin is repealed.
new text end

new text begin (e)new text end new text begin Minnesota Statutes 2022, section 256.8799,new text end new text begin is repealed.
new text end

new text begin (f)new text end new text begin Minnesota Statutes 2022, sections 256J.08, subdivisions 53 and 62; and 256J.37,
subdivision 10,new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin Paragraph (a) is effective March 1, 2025. Paragraph (b) is effective
May 1, 2026. Paragraph (c) is effective March 1, 2026. Paragraph (d) is effective the day
following final enactment. Paragraph (e) is effective July 1, 2023. Paragraph (f) is effective
July 1, 2024.
new text end

ARTICLE 11

HOUSING AND HOMELESSNESS

Section 1.

Minnesota Statutes 2022, section 145.4716, subdivision 3, is amended to read:

Subd. 3.

Youth eligible for services.

Youth 24 years of age or younger deleted text begin shall bedeleted text end new text begin arenew text end
eligible for all services, support, and programs provided under this section and section
145.4717, and all shelter, housing beds, and services provided by the commissioner of
human services to sexually exploited youth and youth at risk of sexual exploitationnew text begin under
section 256K.47new text end .

Sec. 2.

Minnesota Statutes 2022, section 256B.051, subdivision 5, is amended to read:

Subd. 5.

Housing stabilization services.

(a) Housing stabilization services include
housing transition services and housing and tenancy sustaining services.

(b) Housing transition services are defined as:

(1) tenant screening and housing assessment;

(2) assistance with the housing search and application process;

(3) identifying resources to cover onetime moving expenses;

(4) ensuring a new living arrangement is safe and ready for move-in;

(5) assisting in arranging for and supporting details of a move; and

(6) developing a housing support crisis plan.

(1) prevention and early identification of behaviors that may jeopardize continued stable
housing;

(2) education and training on roles, rights, and responsibilities of the tenant and the
property manager;

(3) coaching to develop and maintain key relationships with property managers and
neighbors;

(4) advocacy and referral to community resources to prevent eviction when housing is
at risk;

(5) assistance with housing recertification process;

(6) coordination with the tenant to regularly review, update, and modify the housing
support and crisis plan; and

(7) continuing training on being a good tenant, lease compliance, and household
management.

(d) A housing stabilization service may include person-centered planning for people
who are not eligible to receive person-centered planning through any other service, if the
person-centered planning is provided by a consultation service provider that is under contract
with the department and enrolled as a Minnesota health care program.

new text begin (e) Housing transition costs are available to persons transitioning from a
provider-controlled setting to the person's own home and include:
new text end

new text begin (1) security deposits; and
new text end

new text begin (2) essential furnishings and supplies.
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 earlier.
new text end

Sec. 3.

Minnesota Statutes 2022, section 256I.04, subdivision 1, is amended to read:

Subdivision 1.

Individual eligibility requirements.

An individual is eligible for and
entitled to a housing support payment to be made on the individual's behalf if the agency
has approved the setting where the individual will receive housing support and the individual
meets the requirements in paragraph (a), (b), deleted text begin ordeleted text end (c)new text begin , or (d)new text end .

(a) The individual is aged, blind, or is over 18 years of age with a disability as determined
under the criteria used by the title II program of the Social Security Act, and meets the
resource restrictions and standards of section 256P.02, and the individual's countable income
after deducting the (1) exclusions and disregards of the SSI program, (2) the medical
assistance personal needs allowance under section 256B.35, and (3) an amount equal to the
income actually made available to a community spouse by an elderly waiver participant
under the provisions of sections 256B.0575, paragraph (a), clause (4), and 256B.058,
subdivision 2, is less than the monthly rate specified in the agency's agreement with the
provider of housing support in which the individual resides.

(b) The individual meets a category of eligibility under section 256D.05, subdivision 1,
paragraph (a), clauses (1), (3), (4) to (8), and (13), and paragraph (b), if applicable, and the
individual's resources are less than the standards specified by section 256P.02, and the
individual's countable income as determined under section 256P.06, less the medical
assistance personal needs allowance under section 256B.35 is less than the monthly rate
specified in the agency's agreement with the provider of housing support in which the
individual resides.

(c) The individual lacks a fixed, adequate, nighttime residence upon discharge from a
residential behavioral health treatment program, as determined by treatment staff from the
residential behavioral health treatment program. An individual is eligible under this paragraph
for up to three months, including a full or partial month from the individual's move-in date
at a setting approved for housing support following discharge from treatment, plus two full
months.

new text begin (d) The individual meets the criteria related to establishing a certified disability or
disabling condition in paragraph (a) or (b) and lacks a fixed, adequate, nighttime residence
upon discharge from a correctional facility, as determined by an authorized representative
from a Minnesota-based correctional facility. An individual is eligible under this paragraph
for up to three months, including a full or partial month from the individual's move-in date
at a setting approved for housing support following release, plus two full months. Any
income received by people who meet the disabling condition criteria established in paragraph
(a) or (b) is not countable for the duration of eligibility under this paragraph.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 4.

Minnesota Statutes 2022, section 256I.04, subdivision 3, is amended to read:

Subd. 3.

Moratorium on development of housing support beds.

(a) Agencies shall
not enter into agreements for new housing support beds with total rates in excess of the
MSA equivalent rate except:

(1) for establishments licensed under chapter 245D provided the facility is needed to
meet the census reduction targets for persons with developmental disabilities at regional
treatment centers;

(2) up to 80 beds in a single, specialized facility located in Hennepin County that will
provide housing for chronic inebriates who are repetitive users of detoxification centers and
are refused placement in emergency shelters because of their state of intoxication, and
planning for the specialized facility must have been initiated before July 1, 1991, in
anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
subdivision 20a, paragraph (b);

(3) notwithstanding the provisions of subdivision 2a, for up to 226 supportive housing
units in Anoka, new text begin Carver, new text end Dakota, Hennepin, deleted text begin ordeleted text end Ramseynew text begin , Scott, or Washingtonnew text end County for
homeless adults with a mental illness, a history of substance abuse, or human
immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this
section, "homeless adult" means a person who is living on the street or in a shelter or
discharged from a regional treatment center, community hospital, or residential treatment
program and has no appropriate housing available and lacks the resources and support
necessary to access appropriate housing. At least 70 percent of the supportive housing units
must serve homeless adults with mental illness, substance abuse problems, or human
immunodeficiency virus or acquired immunodeficiency syndrome who are about to be or,
within the previous six months, have been discharged from a regional treatment center, or
a state-contracted psychiatric bed in a community hospital, or a residential mental health
or substance use disorder treatment program. If a person meets the requirements of
subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the housing
support rate for that person is limited to the supplementary rate under section 256I.05,
subdivision 1a, and is determined by subtracting the amount of the person's countable income
that exceeds the MSA equivalent rate from the housing support supplementary service rate.
A resident in a demonstration project site who no longer participates in the demonstration
program shall retain eligibility for a housing support payment in an amount determined
under section 256I.06, subdivision 8, using the MSA equivalent rate. Service funding under
section 256I.05, subdivision 1a, will end June 30, 1997, if federal matching funds are
available and the services can be provided through a managed care entity. If federal matching
funds are not available, then service funding will continue under section 256I.05, subdivision
1a;

(4) for an additional two beds, resulting in a total of 32 beds, for a facility located in
Hennepin County providing services for men with and recovering from substance use
disorder that has had a housing support contract with the county and has been licensed as
a board and lodge facility with special services since 1980;

(5) for a housing support provider located in the city of St. Cloud, or a county contiguous
to the city of St. Cloud, that operates a 40-bed facility, that received financing through the
Minnesota Housing Finance Agency Ending Long-Term Homelessness Initiative and serves
clientele with substance use disorder, providing 24-hour-a-day supervision;

(6) for a new 65-bed facility in Crow Wing County that will serve persons with substance
use disorder, operated by a housing support provider that currently operates a 304-bed
facility in Minneapolis, and a 44-bed facility in Duluth;

(7) for a housing support provider that operates two ten-bed facilities, one located in
Hennepin County and one located in Ramsey County, that provide community support and
24-hour-a-day supervision to serve the mental health needs of individuals who have
chronically lived unsheltered; and

(8) for a facility authorized for recipients of housing support in Hennepin County with
a capacity of up to 48 beds that has been licensed since 1978 as a board and lodging facility
and that until August 1, 2007, operated as a licensed substance use disorder treatment
program.

(b) An agency may enter into a housing support agreement for beds with rates in excess
of the MSA equivalent rate in addition to those currently covered under a housing support
agreement if the additional beds are only a replacement of beds with rates in excess of the
MSA equivalent rate which have been made available due to closure of a setting, a change
of licensure or certification which removes the beds from housing support payment, or as
a result of the downsizing of a setting authorized for recipients of housing support. The
transfer of available beds from one agency to another can only occur by the agreement of
both agencies.

Sec. 5.

Minnesota Statutes 2022, section 256I.05, subdivision 1a, is amended to read:

Subd. 1a.

Supplementary service rates.

(a) Subject to the provisions of section 256I.04,
subdivision 3, the agency may negotiate a payment not to exceed deleted text begin $426.37deleted text end new text begin $494.91new text end for other
services necessary to provide room and board if the residence is licensed by or registered
by the Department of Health, or licensed by the Department of Human Services to provide
services in addition to room and board, and if the provider of services is not also concurrently
receiving funding for services for a recipientnew text begin in the residencenew text end under deleted text begin adeleted text end new text begin the following programs
or funding sources: (1)new text end home and community-based waivernew text begin servicesnew text end under deleted text begin title XIX of the
federal Social Security Actdeleted text end new text begin chapter 256S or section 256B.0913, 256B.092, or 256B.49new text end ; deleted text begin or
funding from the medical assistance programdeleted text end new text begin (2) personal care assistancenew text end under section
256B.0659deleted text begin , for personal care services for residents in the settingdeleted text end ; deleted text begin or residing in a setting
which receives funding underdeleted text end new text begin (3) community first services and supports under section
256B.85; or (4) services for adults with mental illness grants undernew text end section 245.73. If funding
is available for other necessary services through a home and community-based waiverdeleted text begin , ordeleted text end new text begin
under chapter 256S, or section 256B.0913, 256B.092, or 256B.49;new text end personal care new text begin assistance
new text end services under section 256B.0659deleted text begin ,deleted text end new text begin ; community first services and supports under section
256B.85; or services for adults with mental illness grants under section 245.73,new text end then the
housing support rate is limited to the rate set in subdivision 1. Unless otherwise provided
in law, in no case may the supplementary service rate exceed deleted text begin $426.37deleted text end new text begin $494.91new text end . The
registration and licensure requirement does not apply to establishments which are exempt
from state licensure because they are located on Indian reservations and for which the tribe
has prescribed health and safety requirements. Service payments under this section may be
prohibited under rules to prevent the supplanting of federal funds with state funds. deleted text begin The
commissioner shall pursue the feasibility of obtaining the approval of the Secretary of Health
and Human Services to provide home and community-based waiver services under title
XIX of the federal Social Security Act for residents who are not eligible for an existing
home and community-based waiver due to a primary diagnosis of mental illness or substance
use disorder and shall apply for a waiver if it is determined to be cost-effective.
deleted text end

(b) The commissioner is authorized to make cost-neutral transfers from the housing
support fund for beds under this section to other funding programs administered by the
department after consultation with the agency in which the affected beds are located. The
commissioner may also make cost-neutral transfers from the housing support fund to agencies
for beds permanently removed from the housing support census under a plan submitted by
the agency and approved by the commissioner. The commissioner shall report the amount
of any transfers under this provision annually to the legislature.

(c) Agencies must not negotiate supplementary service rates with providers of housing
support that are licensed as board and lodging with special services and that do not encourage
a policy of sobriety on their premises and make referrals to available community services
for volunteer and employment opportunities for residents.

new text begin EFFECTIVE DATE.new text end

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

Sec. 6.

Minnesota Statutes 2022, section 256I.05, subdivision 2, is amended to read:

Subd. 2.

Monthly rates; exemptions.

This subdivision applies to a residence that on
August 1, 1984, was licensed by the commissioner of health only as a boarding care home,
certified by the commissioner of health as an intermediate care facility, and licensed by the
commissioner of human services under Minnesota Rules, parts 9520.0500 to 9520.0670.
Notwithstanding the provisions of subdivision 1c, the rate paid to a facility reimbursed
under this subdivision shall be determined under chapter 256R, if the facility is accepted
by the commissioner for participation in the alternative payment demonstration project. The
rate paid to this facility shall also include adjustments to the room and board rate according
to subdivision 1deleted text begin , and any adjustments applicable to supplemental service rates statewidedeleted text end .

Sec. 7.

Minnesota Statutes 2022, section 256K.45, subdivision 3, is amended to read:

Subd. 3.

Street and community outreach and drop-in program.

Youth drop-in centers
must provide walk-in access to crisis intervention and ongoing supportive services including
one-to-one case management services on a self-referral basis. Street and community outreach
programs must locate, contact, and provide information, referrals, and services to homeless
youth, youth at risk of homelessness, and runaways. Information, referrals, and services
provided may include, but are not limited to:

(1) family reunification services;

(2) conflict resolution or mediation counseling;

(3) assistance in obtaining temporary emergency shelter;

(4) assistance in obtaining food, clothing, medical care, or mental health counseling;

(5) counseling regarding violence, sexual exploitation, substance abuse, sexually
transmitted diseases, and pregnancy;

(6) referrals to other agencies that provide support services to homeless youth, youth at
risk of homelessness, and runaways;

(7) assistance with education, employment, and independent living skills;

(8) aftercare services;

(9) specialized services for highly vulnerable runaways and homeless youth, including
deleted text begin teendeleted text end new text begin but not limited to youth at risk of discrimination based on sexual orientation or gender
identity, youngnew text end parents, emotionally disturbed and mentally ill youth, and sexually exploited
youth; and

(10) homelessness prevention.

Sec. 8.

Minnesota Statutes 2022, section 256K.45, subdivision 7, is amended to read:

Subd. 7.

Provider repair or improvement grants.

(a) Providers that serve homeless
youth deleted text begin under this sectiondeleted text end may apply for a grant of up to deleted text begin $200,000deleted text end new text begin $500,000new text end under this
subdivision to make minor or mechanical repairs or improvements to a facility providing
services to homeless youth or youth at risk of homelessness.

(b) Grant applications under this subdivision must include a description of the repairs
or improvements and the estimated cost of the repairs or improvements.

deleted text begin (c) Grantees under this subdivision cannot receive grant funds under this subdivision
for two consecutive years.
deleted text end

Sec. 9.

Minnesota Statutes 2022, section 256K.45, is amended by adding a subdivision to
read:

new text begin Subd. 8.new text end

new text begin Awarding of grants.new text end

new text begin For grants awarded pursuant to a two-year grant contract,
the commissioner shall permit grant recipients to carry over any unexpended amount from
the first contract year to the second contract year.
new text end

Sec. 10.

new text begin [256K.47] SAFE HARBOR SHELTER AND HOUSING.
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 must
establish a safe harbor shelter and housing grant program. Under this grant program, the
commissioner must award grants to providers who are committed to serving sexually
exploited youth and youth at risk of sexual exploitation. Grantees must use grant money to
provide street and community outreach programs, emergency shelter programs, or supportive
housing programs consistent with the program descriptions in this section to address the
specialized outreach, shelter, and housing needs of sexually exploited youth and youth at
risk of sexual exploitation.
new text end

new text begin Subd. 2.new text end

new text begin Youth eligible for services.new text end

new text begin Youth 24 years of age or younger are eligible for
all shelter, housing beds, and services provided under this section and all services, support,
and programs provided by the commissioner of health to sexually exploited youth and youth
at risk of sexual exploitation under sections 145.4716 and 145.4717.
new text end

new text begin Subd. 3.new text end

new text begin Street and community outreach.new text end

new text begin (a) Street and community outreach programs
must locate, contact, and provide information, referrals, and services to eligible youth.
new text end

new text begin (b) Information, referrals, and services provided by street and community outreach
programs may include but are not limited to:
new text end

new text begin (1) family reunification services;
new text end

new text begin (2) conflict resolution or mediation counseling;
new text end

new text begin (3) assistance in obtaining temporary emergency shelter;
new text end

new text begin (4) assistance in obtaining food, clothing, medical care, or mental health counseling;
new text end

new text begin (5) counseling regarding violence, sexual exploitation, substance use, sexually transmitted
infections, and pregnancy;
new text end

new text begin (6) referrals to other agencies that provide support services to sexually exploited youth
and youth at risk of sexual exploitation;
new text end

new text begin (7) assistance with education, employment, and independent living skills;
new text end

new text begin (8) aftercare services;
new text end

new text begin (9) specialized services for sexually exploited youth and youth at risk of sexual
exploitation, including youth experiencing homelessness and youth with mental health
needs; and
new text end

new text begin (10) services to address the prevention of sexual exploitation and homelessness.
new text end

new text begin Subd. 4.new text end

new text begin Emergency shelter program.new text end

new text begin (a) Emergency shelter programs must provide
eligible youth with referral and walk-in access to emergency short-term residential care.
The program shall provide eligible youth with safe and dignified shelter that includes private
shower facilities, beds, and meals each day and must assist eligible youth with reunification
with that youth's family or legal guardian when required or appropriate.
new text end

new text begin (b) The services provided at emergency shelters may include but are not limited to:
new text end

new text begin (1) specialized services to address the trauma of sexual exploitation;
new text end

new text begin (2) family reunification services;
new text end

new text begin (3) individual, family, and group counseling;
new text end

new text begin (4) assistance obtaining clothing;
new text end

new text begin (5) access to medical and dental care and mental health counseling;
new text end

new text begin (6) counseling regarding violence, sexual exploitation, substance use, sexually transmitted
infections, and pregnancy;
new text end

new text begin (7) education and employment services;
new text end

new text begin (8) recreational activities;
new text end

new text begin (9) advocacy and referral services;
new text end

new text begin (10) independent living skills training;
new text end

new text begin (11) aftercare and follow-up services;
new text end

new text begin (12) transportation; and
new text end

new text begin (13) services to address the prevention of sexual exploitation and homelessness.
new text end

new text begin Subd. 5.new text end

new text begin Supportive housing programs.new text end

new text begin (a) Supportive housing programs must help
eligible youth find and maintain safe and dignified housing and provide related supportive
services and referrals. Supportive housing programs may also provide rental assistance.
new text end

new text begin (b) The services provided in supportive housing programs may include but are not limited
to:
new text end

new text begin (1) specialized services to address the trauma of sexual exploitation;
new text end

new text begin (2) education and employment services;
new text end

new text begin (3) budgeting and money management;
new text end

new text begin (4) assistance in securing housing appropriate to needs and income;
new text end

new text begin (5) counseling regarding violence, sexual exploitation, substance use, sexually transmitted
infections, and pregnancy;
new text end

new text begin (6) referral for medical services or chemical dependency treatment;
new text end

new text begin (7) parenting skills;
new text end

new text begin (8) self-sufficiency support services and independent living skills training;
new text end

new text begin (9) aftercare and follow-up services; and
new text end

new text begin (10) services to address the prevention of sexual exploitation and homelessness
prevention.
new text end

new text begin Subd. 6.new text end

new text begin Funding.new text end

new text begin Money appropriated for this section may be expended on programs
described in subdivisions 3 to 5, technical assistance, and capacity building to meet the
greatest need on a statewide basis.
new text end

Sec. 11.

Laws 2021, First Special Session chapter 7, article 17, section 5, subdivision 1,
is amended to read:

Subdivision 1.

Housing transition cost.

(a) This act includes $682,000 in fiscal year
2022 and $1,637,000 in fiscal year 2023 for a onetime payment per transition of up to $3,000
to cover costs associated with moving to a community setting that are not covered by other
sources. Covered costs include: (1) lease or rent deposits; (2) security deposits; (3) utilities
setup costs, including telephone and Internet services; and (4) essential furnishings and
supplies. The commissioner of human services shall seek an amendment to the medical
assistance state plan to allow for these payments as a housing stabilization service under
Minnesota Statutes, section 256B.051. The general fund base in this act for this purpose is
$1,227,000 in fiscal year 2024 and $0 in fiscal year 2025.

deleted text begin (b) This subdivision expires March 31, 2024.
deleted text end

new text begin (b) An individual is only eligible for a housing transition cost payment if the individual
is moving from an institution or provider-controlled setting into their own home.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective upon federal approval.
new text end

Sec. 12. new text begin HOUSING SUPPORT SUPPLEMENTARY SERVICE RATE STUDY.
new text end

new text begin (a) The commissioner of human services, in consultation with residents of housing
support settings, providers, and lead agencies, must analyze housing support supplementary
service rates under Minnesota Statutes, section 256I.05, to recommend a rate setting
methodology that is person-centered, equitable, and adequately covers the cost to provide
services. The analysis must include but is not limited to:
new text end

new text begin (1) a review of current supplemental rates;
new text end

new text begin (2) recommendations to avoid duplication of services, while ensuring informed choice;
and
new text end

new text begin (3) recommendations on an updated rate setting methodology.
new text end

new text begin (b) By January 15, 2026, the commissioner must submit a report, including
recommendations and draft legislative language, to the chairs and ranking minority members
of the legislative committees with jurisdiction over human services policy and finance.
new text end

Sec. 13. new text begin HOMELESS YOUTH CASH STIPEND PILOT PROJECT.
new text end

new text begin Subdivision 1.new text end

new text begin Pilot project established.new text end

new text begin The commissioner of human services shall
establish a homeless youth cash stipend pilot project to provide a direct cash stipend to
homeless youth in Hennepin and St. Louis Counties. The pilot project must be designed to
meet the needs of underserved communities.
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) "Homeless youth" means a person 18 to 24 years of age who lacks a fixed, regular,
and adequate nighttime residence. The following are not fixed, regular, or adequate nighttime
residences:
new text end

new text begin (1) a supervised publicly or privately operated shelter designed to provide temporary
living accommodations;
new text end

new text begin (2) an institution or a publicly or privately operated shelter designed to provide temporary
living accommodations;
new text end

new text begin (3) transitional housing;
new text end

new text begin (4) a temporary placement with a peer, friend, or family member that has not offered
permanent residence, a residential lease, or temporary lodging for more than 30 days; or
new text end

new text begin (5) a public or private place not designed for, nor ordinarily used as, a regular sleeping
accommodation for human beings.
new text end

new text begin Subd. 3.new text end

new text begin Administration.new text end

new text begin The commissioner, as authorized by Minnesota Statutes,
section 256.01, subdivision 2, paragraph (a), clause (6), shall contract with Youthprise to:
new text end

new text begin (1) identify eligible homeless youth under this section;
new text end

new text begin (2) provide technical assistance to cash stipend recipients;
new text end

new text begin (3) engage with cash stipend recipients to develop youth-designed optional services;
new text end

new text begin (4) evaluate the efficacy and cost-effectiveness of the pilot program;
new text end

new text begin (5) collaborate with youth leaders of each county to identify and contract with the
appropriate service providers to offer financial coaching, housing navigation, employment,
education services, and trauma-informed mentoring and support; and
new text end

new text begin (6) submit annual updates and a final report to the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Eligibility.new text end

new text begin Homeless youth who are 18 to 24 years of age and who live in
Hennepin or St. Louis County at the time of initial enrollment are eligible to participate in
the pilot project.
new text end

new text begin Subd. 5.new text end

new text begin Cash stipend.new text end

new text begin The commissioner, in consultation with Youthprise and Hennepin
and St. Louis Counties, shall establish a stipend amount for eligible homeless youth who
participate in the pilot project.
new text end

new text begin Subd. 6.new text end

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

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

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

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

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

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

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

new text begin (b) The commissioner must not consider cash stipends under this section as income or
assets for medical assistance under Minnesota Statutes, section 256B.056, subdivision 1a,
paragraph (a); 3; or 3c.
new text end

new text begin Subd. 7.new text end

new text begin Report.new text end

new text begin The commissioner, in cooperation with Youthprise and Hennepin and
St. Louis Counties, shall submit an annual report on Youthprise's findings regarding the
efficacy and cost-effectiveness of the homeless youth cash stipend pilot project to the chairs
and ranking minority members of the legislative committees with jurisdiction over homeless
youth policy and finance by January 15, 2024, and each January 15 thereafter.
new text end

new text begin Subd. 8.new text end

new text begin Expiration.new text end

new text begin This section expires June 30, 2027.
new text end

Sec. 14. new text begin EMERGENCY SHELTER FACILITIES.
new text end

new text begin Subdivision 1.new text end

new text begin Definitions.new text end

new text begin (a) For the 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 applicant" means a statutory or home rule charter city, county, Tribal
government, not-for-profit corporation under section 501(c)(3) of the Internal Revenue
Code, or housing and redevelopment authority established under Minnesota Statutes, section
469.003.
new text end

new text begin (d) "Emergency shelter facility" or "facility" means a facility that provides a safe, sanitary,
accessible, and suitable emergency shelter for individuals and families experiencing
homelessness, regardless of whether the facility provides emergency shelter during the day,
overnight, or both.
new text end

new text begin Subd. 2.new text end

new text begin Project criteria.new text end

new text begin (a) The commissioner shall prioritize grants under this section
for projects that improve or expand emergency shelter facility options by:
new text end

new text begin (1) adding additional emergency shelter facilities by renovating existing facilities not
currently operating as emergency shelter facilities;
new text end

new text begin (2) adding additional emergency shelter facility beds by renovating existing emergency
shelter facilities, including major projects that address an accumulation of deferred
maintenance or repair or replacement of mechanical, electrical, and safety systems and
components in danger of failure;
new text end

new text begin (3) adding additional emergency shelter facility beds through acquisition and construction
of new emergency shelter facilities;
new text end

new text begin (4) improving the safety, sanitation, accessibility, and habitability of existing emergency
shelter facilities, including major projects that address an accumulation of deferred
maintenance or repair or replacement of mechanical, electrical, and safety systems and
components in danger of failure; and
new text end

new text begin (5) improving access to emergency shelter facilities that provide culturally appropriate
shelter and gender-inclusive shelter.
new text end

new text begin (b) A grant under this section may be used to pay for 100 percent of total project capital
expenditures or a specified project phase, up to $10,000,000 per project. For eligible
applicants seeking funding under this section for the acquisition and construction of new
emergency shelter facilities under paragraph (a), clause (3), the commissioner must give
priority to projects in which the eligible applicant will provide at least ten percent of total
project funding.
new text end

new text begin (c) All projects funded with a grant under this section must meet all applicable state and
local building codes at the time of project completion.
new text end

new text begin (d) The commissioner must use a competitive request for proposal process to identify
potential projects and eligible applicants on a statewide basis. At least 40 percent of the
appropriation under this section must be awarded to projects located in greater Minnesota.
If the commissioner does not receive sufficient eligible funding requests from greater
Minnesota to award at least 40 percent of the appropriation under this section to projects in
greater Minnesota, the commissioner may award the remaining funds to other eligible
projects.
new text end

new text begin (e) Notwithstanding Minnesota Statutes, sections 16B.98, subdivision 5, paragraph (a),
clauses (1) and (2), and 16C.05, subdivision 2, paragraph (a), clause (3), final grant recipients
from a competitive grant process may incur eligible expenses based on an agreed-upon
predesign and design work plan and budget commencing July 1, 2023, prior to an
encumbrance being established in the accounting system and grant execution.
new text end

ARTICLE 12

CHILDREN AND FAMILIES

Section 1.

Minnesota Statutes 2022, section 4.045, is amended to read:

4.045 CHILDREN'S CABINET.

The Children's Cabinet shall consist of the commissioners of educationdeleted text begin ,deleted text end new text begin ;new text end human servicesdeleted text begin ,deleted text end new text begin ;new text end
employment and economic developmentdeleted text begin ,deleted text end new text begin ;new text end public safetydeleted text begin ,deleted text end new text begin ;new text end correctionsdeleted text begin ,deleted text end new text begin ;new text end management and
budgetdeleted text begin ,deleted text end new text begin ;new text end healthdeleted text begin ,deleted text end new text begin ;new text end administrationdeleted text begin ,deleted text end new text begin ;new text end Housing Finance Agencydeleted text begin , anddeleted text end new text begin ;new text end transportationdeleted text begin ,deleted text end new text begin ;new text end and deleted text begin the
director of the Office of Strategic and Long-Range Planningdeleted text end new text begin children, youth, and familiesnew text end .
The governor shall designate one member to serve as cabinet chair. The chair is responsible
for ensuring that the duties of the Children's Cabinet are performed.

new text begin EFFECTIVE DATE.new text end

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

Sec. 2.

Minnesota Statutes 2022, section 10.65, subdivision 2, is amended to read:

Subd. 2.

Definitions.

(a) As used in this section, the following terms have the meanings
given:

(1) "agency" means the Department of Administrationdeleted text begin ,deleted text end new text begin ;new text end Department of Agriculturedeleted text begin ,deleted text end new text begin ;
Department of Children, Youth, and Families;new text end Department of Commercedeleted text begin ,deleted text end new text begin ;new text end Department of
Correctionsdeleted text begin ,deleted text end new text begin ;new text end Department of Educationdeleted text begin ,deleted text end new text begin ;new text end Department of Employment and Economic
Developmentdeleted text begin ,deleted text end new text begin ;new text end Department of Healthdeleted text begin ,deleted text end new text begin ;new text end Office of Higher Educationdeleted text begin ,deleted text end new text begin ;new text end Housing Finance
Agencydeleted text begin ,deleted text end new text begin ;new text end Department of Human Rightsdeleted text begin ,deleted text end new text begin ;new text end Department of Human Servicesdeleted text begin ,deleted text end new text begin ;new text end Department of
Information Technology Servicesdeleted text begin ,deleted text end new text begin ;new text end Department of Iron Range Resources and Rehabilitationdeleted text begin ,deleted text end new text begin ;new text end
Department of Labor and Industrydeleted text begin ,deleted text end new text begin ;new text end Minnesota Management and Budgetdeleted text begin ,deleted text end new text begin ;new text end Bureau of
Mediation Servicesdeleted text begin ,deleted text end new text begin ;new text end Department of Military Affairsdeleted text begin ,deleted text end new text begin ;new text end Metropolitan Councildeleted text begin ,deleted text end new text begin ;new text end Department
of Natural Resourcesdeleted text begin ,deleted text end new text begin ;new text end Pollution Control Agencydeleted text begin ,deleted text end new text begin ;new text end Department of Public Safetydeleted text begin ,deleted text end new text begin ;new text end Department
of Revenuedeleted text begin ,deleted text end new text begin ;new text end Department of Transportationdeleted text begin ,deleted text end new text begin ;new text end Department of Veterans Affairsdeleted text begin ,deleted text end new text begin ;new text end Gambling
Control Boarddeleted text begin ,deleted text end new text begin ;new text end Racing Commissiondeleted text begin ,deleted text end new text begin ;new text end the Minnesota Lotterydeleted text begin ,deleted text end new text begin ;new text end the Animal Health Boarddeleted text begin ,deleted text end new text begin ;new text end
and the Board of Water and Soil Resources;

(2) "consultation" means the direct and interactive involvement of the Minnesota Tribal
governments in the development of policy on matters that have Tribal implications.
Consultation is the proactive, affirmative process of identifying and seeking input from
appropriate Tribal governments and considering their interest as a necessary and integral
part of the decision-making process. This definition adds to statutorily mandated notification
procedures. During a consultation, the burden is on the agency to show that it has made a
good faith effort to elicit feedback. Consultation is a formal engagement between agency
officials and the governing body or bodies of an individual Minnesota Tribal government
that the agency or an individual Tribal government may initiate. Formal meetings or
communication between top agency officials and the governing body of a Minnesota Tribal
government is a necessary element of consultation;

(3) "matters that have Tribal implications" means rules, legislative proposals, policy
statements, or other actions that have substantial direct effects on one or more Minnesota
Tribal governments, or on the distribution of power and responsibilities between the state
and Minnesota Tribal governments;

(4) "Minnesota Tribal governments" means the federally recognized Indian Tribes located
in Minnesota including: Bois Forte Band; Fond Du Lac Band; Grand Portage Band; Leech
Lake Band; Mille Lacs Band; White Earth Band; Red Lake Nation; Lower Sioux Indian
Community; Prairie Island Indian Community; Shakopee Mdewakanton Sioux Community;
and Upper Sioux Community; and

(5) "timely and meaningful" means done or occurring at a favorable or useful time that
allows the result of consultation to be included in the agency's decision-making process for
a matter that has Tribal implications.

new text begin EFFECTIVE DATE.new text end

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

Sec. 3.

Minnesota Statutes 2022, section 15.01, is amended to read:

15.01 DEPARTMENTS OF THE STATE.

The following agencies are designated as the departments of the state government: the
Department of Administration; the Department of Agriculture; new text begin the Department of Children,
Youth, and Families; new text end the Department of Commerce; the Department of Corrections; the
Department of Education; the Department of Employment and Economic Development;
the Department of Health; the Department of Human Rights; the Department of Information
Technology Services; the Department of Iron Range Resources and Rehabilitation; the
Department of Labor and Industry; the Department of Management and Budget; the
Department of Military Affairs; the Department of Natural Resources; the Department of
Public Safety; the Department of Human Services; the Department of Revenue; the
Department of Transportation; the Department of Veterans Affairs; and their successor
departments.

new text begin EFFECTIVE DATE.new text end

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

Sec. 4.

Minnesota Statutes 2022, section 15.06, subdivision 1, is amended to read:

Subdivision 1.

Applicability.

This section applies to the following departments or
agencies: the Departments of Administrationdeleted text begin ,deleted text end new text begin ;new text end Agriculturedeleted text begin ,deleted text end new text begin ; Children, Youth, and Families;new text end
Commercedeleted text begin ,deleted text end new text begin ;new text end Correctionsdeleted text begin ,deleted text end new text begin ;new text end Educationdeleted text begin ,deleted text end new text begin ;new text end Employment and Economic Developmentdeleted text begin ,deleted text end new text begin ;new text end Healthdeleted text begin ,deleted text end new text begin ;new text end
Human Rightsdeleted text begin ,deleted text end new text begin ;new text end Labor and Industrydeleted text begin ,deleted text end new text begin ;new text end Management and Budgetdeleted text begin ,deleted text end new text begin ;new text end Natural Resourcesdeleted text begin ,deleted text end new text begin ;new text end Public
Safetydeleted text begin ,deleted text end new text begin ;new text end Human Servicesdeleted text begin ,deleted text end new text begin ;new text end Revenuedeleted text begin ,deleted text end new text begin ;new text end Transportationdeleted text begin ,deleted text end new text begin ;new text end and Veterans Affairs; the Housing
Finance and Pollution Control Agencies; the Office of Commissioner of Iron Range
Resources and Rehabilitation; the Department of Information Technology Services; the
Bureau of Mediation Services; and their successor departments and agencies. The heads of
the foregoing departments or agencies are "commissioners."

new text begin EFFECTIVE DATE.new text end

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

Sec. 5.

Minnesota Statutes 2022, section 15A.0815, subdivision 2, is amended to read:

Subd. 2.

Group I salary limits.

The salary for a position listed in this subdivision shall
not exceed 133 percent of the salary of the governor. This limit must be adjusted annually
on January 1. The new limit must equal the limit for the prior year increased by the percentage
increase, if any, in the Consumer Price Index for all urban consumers from October of the
second prior year to October of the immediately prior year. The commissioner of management
and budget must publish the limit on the department's website. This subdivision applies to
the following positions:

Commissioner of administration;

Commissioner of agriculture;

Commissioner of education;

new text begin Commissioner of children, youth, and families;
new text end

Commissioner of commerce;

Commissioner of corrections;

Commissioner of health;

Commissioner, Minnesota Office of Higher Education;

Commissioner, Housing Finance Agency;

Commissioner of human rights;

Commissioner of human services;

Commissioner of labor and industry;

Commissioner of management and budget;

Commissioner of natural resources;

Commissioner, Pollution Control Agency;

Commissioner of public safety;

Commissioner of revenue;

Commissioner of employment and economic development;

Commissioner of transportation; and

Commissioner of veterans affairs.

new text begin EFFECTIVE DATE.new text end

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

Sec. 6.

Minnesota Statutes 2022, section 43A.08, subdivision 1a, is amended to read:

Subd. 1a.

Additional unclassified positions.

Appointing authorities for the following
agencies may designate additional unclassified positions according to this subdivision: the
Departments of Administration; Agriculture; new text begin Children, Youth, and Families; new text end Commerce;
Corrections; Education; Employment and Economic Development; Explore Minnesota
Tourism; Management and Budget; Health; Human Rights; Labor and Industry; Natural
Resources; Public Safety; Human Services; Revenue; Transportation; and Veterans Affairs;
the Housing Finance and Pollution Control Agencies; the State Lottery; the State Board of
Investment; the Office of Administrative Hearings; the Department of Information
Technology Services; the Offices of the Attorney General, Secretary of State, and State
Auditor; the Minnesota State Colleges and Universities; the Minnesota Office of Higher
Education; the Perpich Center for Arts Education; and the Minnesota Zoological Board.

A position designated by an appointing authority according to this subdivision must
meet the following standards and criteria:

(1) the designation of the position would not be contrary to other law relating specifically
to that agency;

(2) the person occupying the position would report directly to the agency head or deputy
agency head and would be designated as part of the agency head's management team;

(3) the duties of the position would involve significant discretion and substantial
involvement in the development, interpretation, and implementation of agency policy;

(4) the duties of the position would not require primarily personnel, accounting, or other
technical expertise where continuity in the position would be important;

(5) there would be a need for the person occupying the position to be accountable to,
loyal to, and compatible with, the governor and the agency head, the employing statutory
board or commission, or the employing constitutional officer;

(6) the position would be at the level of division or bureau director or assistant to the
agency head; and

(7) the commissioner has approved the designation as being consistent with the standards
and criteria in this subdivision.

new text begin EFFECTIVE DATE.new text end

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

Sec. 7.

Minnesota Statutes 2022, section 119B.011, subdivision 2, is amended to read:

Subd. 2.

Applicant.

"Child care fund applicants" means all parentsdeleted text begin ,deleted text end new text begin ;new text end stepparentsdeleted text begin ,deleted text end new text begin ;new text end legal
guardiansdeleted text begin , ordeleted text end new text begin ;new text end eligible relative caregivers deleted text begin who aredeleted text end new text begin ; relative custodians who accepted a transfer
of permanent legal and physical custody of a child under section 260C.515, subdivision 4,
or similar permanency disposition in Tribal code; successor custodians or guardians as
established by section 256N.22, subdivision 10; or foster parents providing care to a child
placed in a family foster home under section 260C.007, subdivision 16b. Applicants must
benew text end members of the family and reside in the household that applies for child care assistance
under the child care fund.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective August 25, 2024.
new text end

Sec. 8.

Minnesota Statutes 2022, section 119B.011, subdivision 5, is amended to read:

Subd. 5.

Child care.

"Child care" means the care of a child by someone other than a
parentdeleted text begin ,deleted text end new text begin ;new text end stepparentdeleted text begin ,deleted text end new text begin ;new text end legal guardiandeleted text begin ,deleted text end new text begin ;new text end eligible relative caregiverdeleted text begin ,deleted text end new text begin ; relative custodian who
accepted a transfer of permanent legal and physical custody of a child under section
260C.515, subdivision 4, or similar permanency disposition in Tribal code; successor
custodian or guardian as established according to section 256N.22, subdivision 10; foster
parent providing care to a child placed in a family foster home under section 260C.007,
subdivision 16b;new text end or deleted text begin the spousesdeleted text end new text begin spousenew text end of any of the foregoing in or outside the child's own
home for gain or otherwise, on a regular basis, for any part of a 24-hour day.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective August 25, 2024.
new text end

Sec. 9.

Minnesota Statutes 2022, section 119B.011, subdivision 13, is amended to read:

Subd. 13.

Family.

"Family" means parentsdeleted text begin ,deleted text end new text begin ;new text end stepparentsdeleted text begin ,deleted text end new text begin ;new text end guardians and their spousesdeleted text begin ,
ordeleted text end new text begin ;new text end other eligible relative caregivers and their spousesdeleted text begin ,deleted text end new text begin ; relative custodians who accepted a
transfer of permanent legal and physical custody of a child under section 260C.515,
subdivision 4, or similar permanency disposition in Tribal code, and their spouses; successor
custodians or guardians as established by section 256N.22, subdivision 10, and their spouses;
foster parents providing care to a child placed in a family foster home under section
260C.007, subdivision 16b, and their spouses;new text end and deleted text begin their blood relateddeleted text end new text begin the blood-relatednew text end
dependent children and adoptive siblings under the age of 18 years living in the same home
deleted text begin includingdeleted text end new text begin as any of the above. Family includesnew text end children temporarily absent from the
household in settings such as schools, foster care, and residential treatment facilities deleted text begin or
parents, stepparents, guardians and their spouses, or other relative caregivers and their
spousesdeleted text end new text begin and adultsnew text end temporarily absent from the household in settings such as schools, military
service, or rehabilitation programs. An adult family member who is not in an authorized
activity under this chapter may be temporarily absent for up to 60 days. When a minor
parent or parents and his, her, or their child or children are living with other relatives, and
the minor parent or parents apply for a child care subsidy, "family" means only the minor
parent or parents and their child or children. An adult age 18 or older who meets this
definition of family and is a full-time high school or postsecondary student may be considered
a dependent member of the family unit if 50 percent or more of the adult's support is provided
by the parentsdeleted text begin ,deleted text end new text begin ;new text end stepparentsdeleted text begin ,deleted text end new text begin ;new text end guardiansnew text begin and their spouses; relative custodians who accepted
a transfer of permanent legal and physical custody of a child under section 260C.515,
subdivision 4, or similar permanency disposition in Tribal code, and their spouses; successor
custodians or guardians as established by section 256N.22, subdivision 10, and their spouses;
foster parents providing care to a child placed in a family foster home under section
260C.007, subdivision 16bnew text end , and their spousesnew text begin ;new text end or eligible relative caregivers and their spouses
residing in the same household.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective August 25, 2024.
new text end

Sec. 10.

Minnesota Statutes 2022, section 119B.03, subdivision 4a, is amended to read:

Subd. 4a.

deleted text begin Temporary reprioritizationdeleted text end new text begin Funding prioritiesnew text end .

(a) deleted text begin Notwithstanding
subdivision 4deleted text end new text begin In the event that inadequate funding necessitates the use of waiting listsnew text end ,
priority for child care assistance under the basic sliding fee assistance program shall be
determined according to this subdivision deleted text begin beginning July 1, 2021, through May 31, 2024deleted text end .

(1) child care needs of minor parents;

(2) child care needs of parents under 21 years of age; and

(3) child care needs of other parents within the priority group described in this paragraph.

(c) Second priority must be given to families in which at least one parent is a veteran,
as defined under section 197.447.

(d) Third priority must be given to eligible families who do not meet the specifications
of paragraph (b), (c), (e), or (f).

(e) Fourth priority must be given to families who are eligible for portable basic sliding
fee assistance through the portability pool under subdivision 9.

(f) Fifth priority must be given to eligible families receiving services under section
119B.011, subdivision 20a, if the parents have completed their MFIP or DWP transition
year, or if the parents are no longer receiving or eligible for DWP supports.

(g) Families under paragraph (f) must be added to the basic sliding fee waiting list on
the date they complete their transition year under section 119B.011, subdivision 20.

Sec. 11.

Minnesota Statutes 2022, section 119B.13, subdivision 1, is amended to read:

Subdivision 1.

Subsidy restrictions.

(a) Beginning deleted text begin November 15, 2021deleted text end new text begin October 30,
2023new text end , the maximum rate paid for child care assistance in any county or county price cluster
under the child care fund shall bedeleted text begin :
deleted text end

deleted text begin (1) for all infants and toddlers,deleted text end the greater of the deleted text begin 40thdeleted text end new text begin 75thnew text end percentile of the 2021 child
care provider rate survey or the rates in effect at the time of the updatedeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (2) for all preschool and school-age children, the greater of the 30th percentile of the
2021 child care provider rate survey or the rates in effect at the time of the update.
deleted text end

(b) Beginning the first full service period on or after January 1, 2025, new text begin and every three
years thereafter, new text end the maximum rate paid for child care assistance in a county or county price
cluster under the child care fund shall bedeleted text begin :
deleted text end

deleted text begin (1) for all infants and toddlers,deleted text end the greater of the deleted text begin 40thdeleted text end new text begin 75thnew text end percentile of the deleted text begin 2024deleted text end new text begin most
recentnew text end child care provider rate survey or the rates in effect at the time of the updatedeleted text begin ; anddeleted text end new text begin .
new text end

deleted text begin (2) for all preschool and school-age children, the greater of the 30th percentile of the
2024 child care provider rate survey or the rates in effect at the time of the update.
deleted text end

The rates under paragraph (a) continue until the rates under this paragraph go into effect.

(c) For a child care provider located within the boundaries of a city located in two or
more of the counties of Benton, Sherburne, and Stearns, the maximum rate paid for child
care assistance shall be equal to the maximum rate paid in the county with the highest
maximum reimbursement rates or the provider's charge, whichever is less. The commissioner
may: (1) assign a county with no reported provider prices to a similar price cluster; and (2)
consider county level access when determining final price clusters.

(d) A rate which includes a special needs rate paid under subdivision 3 may be in excess
of the maximum rate allowed under this subdivision.

(e) The department shall monitor the effect of this paragraph on provider rates. The
county shall pay the provider's full charges for every child in care up to the maximum
established. The commissioner shall determine the maximum rate for each type of care on
an hourly, full-day, and weekly basis, including special needs and disability care.

(f) If a child uses one provider, the maximum payment for one day of care must not
exceed the daily rate. The maximum payment for one week of care must not exceed the
weekly rate.

(g) If a child uses two providers under section 119B.097, the maximum payment must
not exceed:

(1) the daily rate for one day of care;

(2) the weekly rate for one week of care by the child's primary provider; and

(3) two daily rates during two weeks of care by a child's secondary provider.

(h) Child care providers receiving reimbursement under this chapter must not be paid
activity fees or an additional amount above the maximum rates for care provided during
nonstandard hours for families receiving assistance.

(i) If the provider charge is greater than the maximum provider rate allowed, the parent
is responsible for payment of the difference in the rates in addition to any family co-payment
fee.

(j) new text begin Beginning October 30, 2023, new text end the maximum registration fee paid for child care
assistance in any county or county price cluster under the child care fund shall be deleted text begin set as
follows: (1) beginning November 15, 2021,deleted text end the greater of the deleted text begin 40thdeleted text end new text begin 75thnew text end percentile of the
deleted text begin 2021deleted text end new text begin most recentnew text end child care provider rate survey or the registration fee in effect at the time
of the updatedeleted text begin ; and (2) beginning the first full service period on or after January 1, 2025, the
maximum registration fee shall be the greater of the 40th percentile of the 2024 child care
provider rate survey or the registration fee in effect at the time of the update. The registration
fees under clause (1) continue until the registration fees under clause (2) go into effectdeleted text end .

(k) Maximum registration fees must be set for licensed family child care and for child
care centers. For a child care provider located in the boundaries of a city located in two or
more of the counties of Benton, Sherburne, and Stearns, the maximum registration fee paid
for child care assistance shall be equal to the maximum registration fee paid in the county
with the highest maximum registration fee or the provider's charge, whichever is less.

Sec. 12.

new text begin [119B.196] FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.
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 a
family, friend, and neighbor (FFN) grant program to promote children's social-emotional
learning and healthy development, early literacy, and other skills to succeed as learners and
to foster community partnerships that will help children thrive when they enter school.
new text end

new text begin Subd. 2.new text end

new text begin Grant awards.new text end

new text begin The commissioner may award grants under this section to the
following entities working with FFN caregivers: community-based organizations, nonprofit
organizations, local or regional libraries, local public health agencies, and Indian Tribes
and Tribal organizations. Grantees may use grant money received under this section to:
new text end

new text begin (1) provide culturally and linguistically appropriate training, support, and resources to
FFN caregivers and children's families to improve and promote children's health, safety,
nutrition, and learning;
new text end

new text begin (2) connect FFN caregivers and children's families with community resources that support
the families' physical and mental health and economic and developmental needs;
new text end

new text begin (3) connect FFN caregivers and children's families to early childhood screening programs
and facilitate referrals to state and local agencies, schools, community organizations, and
medical providers, as appropriate;
new text end

new text begin (4) provide FFN caregivers and children's families with information about high-quality,
community-based early care and learning programs and financial assistance available to the
families, including but not limited to child care assistance under this chapter and early
learning scholarships under section 124D.165;
new text end

new text begin (5) provide FFN caregivers with information about registering as a legal nonlicensed
child care provider as defined in section 119B.011, subdivision 16, and establishing a
licensed family or group family child care program;
new text end

new text begin (6) provide transportation for FFN caregivers and children's families to educational and
other early childhood training activities;
new text end

new text begin (7) translate materials for FFN caregivers and children's families and provide translation
services to FFN caregivers and children's families;
new text end

new text begin (8) develop and disseminate social-emotional learning, health and safety, and early
learning kits to FFN caregivers; and
new text end

new text begin (9) establish play and learning groups for FFN caregivers.
new text end

new text begin Subd. 3.new text end

new text begin Administration.new text end

new text begin Applicants must apply for the grants using the forms and
according to timelines established by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Reporting requirements.new text end

new text begin (a) Grantees shall provide data and program outcomes
to the commissioner in a form and manner specified by the commissioner for the purpose
of evaluating the grant program.
new text end

new text begin (b) Beginning February 1, 2024, and every two years thereafter, the commissioner shall
report to the chairs and ranking minority members of the legislative committees with
jurisdiction over child care on program outcomes.
new text end

Sec. 13.

new text begin [143.01] DEFINITIONS.
new text end

new text begin Subdivision 1.new text end

new text begin Application.new text end

new text begin The definitions in this section apply to this chapter.
new text end

new text begin Subd. 2.new text end

new text begin Commissioner.new text end

new text begin "Commissioner" means the commissioner of children, youth,
and families.
new text end

new text begin Subd. 3.new text end

new text begin Department.new text end

new text begin "Department" means the Department of Children, Youth, and
Families.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 14.

new text begin [143.02] CREATION OF THE DEPARTMENT OF CHILDREN, YOUTH,
AND FAMILIES.
new text end

new text begin Subdivision 1.new text end

new text begin Department.new text end

new text begin The Department of Children, Youth, and Families is
established.
new text end

new text begin Subd. 2.new text end

new text begin Transfer and restructuring provisions.new text end

new text begin The restructuring of agencies under
this act must be conducted in accordance with sections 15.039 and 43A.045.
new text end

new text begin Subd. 3.new text end

new text begin Successor and employee protection clause.new text end

new text begin (a) Personnel relating to the
functions assigned to the commissioner in section 143.03 are transferred to the department
effective 30 days after approval by the commissioner.
new text end

new text begin (b) Before the commissioner's appointment, personnel relating to the functions in this
section may be transferred beginning July 1, 2024, with 30 days' notice from the
commissioner of management and budget.
new text end

new text begin (c) The following protections shall apply to employees who are transferred to the
department from state agencies:
new text end

new text begin (1) no transferred employee shall have their employment status and job classification
altered as a result of the transfer;
new text end

new text begin (2) transferred employees who were represented by an exclusive representative prior to
the transfer shall continue to be represented by the same exclusive representative after the
transfer;
new text end

new text begin (3) any applicable collective bargaining agreements with exclusive representatives shall
continue in full force and effect for transferred employees after the transfer;
new text end

new text begin (4) when an employee in a temporary unclassified position is transferred to the
department, the total length of time that the employee has served in the appointment shall
include all time served in the appointment at the transferring agency and the time served in
the appointment at the department. An employee in a temporary unclassified position who
was hired by a transferring agency through an open competitive selection process in
accordance with a policy enacted by the commissioner of management and budget shall be
considered to have been hired through such process after the transfer;
new text end

new text begin (5) the state shall have the obligation to meet and negotiate with the exclusive
representatives of the transferred employees about any proposed changes affecting or relating
to the transferred employees' terms and conditions of employment to the extent that the
proposed changes are not addressed in the applicable collective bargaining agreement; and
new text end

new text begin (6) in the event that the state transfers ownership or control of any facilities, services,
or operations of the department to another private or public entity by subcontracting, sale,
assignment, lease, or other transfer, the state shall require as a written condition of the
transfer of ownership or control the following:
new text end

new text begin (i) employees who perform work in the facilities, services, or operations must be offered
employment with the entity acquiring ownership or control before the entity offers
employment to any individual who was not employed by the transferring agency at the time
of the transfer; and
new text end

new text begin (ii) the wage and benefit standards of the transferred employees must not be reduced by
the entity acquiring ownership or control through the expiration of the collective bargaining
agreement in effect at the time of the transfer or for a period of two years after the transfer,
whichever is longer.
new text end

new text begin There is no liability on the part of, and no cause of action arises against, the state of
Minnesota or its officers or agents for any action or inaction of any entity acquiring ownership
or control of any facilities, services, or operations of the department.
new text end

new text begin (d) To the extent that departmental changes affect the operations of any school district
or charter school, employers have the obligation to bargain about any changes affecting or
relating to employees' terms and conditions of employment if the changes are necessary
during or after the term of an existing collective bargaining agreement.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 15.

new text begin [143.03] COMMISSIONER.
new text end

new text begin Subdivision 1.new text end

new text begin General.new text end

new text begin The department is under the administrative control of the
commissioner. The commissioner is appointed by the governor with the advice and consent
of the senate. The commissioner has the general powers provided in section 15.06,
subdivision 6. The commissioner's salary must be established according to the procedure
in section 15A.0815, subdivision 5, in the same range as specified for the commissioner of
management and budget.
new text end

new text begin Subd. 2.new text end

new text begin Duties of the commissioner.new text end

new text begin (a) The commissioner may apply for and accept
on behalf of the state any grants, bequests, gifts, or contributions for the purpose of carrying
out the duties and responsibilities of the commissioner. Any money received under this
paragraph is appropriated and dedicated for the purpose for which the money is granted.
The commissioner must biennially report to the chairs and ranking minority members of
relevant legislative committees and divisions by January 15 of each even-numbered year a
list of all grants and gifts received under this subdivision.
new text end

new text begin (b) Pursuant to law, the commissioner may apply for and receive money made available
from federal sources for the purpose of carrying out the duties and responsibilities of the
commissioner.
new text end

new text begin (c) The commissioner may make contracts with and grants to Tribal Nations, public and
private agencies and for-profit and nonprofit organizations, and individuals using appropriated
money.
new text end

new text begin (d) The commissioner must develop program objectives and performance measures for
evaluating progress toward achieving the objectives. The commissioner must identify the
objectives, performance measures, and current status of achieving the measures in a biennial
report to the chairs and ranking minority members of relevant legislative committees and
divisions. The report is due no later than January 15 each even-numbered year. The report
must include, when possible, the following objectives:
new text end

new text begin (1) centering and including the lived experiences of children and youth, including those
with disabilities and mental illness and their families, in all aspects of the department's work;
new text end

new text begin (2) increasing the effectiveness of the department's programs in addressing the needs of
children and youth facing racial, economic, or geographic inequities;
new text end

new text begin (3) increasing coordination and reducing inefficiencies among the department's programs
and the funding sources that support the programs;
new text end

new text begin (4) increasing the alignment and coordination of family access to child care and early
learning programs and improving systems of support for early childhood and learning
providers and services;
new text end

new text begin (5) improving the connection between the department's programs and the kindergarten
through grade 12 and higher education systems; and
new text end

new text begin (6) minimizing and streamlining the effort required of youth and families to receive
services to which the youth and families are entitled.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 16.

new text begin [143.04] STATE AND COUNTY SYSTEMS.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment of systems.new text end

new text begin (a) The commissioner shall establish and
enhance computer systems necessary for the efficient operation of the programs the
commissioner supervises, including:
new text end

new text begin (1) management and administration of the Supplemental Nutrition Assistance Program
(SNAP) and income maintenance program, including the electronic distribution of benefits;
and
new text end

new text begin (2) management and administration of the child support enforcement program.
new text end

new text begin (b) The commissioner's development costs incurred by computer systems for statewide
programs administered with that computer system and mandated by state or federal law
must not be assessed against county agencies. The commissioner may charge a county for
development and operating costs incurred by computer systems for functions requested by
the county and not mandated by state or federal law for programs administered by the
computer system incurring the cost.
new text end

new text begin (c) The commissioner shall distribute the nonfederal share of the costs of operating and
maintaining the systems to the commissioner and to the counties participating in the system
in a manner that reflects actual system usage, except that the nonfederal share of the costs
of the MAXIS computer system and child support enforcement systems for statewide
programs administered by those systems and mandated by state or federal law shall be borne
entirely by the commissioner.
new text end

new text begin (d) The commissioner may enter into contractual agreements with federally recognized
Indian Tribes with a reservation in Minnesota to participate in state-operated computer
systems related to the management and administration of the SNAP, income maintenance,
and child support enforcement programs to the extent necessary for the Tribe to operate a
federally approved family assistance program or any other program under the supervision
of the commissioner.
new text end

new text begin Subd. 2.new text end

new text begin State systems account created.new text end

new text begin A state systems account for the Department
of Children, Youth, and Families is created in the state treasury. Money collected by the
commissioner for the programs in subdivision 1 must be deposited in the account. Money
in the state systems account and federal matching money are appropriated to the
commissioner for purposes of this section.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 17.

new text begin [143.05] RULEMAKING.
new text end

new text begin (a) The commissioner may use the procedure in section 14.386, paragraph (a), to adopt
rules necessary to implement the responsibilities transferred under this article or through
section 16B.37. Section 14.386, paragraph (b), does not apply to these rules.
new text end

new text begin (b) The commissioner must amend Minnesota Rules to make conforming changes related
to the transfer of responsibilities under this act or through section 16B.37. The commissioner
must obtain the approval of the commissioners of human services, education, health, and
public safety for any amendments to or repeal of rules in existence on the effective date of
this section and administered under the authority of those agencies.
new text end

new text begin (c) The time limit in section 14.125 is extended to 36 months for rulemaking under
paragraphs (a) and (b). The commissioner must publish a notice of intent to adopt rules or
a notice of hearing within 36 months of the effective date reported under section 143.05,
subdivision 1, paragraph (c).
new text end

new text begin (d) The commissioner may adopt rules for the administration of activities related to the
department. Rules adopted under this paragraph are subject to the rulemaking requirements
of chapter 14.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 18.

new text begin [145.9285] COMMUNITY SOLUTIONS FOR HEALTHY CHILD
DEVELOPMENT GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The commissioner of health shall establish the community
solutions for healthy child development grant program. The purpose of the program is to:
new text end

new text begin (1) improve child development outcomes as related to the well-being of children of color
and American Indian children from prenatal to grade 3 and their families, including but not
limited to the goals outlined by the Department of Human Services' early childhood systems
reform effort for: early learning; health and well-being; economic security; and safe, stable,
nurturing relationships and environments by funding community-based solutions for
challenges that are identified by the affected community;
new text end

new text begin (2) reduce racial disparities in children's health and development from prenatal to grade
3; and
new text end

new text begin (3) promote racial and geographic equity.
new text end

new text begin Subd. 2.new text end

new text begin Commissioner's duties.new text end

new text begin The commissioner shall:
new text end

new text begin (1) develop a request for proposals for the healthy child development grant program in
consultation with the Community Solutions Advisory Council;
new text end

new text begin (2) provide outreach, technical assistance, and program development support to increase
capacity for new and existing service providers in order to better meet statewide needs,
particularly in greater Minnesota and areas where services to reduce health disparities have
not been established;
new text end

new text begin (3) review responses to requests for proposals, in consultation with the Community
Solutions Advisory Council, and award grants under this section;
new text end

new text begin (4) ensure communication with the ethnic councils, Minnesota Indian Affairs Council,
and the state advisory council on early childhood education and care on the request for
proposal process;
new text end

new text begin (5) establish a transparent and objective accountability process, in consultation with the
Community Solutions Advisory Council, that is focused on outcomes that grantees agree
to achieve;
new text end

new text begin (6) provide grantees with access to data to assist grantees in establishing and
implementing effective community-led solutions;
new text end

new text begin (7) maintain data on outcomes reported by grantees; and
new text end

new text begin (8) contract with an independent third-party entity to evaluate the success of the grant
program and to build the evidence base for effective community solutions in reducing health
disparities of children of color and American Indian children from prenatal to grade 3.
new text end

new text begin Subd. 3.new text end

new text begin Community Solutions Advisory Council; establishment; duties;
compensation.new text end

new text begin (a) The commissioner, in consultation with the three ethnic councils under
section 15.0145 and the Indian Affairs Council under section 3.922, shall appoint a
13-member Community Solutions Advisory Council, as follows:
new text end

new text begin (1) three members representing Black Minnesotans of African heritage, one of whom
is a parent with a child under the age of eight years at the time of the appointment;
new text end

new text begin (2) three members representing Latino and Latina Minnesotans with an ethnic heritage
from Mexico, a country in Central or South America, Cuba, the Dominican Republic, or
Puerto Rico, one of whom is a parent with a child under the age of eight years at the time
of the appointment;
new text end

new text begin (3) three members representing Asian-Pacific Minnesotans with Asian-Pacific heritage,
one of whom is a parent with a child under the age of eight years at the time of the
appointment;
new text end

new text begin (4) three members representing the American Indian community, one of whom is a
parent of a child under the age of eight years at the time of the appointment; and
new text end

new text begin (5) one member with research or academic expertise in racial equity and healthy child
development.
new text end

new text begin (b) The commissioner must include representation from organizations with expertise in
advocacy on behalf of communities of color and Indigenous communities in areas related
to the grant program.
new text end

new text begin (c) At least three of the 13 members appointed under paragraph (a), clauses (1) to (4),
of the advisory council must come from outside the seven-county metropolitan area.
new text end

new text begin (d) The Community Solutions Advisory Council shall:
new text end

new text begin (1) advise the commissioner on the development of the request for proposals for
community solutions healthy child development grants. In advising the commissioner, the
council must consider how to build on the capacity of communities to promote child and
family well-being and address social determinants of healthy child development;
new text end

new text begin (2) review responses to requests for proposals and advise the commissioner on the
selection of grantees and grant awards;
new text end

new text begin (3) advise the commissioner on the establishment of a transparent and objective
accountability process focused on outcomes the grantees agree to achieve;
new text end

new text begin (4) advise the commissioner on ongoing oversight and necessary support in the
implementation of the program; and
new text end

new text begin (5) support the commissioner on other racial equity and early childhood grant efforts.
new text end

new text begin (e) Member terms, compensation, and removal shall be as provided in section 15.059,
subdivisions 2 to 4.
new text end

new text begin (f) The commissioner must convene meetings of the advisory council at least four times
per year.
new text end

new text begin (g) The advisory council shall expire upon expiration or repeal of the healthy childhood
development program.
new text end

new text begin (h) The commissioner of health must provide meeting space and administrative support
for the advisory council.
new text end

new text begin Subd. 4.new text end

new text begin Eligible grantees.new text end

new text begin Organizations eligible to receive grant funding under this
section include:
new text end

new text begin (1) organizations or entities that work with communities of color and American Indian
communities;
new text end

new text begin (2) Tribal Nations and Tribal organizations as defined in section 658P of the Child Care
and Development Block Grant Act of 1990; and
new text end

new text begin (3) organizations or entities focused on supporting healthy child development.
new text end

new text begin Subd. 5.new text end

new text begin Strategic consideration and priority of proposals; eligible populations;
grant awards.new text end

new text begin (a) The commissioner, in consultation with the Community Solutions
Advisory Council, shall develop a request for proposals for healthy child development
grants. In developing the proposals and awarding the grants, the commissioner shall consider
building on the capacity of communities to promote child and family well-being and address
social determinants of healthy child development. Proposals must focus on increasing racial
equity and healthy child development and reducing health disparities experienced by children
of color and American Indian children from prenatal to grade 3 and their families.
new text end

new text begin (b) In awarding the grants, the commissioner shall provide strategic consideration and
give priority to proposals from:
new text end

new text begin (1) organizations or entities led by people of color and serving communities of color;
new text end

new text begin (2) organizations or entities led by American Indians and serving American Indians,
including Tribal Nations and Tribal organizations;
new text end

new text begin (3) organizations or entities with proposals focused on healthy development from prenatal
to grade 3;
new text end

new text begin (4) organizations or entities with proposals focusing on multigenerational solutions;
new text end

new text begin (5) organizations or entities located in or with proposals to serve communities located
in counties that are moderate to high risk according to the Wilder Research Risk and Reach
Report; and
new text end

new text begin (6) community-based organizations that have historically served communities of color
and American Indians and have not traditionally had access to state grant funding.
new text end

new text begin The advisory council may recommend additional strategic considerations and priorities to
the commissioner.
new text end

new text begin (c) The first round of grants must be awarded no later than April 15, 2024. Grants must
be awarded annually thereafter. Grants are awarded for a period of three years.
new text end

new text begin Subd. 6.new text end

new text begin Geographic distribution of grants.new text end

new text begin The commissioner and the advisory council
shall ensure that grant money is prioritized and awarded to organizations and entities that
are within counties that have a higher proportion of people of color and American Indians
than the state average, to the extent possible.
new text end

new text begin Subd. 7.new text end

new text begin Report.new text end

new text begin Grantees must report grant program outcomes to the commissioner on
the forms and according to the timelines established by the commissioner.
new text end

Sec. 19.

Minnesota Statutes 2022, section 256.014, subdivision 1, is amended to read:

Subdivision 1.

Establishment of systems.

(a) The commissioner of human services
shall establish and enhance computer systems necessary for the efficient operation of deleted text begin thedeleted text end new text begin
medical assistance and othernew text end programs the commissioner supervisesdeleted text begin , including:deleted text end new text begin .
new text end

deleted text begin (1) management and administration of the Supplemental Nutrition Assistance Program
(SNAP) and income maintenance program, including the electronic distribution of benefits;
deleted text end

deleted text begin (2) management and administration of the child support enforcement program; and
deleted text end

deleted text begin (3) administration of medical assistance.
deleted text end

(b) The commissioner's development costs incurred by computer systems for statewide
programs administered by that computer system and mandated by state or federal law must
not be assessed against county agencies. The commissioner may charge a county for
development and operating costs incurred by computer systems for functions requested by
the county and not mandated by state or federal law for programs administered by the
computer system incurring the cost.

(c) The commissioner shall distribute the nonfederal share of the costs of operating and
maintaining the systems to the commissioner and to the counties participating in the system
in a manner that reflects actual system usage, except that the nonfederal share of the costs
of the MAXIS computer system deleted text begin and child support enforcement systemsdeleted text end for statewide
programs administered by deleted text begin those systemsdeleted text end new text begin that systemnew text end and mandated by state or federal law
shall be borne entirely by the commissioner.

The commissioner may enter into contractual agreements with federally recognized
Indian Tribes with a reservation in Minnesota to participate in state-operated computer
systems related to the management and administration of the deleted text begin SNAP, income maintenance,
child support enforcement, anddeleted text end medical assistance deleted text begin programsdeleted text end new text begin programnew text end to the extent necessary
for the Tribe to operate deleted text begin a federally approved familydeleted text end new text begin the medicalnew text end assistance program or any
other program under the supervision of the commissioner.

new text begin EFFECTIVE DATE.new text end

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

Sec. 20.

Minnesota Statutes 2022, section 256.014, subdivision 2, is amended to read:

Subd. 2.

State systems account created.

A state systems accountnew text begin for the Department
of Human Servicesnew text end is created in the state treasury. Money collected by the commissioner
of human services for the programs in subdivision 1 must be deposited in the account.
Money in the state systems account and federal matching money is appropriated to the
commissioner of human services for purposes of this section.

new text begin EFFECTIVE DATE.new text end

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

Sec. 21.

new text begin [256E.38] DIAPER DISTRIBUTION GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment; purpose.new text end

new text begin The commissioner of human services shall
establish a diaper distribution program to award competitive grants to eligible applicants
to provide diapers to underresourced families statewide.
new text end

new text begin Subd. 2.new text end

new text begin Eligibility.new text end

new text begin To be eligible for a grant under this section, an applicant must
demonstrate its capacity to distribute diapers statewide by having:
new text end

new text begin (1) a network of well-established partners for diaper distribution;
new text end

new text begin (2) the infrastructure needed to efficiently manage diaper procurement and distribution
statewide;
new text end

new text begin (3) relationships with national organizations that support and enhance the work of
addressing diaper need;
new text end

new text begin (4) the ability to engage in building community awareness of diaper need and advocate
for diaper need at local, state, and federal levels;
new text end

new text begin (5) a commitment to and demonstration of working with organizations across ideological
and political spectrums;
new text end

new text begin (6) the ability to address diaper need for children from birth through early childhood;
and
new text end

new text begin (7) a commitment to working within an equity framework by ensuring access to
organizations that provide culturally specific services or are located in communities with
high concentrations of poverty.
new text end

new text begin Subd. 3.new text end

new text begin Application.new text end

new text begin Applicants must apply to the commissioner in a form and manner
prescribed by the commissioner. Applications must be filed at the times and for the periods
determined by the commissioner.
new text end

new text begin Subd. 4.new text end

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

new text begin An eligible applicant that receives grant money
under this section shall use the money to purchase diapers and wipes and may use up to
four percent of the money for administrative costs.
new text end

new text begin Subd. 5.new text end

new text begin Enforcement.new text end

new text begin (a) An eligible applicant that receives grant money under this
section must:
new text end

new text begin (1) retain records documenting expenditure of the grant money;
new text end

new text begin (2) report to the commissioner on the use of the grant money; and
new text end

new text begin (3) comply with any additional requirements imposed by the commissioner.
new text end

new text begin (b) The commissioner may require that a report submitted under this subdivision include
an independent audit.
new text end

Sec. 22.

Laws 2023, chapter 52, article 5, section 27, is amended to read:

Sec. 27.

299A.95 OFFICE OF RESTORATIVE PRACTICES.

Subdivision 1.

Definition.

As used in this section, "restorative practices" means a practice
within a program or policy that incorporates core restorative principles, including but not
limited to voluntariness, prioritization of agreement by the people closest to the harm on
what is needed to repair the harm, reintegration into the community, honesty, and respect.
Restorative practices include but are not limited to victim-offender conferences, family
group conferences, circles, community conferences, and other similar victim-centered
practices. Restorative practices funded under this statute may be used at any point including
before court involvement, after court involvement, to prevent court involvement, or in
conjunction with court involvement. Restorative practices are rooted in community values
and create meaningful outcomes that may include but are not limited to:

(1) establishing and meeting goals related to increasing connection to community,
restoring relationships, and increasing empathy; considering all perspectives involved; and
taking responsibility for impact of actions by all parties involved;

(2) addressing the needs of those who have been harmed;

(3) recognizing and addressing the underlying issues of behavior;

(4) engaging with those most directly affected by an incident and including community
members that reflect the diversity of the individual's environment;

(5) determining the appropriate responses to specific incidents through the use of a
collaborative process;

(6) providing solutions and approaches that affirm and are tailored to specific cultures;
and

(7) implementing policies and procedures that are informed by the science of the social,
emotional, and cognitive development of children.

Subd. 2.

Establishment.

The Office of Restorative Practices is established within the
Department of Public Safety. The Office of Restorative Practices shall have the powers and
duties described in this section.

deleted text begin Subd. 3.deleted text end

deleted text begin Department of Children, Youth, and Family; automatic transfer.deleted text end

deleted text begin In the
event that a Department of Children, Youth, and Family is created as an independent agency,
the Office of Restorative Practices shall be transferred to that department pursuant to section
15.039 effective six months following the effective date for legislation creating that
department.
deleted text end

Subd. 4.

Director; other staff.

(a) The commissioner of public safety shall appoint a
director of the Office of Restorative Practices. The director should have qualifications that
include or are similar to the following:

(1) experience in the many facets of restorative justice and practices such as peacemaking
circles, sentencing circles, community conferencing, community panels, and family group
decision making;

(2) experience in victim-centered and trauma-informed practices;

(3) knowledge of the range of social problems that bring children and families to points
of crisis such as poverty, racism, unemployment, and unequal opportunity;

(4) knowledge of the many ways youth become involved in other systems such as truancy,
juvenile delinquency, child protection; and

(5) understanding of educational barriers.

(b) The director shall hire additional staff to perform the duties of the Office of
Restorative Practices. The staff shall be in the classified service of the state and their
compensation shall be established pursuant to chapter 43A.

Subd. 5.

Duties.

(a) The Office of Restorative Practices shall promote the use of
restorative practices across multiple disciplines, including but not limited to:

(1) pretrial diversion programs established pursuant to section 388.24;

(2) delinquency, criminal justice, child welfare, and education systems; and

(3) community violence prevention practices.

(b) The Office of Restorative Practices shall collaborate with Tribal communities,
counties, multicounty agencies, other state agencies, nonprofit agencies, and other
jurisdictions, and with existing restorative practices initiatives in those jurisdictions to
establish new restorative practices initiatives, support existing restorative practices initiatives,
and identify effective restorative practices initiatives.

(c) The Office of Restorative Practices shall encourage collaboration between jurisdictions
by creating a statewide network, led by restorative practitioners, to share effective methods
and practices.

(d) The Office of Restorative Practices shall create a statewide directory of restorative
practices initiatives. The office shall make this directory available to all restorative practices
initiatives, counties, multicounty agencies, nonprofit agencies, and Tribes in order to facilitate
referrals to restorative practices initiatives and programs.

(e) The Office of Restorative Practices shall work throughout the state to build capacity
for the use of restorative practices in all jurisdictions and shall encourage every county to
have at least one available restorative practices initiative.

(f) The Office of Restorative Practices shall engage restorative practitioners in discerning
ways to measure the effectiveness of restorative efforts throughout the state.

(g) The Office of Restorative Practices shall oversee the coordination and establishment
of local restorative practices advisory committees. The office shall oversee compliance with
the conditions of this funding program. If a complaint or concern about a local advisory
committee or a grant recipient is received, the Office of Restorative Practices shall exercise
oversight as provided in this section.

(h) The Office of Restorative Practices shall provide information to local restorative
practices advisory committees, or restorative practices initiatives in Tribal communities and
governments, counties, multicounty agencies, other state agencies, and other jurisdictions
about best practices that are developmentally tailored to youth, trauma-informed, and
healing-centered, and provide technical support. Providing information includes but is not
limited to sharing data on successful practices in other jurisdictions, sending notification
about available training opportunities, and sharing known resources for financial support.
The Office of Restorative Practices shall also provide training and technical support to local
restorative practices advisory committees. Training includes but is not limited to the use
and scope of restorative practices, victim-centered restorative practices, and trauma-informed
care.

(i) The Office of Restorative Practices shall annually establish minimum requirements
for the grant application process.

(j) The Office of Restorative Practices shall work with Tribes, counties, multicounty
agencies, and nonprofit agencies throughout the state to educate those entities about the
application process for grants and encourage applications.

Subd. 6.

Grants.

(a) Within available appropriations, the director shall award grants to
establish and support restorative practices initiatives. An approved applicant must receive
a grant of up to $500,000 each year.

(b) On an annual basis, the Office of Restorative Practices shall establish a minimum
number of applications that must be received during the application process. If the minimum
number of applications is not received, the office must reopen the application process.

(c) Grants may be awarded to private and public nonprofit agencies; local units of
government, including cities, counties, and townships; local educational agencies; and Tribal
governments. A restorative practices advisory committee may support multiple entities
applying for grants based on community needs, the number of youth and families in the
jurisdiction, and the number of restorative practices available to the community. Budgets
supported by grant funds can include contracts with partner agencies.

(d) Applications must include the following:

(1) a list of willing restorative practices advisory committee members;

(2) letters of support from potential restorative practices advisory committee members;

(3) a description of the planning process that includes:

(i) a description of the origins of the initiative, including how the community provided
input; and

(ii) an estimated number of participants to be served; and

(4) a formal document containing a project description that outlines the proposed goals,
activities, and outcomes of the initiative including, at a minimum:

(i) a description of how the initiative meets the minimum eligibility requirements of the
grant;

(ii) the roles and responsibilities of key staff assigned to the initiative;

(iii) identification of any key partners, including a summary of the roles and
responsibilities of those partners;

(iv) a description of how volunteers and other community members are engaged in the
initiative; and

(v) a plan for evaluation and data collection.

(e) In determining the appropriate amount of each grant, the Office of Restorative
Practices shall consider the number of individuals likely to be served by the local restorative
practices initiative.

Subd. 7.

Restorative practices advisory committees; membership and duties.

(a)
Restorative practices advisory committees must include:

(1) a judge of the judicial district that will be served by the restorative practices initiative;

(2) the county attorney of a county that will be served by the restorative practices initiative
or a designee;

(3) the chief district public defender in the district that will be served by the local
restorative justice program or a designee;

(4) a representative from the children's unit of a county social services agency assigned
to the area that will be served by the restorative practices initiative;

(5) a representative from the local probation department or community corrections
agency that works with youth in the area that will be served by the restorative practices
initiative;

(6) a representative from a local law enforcement agency that operates in the area that
will be served by the restorative practices initiative;

(7) a school administrator or designee from a school or schools that operate in the area
that will be served by the restorative practices initiative;

(8) multiple community members that reflect the racial, socioeconomic, and other
diversity of the population of a county that will be served by the local restorative justice
program and the individuals most frequently involved in the truancy, juvenile offender, and
juvenile safety and placement systems;

(9) restorative practitioners, including restorative practitioners from within the community
if available and, if not, from nearby communities;

(10) parents, youth, and justice-impacted participants; and

(11) at least one representative from a victims advocacy group.

(b) Community members described in paragraph (a), clause (8), must make up at least
one-third of the restorative practices advisory committee.

(c) Community members, parents, youth, and justice-impacted participants participating
in the advisory committee may receive a per diem from grant funds in the amount determined
by the General Services Administration.

(d) The restorative practices advisory committees must utilize restorative practices in
their decision-making process and come to consensus when developing, expanding, and
maintaining restorative practices criteria and referral processes for their communities.

(e) Restorative practices advisory committees shall be responsible for establishing
eligibility requirements for referrals to the local restorative practices initiative. Once
restorative practices criteria and referral processes are developed, children, families, and
cases, depending upon the point of prevention or intervention, must be referred to the local
restorative practices initiatives or programs that serve the county, local community, or Tribal
community where the child and family reside.

(f) Referrals may be made under circumstances, including but not limited to:

(1) as an alternative to arrest as outlined in section 260B.1755;

(2) for a juvenile petty offense;

(3) for a juvenile traffic offense;

(4) for a juvenile delinquency offense, including before and after a delinquency petition
has been filed;

(5) for a child protection case, including before and after adjudication;

(6) for a children's mental health case;

(7) for a juvenile status offense, including but not limited to truancy or running away;

(8) for substance use issues;

(9) for situations involving transition to or from the community; and

(10) through self-referral.

Subd. 8.

Oversight of restorative practices advisory committees.

(a) Complaints by
restorative practices advisory committee members, community members, restorative practices
initiatives, or restorative practices practitioners regarding concerns about grant recipients
may be made to the Office of Restorative Practices.

(b) The Office of Restorative Practices may prescribe the methods by which complaints
to the office are to be made, reviewed, and acted upon.

(c) The Office of Restorative Practices shall establish and use a restorative process to
respond to complaints so that grant recipients are being held to their agreed upon
responsibilities and continue to meet the minimum eligibility requirements for grants to
local restorative practices initiatives for the duration of the grant.

Subd. 9.

Report.

By February 15 of each year, the director shall report to the chairs and
ranking minority members of the legislative committees and divisions with jurisdiction over
public safety, human services, and education, on the work of the Office of Restorative
Practices, any grants issued pursuant to this section, and the status of local restorative
practices initiatives in the state that were reviewed in the previous year.

Sec. 23. new text begin 2023 S.F. No. 2292, section 20, subdivision 13, if enacted:
new text end

Subd. 13.

Quality rating and improvement system.

(a) For transfer to the commissioner
of human services for the purposes of expanding the quality rating and improvement system
under Minnesota Statutes, section 124D.142, in greater Minnesota and increasing supports
for providers participating in the quality rating and improvement system:

	$	2,850,000	.....	2024
	$	1,750,000	.....	2025

(b) The amounts in paragraph (a) must be in addition to any federal funding under the
child care and development block grant authorized under Public Law 101-508 in that year
for the system under Minnesota Statutes, section 124D.142.

(c) The commissioner of human services shall use up to $1,100,000 in fiscal year 2024
from the amount appropriated under paragraph (a) to establish and report on the automatic
one-star rating under Minnesota Statutes, section 124D.142, subdivision 2, paragraph (a),
and to offer related supports.

new text begin (d) Any balance in the first year does not cancel but is available in the second year.
new text end

Sec. 24. new text begin DIRECTION TO COMMISSIONER; ALLOCATING BASIC SLIDING
FEE MONEY.
new text end

new text begin Notwithstanding Minnesota Statutes, section 119B.03, subdivisions 6, 6a, and 6b, the
commissioner of human services must allocate additional basic sliding fee child care money
for calendar year 2025 to counties and Tribes to account for the change in the definition of
family in Minnesota Statutes, section 119B.011, in this article. In allocating the additional
money, the commissioner shall consider:
new text end

new text begin (1) the number of children in the county or Tribe who receive care from a relative
custodian who accepted a transfer of permanent legal and physical custody of a child under
Minnesota Statutes, section 260C.515, subdivision 4, or similar permanency disposition in
Tribal code; successor custodian or guardian as established according to Minnesota Statutes,
section 256N.22, subdivision 10; or foster parents in a family foster home under Minnesota
Statutes, section 260C.007, subdivision 16b; and
new text end

new text begin (2) the average basic sliding fee cost of care in the county or Tribe.
new text end

Sec. 25. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; COST
ESTIMATION MODEL FOR EARLY CARE AND LEARNING PROGRAMS.
new text end

new text begin (a) The commissioner of human services shall develop a cost estimation model for
providing early care and learning in the state. In developing the model, the commissioner
shall consult with relevant entities and stakeholders, including but not limited to the State
Advisory Council on Early Childhood Education and Care under Minnesota Statutes, section
124D.141; county administrators; child care resource and referral organizations under
Minnesota Statutes, section 119B.19, subdivision 1; and organizations representing
caregivers, teachers, and directors.
new text end

new text begin (b) The commissioner shall contract with an organization with experience and expertise
in early care and learning cost estimation modeling to conduct the work outlined in this
section. If practicable, the commissioner shall contract with First Children's Finance.
new text end

new text begin (c) The commissioner shall ensure that the model can estimate variation in the cost of
early care and learning by:
new text end

new text begin (1) the quality of care;
new text end

new text begin (2) the geographic area;
new text end

new text begin (3) the type of child care provider and associated licensing standards;
new text end

new text begin (4) the age of the child;
new text end

new text begin (5) whether the early care and learning is inclusive by caring for children with disabilities
alongside children without disabilities;
new text end

new text begin (6) child care provider and staff compensation, including benefits such as professional
development stipends, health care benefits, and retirement benefits;
new text end

new text begin (7) a child care provider's fixed costs, including rent and mortgage payments, property
taxes, and business-related insurance payments;
new text end

new text begin (8) a child care provider's operating expenses, including expenses for training and
substitutes; and
new text end

new text begin (9) a child care provider's hours of operation.
new text end

new text begin (d) By January 30, 2025, the commissioner must submit a report to the legislative
committees with jurisdiction over early childhood programs on the development of the cost
estimation model. The report must include:
new text end

new text begin (1) recommendations on how the model could be used in conjunction with a child care
and early education professional wage scale to set child care provider payment rates for
child care assistance under Minnesota Statutes, chapter 119B, and great start scholarships
under Minnesota Statutes, section 119C.01; and
new text end

new text begin (2) a plan to seek federal approval to use the model for child care provider payment rates
for child care assistance.
new text end

Sec. 26. new text begin DIRECTION TO COMMISSIONER; INCREASE FOR MAXIMUM CHILD
CARE ASSISTANCE RATES.
new text end

new text begin Notwithstanding Minnesota Statutes, section 119B.03, subdivisions 6, 6a, and 6b, the
commissioner must allocate the additional basic sliding fee child care money for calendar
year 2024 to counties and Tribes for updated maximum rates based on relative need to cover
maximum rate increases. In distributing the additional money, the commissioner shall
consider the following factors by county and Tribe:
new text end

new text begin (1) the number of children;
new text end

new text begin (2) the provider type;
new text end

new text begin (3) the age of children served; and
new text end

new text begin (4) the amount of the increase in maximum rates.
new text end

Sec. 27. new text begin FIRST APPOINTMENTS AND TERMS FOR THE COMMUNITY
SOLUTIONS ADVISORY COUNCIL.
new text end

new text begin The commissioner of health must appoint members to the Community Solutions Advisory
Council under Minnesota Statutes, section 145.9285, by July 1, 2023, and must convene
the first meeting by September 15, 2023. The commissioner must designate half of the
members appointed under Minnesota Statutes, section 145.9285, subdivision 3, paragraph
(a), clauses (1) to (4), to serve a two-year term and the remaining members will serve a
four-year term. The commissioner may appoint people who are serving on or who have
served on the council established under Laws 2019, First Special Session chapter 9, article
11, section 107, subdivision 3.
new text end

Sec. 28. new text begin APPOINTMENT OF COMMISSIONER OF CHILDREN, YOUTH, AND
FAMILIES.
new text end

new text begin The governor shall appoint a commissioner-designee of the Department of Children,
Youth, and Families. The person appointed becomes the governor's appointee as the
commissioner of children, youth, and families on July 1, 2024.
new text end

Sec. 29. new text begin DATA PRACTICES.
new text end

new text begin (a) To the extent not prohibited by state or federal law, and notwithstanding the data's
classification under Minnesota Statutes, chapter 13:
new text end

new text begin (1) the commissioner of children, youth, and families may access data maintained by
the commissioners of education, human services, and public safety related to the
responsibilities transferred under section 30; and
new text end

new text begin (2) the commissioners of education, human services, and public safety may access data
maintained by the commissioner of children, youth, and families related to each department's
respective responsibilities transferred under section 30.
new text end

new text begin (b) Data sharing authorized by this subdivision includes only the data necessary to
coordinate department activities and services transferred under section 30.
new text end

new text begin (c) Any data shared under this section retain the data's classification from the agency
holding the data.
new text end

new text begin (d) Existing limitations and legal requirements under Minnesota Statutes, chapter 13,
including but not limited to any applicable data subject to consent requirements, apply to
any data accessed, transferred, disseminated, or shared under this section.
new text end

new text begin (e) This section expires July 1, 2027.
new text end

Sec. 30. new text begin TRANSFERS FROM OTHER AGENCIES.
new text end

new text begin Subdivision 1.new text end

new text begin General.new text end

new text begin (a) Between July 1, 2024, and July 1, 2025, the Departments
of Human Services, Education, and Public Safety must transition all of the responsibilities
held by these departments and described in this section to the Department of Children,
Youth, and Families.
new text end

new text begin (b) Notwithstanding paragraph (a), any programs identified in paragraph (a) that require
federal approval to move to the Department of Children, Youth, and Families must be
transferred on or after July 1, 2024, and upon the federal government granting transfer
authority to the commissioner of children, youth, and families.
new text end

new text begin (c) The commissioner of children, youth, and families must report an effective date of
the transfer of each responsibility identified in this section to the commissioners of
administration, management and budget, and other relevant departments along with the
secretary of the senate, the chief clerk of the house of representatives, and the chairs and
ranking minority members of relevant legislative committees and divisions. The reported
date is the effective date of transfer of responsibilities under Minnesota Statutes, section
15.039.
new text end

new text begin (d) The requirement in Minnesota Statutes, section 16B.37, subdivision 1, that a state
agency must have been in existence for at least one year before being eligible for receiving
a transfer of personnel, powers, or duties does not apply to the Department of Children,
Youth, and Families.
new text end

new text begin (e) Notwithstanding Minnesota Statutes, section 15.039, subdivision 6, for the transfer
of responsibilities conducted under this chapter, the unexpended balance of any appropriation
to an agency for the purposes of any responsibilities that are transferred to the Department
of Children, Youth, and Families, along with the operational functions to support the
responsibilities transferred, including administrative, legal, information technology, and
personnel support, and a proportional share of base funding, are transferred and appropriated
under the same conditions as the original appropriation to the Department of Children,
Youth, and Families effective on the date of the transfer of responsibilities and related
elements. The commissioner of management and budget shall identify and allocate any
unexpended appropriations and base funding. Funds that are transferred and appropriated
to the Department of Children, Youth, and Families under this subdivision are part of the
agency's base in future years under the same conditions as the original appropriations.
new text end

new text begin (f) The commissioner of children, youth, and families or management and budget may
request an extension to transfer any responsibility listed in this section. The commissioner
of children, youth, and families or management and budget may request that the transfer of
any responsibility listed in this section be canceled if an effective date has not been reported
under paragraph (c). Any request under this paragraph must be made in writing to the
governor. Upon approval from the governor, the transfer may be delayed or canceled. Within
ten days after receiving the approval of the governor, the commissioner who requested the
transfer shall submit to the chairs and ranking minority members of relevant legislative
committees and divisions a notice of any extensions or cancellations granted under this
paragraph.
new text end

new text begin (g) The commissioner of children, youth, and families must provide four successive
quarterly reports to relevant legislative committees on the status of transferring programs;
responsibilities; not public data as defined in section 13.02, subdivision 8a; and personnel
under this section. The first report must cover the quarter starting July 1, 2024, and each
report must be submitted by the 15th of the month following the quarter end.
new text end

new text begin Subd. 2.new text end

new text begin Department of Human Services.new text end

new text begin The powers and duties of the Department
of Human Services with respect to the following responsibilities and related elements are
transferred to the Department of Children, Youth, and Families according to Minnesota
Statutes, section 15.039:
new text end

new text begin (1) family services and community-based collaboratives under Minnesota Statutes,
section 124D.23;
new text end

new text begin (2) child care programs under Minnesota Statutes, chapter 119B;
new text end

new text begin (3) Parent Aware quality rating and improvement system under Minnesota Statutes,
section 124D.142;
new text end

new text begin (4) migrant child care services under Minnesota Statutes, section 256M.50;
new text end

new text begin (5) early childhood and school-age professional development training under Laws 2007,
chapter 147, article 2, section 56;
new text end

new text begin (6) licensure of family child care and child care centers, child foster care, and private
child placing agencies under Minnesota Statutes, chapter 245A;
new text end

new text begin (7) certification of license-exempt child care centers under Minnesota Statutes, chapter
245H;
new text end

new text begin (8) program integrity and fraud related to the Child Care Assistance Program (CCAP),
the Minnesota Family Investment Program (MFIP), and the Supplemental Nutrition
Assistance Program (SNAP) under Minnesota Statutes, chapters 119B and 245E;
new text end

new text begin (9) SNAP under Minnesota Statutes, sections 256D.60 to 256D.63;
new text end

new text begin (10) electronic benefit transactions under Minnesota Statutes, sections 256.9862,
256.9863, 256.9865, 256.987, 256.9871, 256.9872, and 256J.77;
new text end

new text begin (11) Minnesota food assistance program under Minnesota Statutes, section 256D.64;
new text end

new text begin (12) Minnesota food shelf program under Minnesota Statutes, section 256E.34;
new text end

new text begin (13) MFIP and Temporary Assistance for Needy Families (TANF) under Minnesota
Statutes, sections 256.9864 and 256.9865 and chapters 256J and 256P;
new text end

new text begin (14) Diversionary Work Program (DWP) under Minnesota Statutes, section 256J.95;
new text end

new text begin (15) resettlement programs under Minnesota Statutes, section 256B.06, subdivision 6;
new text end

new text begin (16) child abuse under Minnesota Statutes, chapter 256E;
new text end

new text begin (17) reporting of the maltreatment of minors under Minnesota Statutes, chapter 260E;
new text end

new text begin (18) children in voluntary foster care for treatment under Minnesota Statutes, chapter
260D;
new text end

new text begin (19) juvenile safety and placement under Minnesota Statutes, chapter 260C;
new text end

new text begin (20) the Minnesota Indian Family Preservation Act under Minnesota Statutes, sections
260.751 to 260.835;
new text end

new text begin (21) the Interstate Compact for Juveniles under Minnesota Statutes, section 260.515,
and the Interstate Compact on the Placement of Children under Minnesota Statutes, sections
260.851 to 260.93;
new text end

new text begin (22) adoption under Minnesota Statutes, sections 259.20 to 259.89;
new text end

new text begin (23) Northstar Care for Children under Minnesota Statutes, chapter 256N;
new text end

new text begin (24) child support under Minnesota Statutes, chapters 13, 13B, 214, 256, 256J, 257, 259,
518, 518A, 518C, 551, 552, 571, and 588, and Minnesota Statutes, section 609.375;
new text end

new text begin (25) community action programs under Minnesota Statutes, sections 256E.30 to 256E.32;
and
new text end

new text begin (26) Family Assets for Independence in Minnesota under Minnesota Statutes, section
256E.35.
new text end

new text begin Subd. 3.new text end

new text begin Department of Education.new text end

new text begin The powers and duties of the Department of
Education with respect to the following responsibilities and related elements are transferred
to the Department of Children, Youth, and Families according to Minnesota Statutes, section
15.039:
new text end

new text begin (1) Head Start Program and Early Head Start under Minnesota Statutes, sections 119A.50
to 119A.545;
new text end

new text begin (2) the early childhood screening program under Minnesota Statutes, sections 121A.16
to 121A.19;
new text end

new text begin (3) early learning scholarships under Minnesota Statutes, section 124D.165;
new text end

new text begin (4) the interagency early childhood intervention system under Minnesota Statutes,
sections 125A.259 to 125A.48;
new text end

new text begin (5) voluntary prekindergarten programs and school readiness plus programs under
Minnesota Statutes, section 124D.151;
new text end

new text begin (6) early childhood family education programs under Minnesota Statutes, sections
124D.13 to 124D.135;
new text end

new text begin (7) school readiness under Minnesota Statutes, sections 124D.15 to 124D.16; and
new text end

new text begin (8) after-school community learning programs under Minnesota Statutes, section
124D.2211.
new text end

new text begin Subd. 4.new text end

new text begin Department of Public Safety.new text end

new text begin The powers and duties of the Department of
Public Safety with respect to the following responsibilities and related elements are
transferred to the Department of Children, Youth, and Families according to Minnesota
Statutes, section 15.039:
new text end

new text begin (1) the juvenile justice program under Minnesota Statutes, section 299A.72;
new text end

new text begin (2) grants-in-aid to youth intervention programs under Minnesota Statutes, section
299A.73; and
new text end

new text begin (3) the Office of Restorative Practices under Minnesota Statutes, section 299A.95.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 31. new text begin TRANSITION REPORT TO THE LEGISLATURE.
new text end

new text begin By March 1, 2024, the commissioner of management and budget must report to the
legislature on the status of work related to establishing and setting up the Department of
Children, Youth, and Families. The report must address, at a minimum:
new text end

new text begin (1) the completed, ongoing, and anticipated work related to the transfer of programs,
responsibilities, and personnel to the department;
new text end

new text begin (2) the development of interagency agreements for services that will be shared by
agencies, including any agreements related to access or sharing of not public data;
new text end

new text begin (3) efforts to secure needed federal approvals for the transfer of programs and
responsibilities;
new text end

new text begin (4) regular engagement with leaders and staff of state agencies, county and Tribal
governments, and school districts about the creation of the department and the transfer of
programs; responsibilities; not public data as defined in section 13.02, subdivision 8a; and
personnel to the department;
new text end

new text begin (5) input from individuals impacted by the programs that are to be transferred to the
department and input from local services providers and other stakeholders about how to
improve services through the creation of the department; and
new text end

new text begin (6) plans and timelines related to the items referenced in clauses (1) to (5).
new text end

new text begin (b) The report must include recommendations for how to coordinate and partner with
county and Tribal governments, including through the use of a governing authority, such
as an intergovernmental advisory committee. The recommendations must be developed in
coordination with county and Tribal governments.
new text end

new text begin (c) The report must include input from stakeholders and recommendations for improving
service coordination and delivery for families with children who have disabilities, including
recommendations for coordinating services between state agencies in the areas of child
protection, early education, children's mental health, disability services, and other areas
relevant to families with children who have disabilities.
new text end

Sec. 32. new text begin MODERNIZING INFORMATION TECHNOLOGY FOR PROGRAMS
IMPACTING CHILDREN AND FAMILIES.
new text end

new text begin (a) To the extent there is funding available for this purpose in the state systems account
established under Minnesota Statutes, section 256.014, subdivision 2, the commissioner of
human services shall develop and implement a plan to transform and modernize the
information technology systems that support the programs impacting children and families,
including youth programs and child care and early learning programs, currently administered
by the Departments of Education and Human Services and other departments with programs
impacting children and families as identified by the Children's Cabinet. The commissioner
may contract for the services contained in this section.
new text end

new text begin (b) The plan must support the goal of creating new or modernizing existing information
technology systems for child- and family-focused programs that collect, analyze, share, and
report data on program participation and service coordination and school readiness, early
screening, and other childhood indicators. The plan must include strategies to:
new text end

new text begin (1) minimize the time and effort needed for families to apply for, enroll in, and maintain
enrollment in programs;
new text end

new text begin (2) minimize the time and effort needed for providers to administer programs;
new text end

new text begin (3) improve coordination among programs for families;
new text end

new text begin (4) assess the impact of childhood programs on children's outcomes, including school
readiness and educational outcomes; and
new text end

new text begin (5) monitor and collect nonbiometric attendance data at child care centers licensed under
Minnesota Rules, chapter 9503, through a combination of state-provided technology and
integration with private child care management systems.
new text end

new text begin (c) In developing and implementing the plan required under this section, the commissioner
must consult with the commissioners of education and information technology services and
other departments with programs impacting children and families as identified by the
Children's Cabinet and other stakeholders. The plan and corresponding implementation
must be coordinated and aligned with other systems modernization activities that affect the
same state agencies and programs.
new text end

new text begin (d) By February 1 of each year, the commissioner, in collaboration with the commissioner
of information technology services, must provide a report to the legislative committees with
jurisdiction over impacted programs on the status of the use of money, plan development,
and strategy implementation. This paragraph expires on February 1 of the year after all the
funds appropriated for the purposes described in paragraph (a) in the state systems account
established under Minnesota Statutes, section 256.014, subdivision 2, have been spent.
new text end

new text begin (e) When the Department of Children, Youth, and Families is operational, the
responsibilities and authorities given to the commissioner of human services under this
section shall transfer to the commissioner of children, youth, and families.
new text end

Sec. 33. new text begin PREPARED MEALS FOOD RELIEF GRANTS.
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 a
prepared meals grant program to provide hunger relief to Minnesotans experiencing food
insecurity and who have difficulty preparing meals due to limited mobility, disability, age,
or limited resources to prepare their own meal.
new text end

new text begin Subd. 2.new text end

new text begin Eligible grantees.new text end

new text begin Eligible grantees are nonprofit organizations and federally
recognized American Indian Tribes or Bands located in Minnesota as defined in Minnesota
Statutes, section 10.65, with a demonstrated history of providing and distributing prepared
meals customized for the population that they serve, including tailoring meals to the cultural,
religious, and dietary needs of the population served. Eligible grantees must prepare meals
in a licensed commercial kitchen and distribute meals according to ServSafe guidelines.
new text end

new text begin Subd. 3.new text end

new text begin Application.new text end

new text begin Applicants for grant money under this section shall apply to the
commissioner on the forms and in the time and manner established by the commissioner.
new text end

new text begin Subd. 4.new text end

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

new text begin (a) Eligible grantees must use grant money
awarded under this section to fund a prepared meals program that primarily targets individuals
between 18 and 60 years of age, and their dependents, experiencing food insecurity. Grantees
must avoid duplication with existing state and federal meal programs.
new text end

new text begin (b) Grant money must supplement, but not supplant, any state or federal funding used
to provide prepared meals to Minnesotans experiencing food insecurity.
new text end

new text begin Subd. 5.new text end

new text begin Duties of the commissioner.new text end

new text begin (a) The commissioner shall develop a process
for determining eligible grantees under this section.
new text end

new text begin (b) In granting money, the commissioner shall prioritize applicants that:
new text end

new text begin (1) have demonstrated ability to provide prepared meals to racially and geographically
diverse populations at greater risk for food insecurity;
new text end

new text begin (2) work with external community partners to distribute meals targeting nontraditional
meal sites reaching those most in need; and
new text end

new text begin (3) have a demonstrated history of sourcing at least 50 percent of the prepared meal
ingredients from:
new text end

new text begin (i) Minnesota food producers and processors; or
new text end

new text begin (ii) food that is donated or would otherwise be waste.
new text end

new text begin (c) The commissioner shall consider geographic distribution to ensure statewide coverage
when awarding grants and minimize the number of grantees to simplify administrative
burdens and costs.
new text end

Sec. 34. new text begin DIRECTION TO COMMISSIONER; ADMINISTRATION OF GREAT
START SCHOLARSHIPS PROGRAM.
new text end

new text begin The commissioner of human services, in collaboration with the commissioner of education
and the Children's Cabinet, shall administer the great start scholarships program under
Minnesota Statutes, section 119C.01, until the Department of Children, Youth, and Families
is operational. The commissioner of human services may transfer administration of the
program to the commissioner of children, youth, and families when the Department of
Children, Youth, and Families is operational.
new text end

Sec. 35. new text begin REVISOR INSTRUCTION.
new text end

new text begin The revisor of statutes must identify, in consultation with the commissioners of
management and budget; human services; education; health; and public safety, any changes
to Minnesota Statutes and Minnesota Rules necessary to facilitate the transfer of
responsibilities under this act, the authority to fulfill the responsibilities under this act, and
the related operational functions needed to implement the necessary legal changes and
responsibilities under this act. By February 1, 2024, the revisor of statutes must submit to
the chairs and ranking minority members of relevant legislative committees and divisions
draft legislation with the statutory changes necessary to implement this act.
new text end

Sec. 36. new text begin REPEALER.
new text end

new text begin (a)new text end new text begin Minnesota Statutes 2022, section 119B.03, subdivision 4,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 245C.11, subdivision 3,new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin Paragraph (b) is effective April 28, 2025.
new text end

ARTICLE 13

CHILD CARE WORKFORCE

Section 1.

Minnesota Statutes 2022, section 119B.011, subdivision 19a, is amended to
read:

Subd. 19a.

Registration.

"Registration" means the process used by deleted text begin a countydeleted text end new text begin the
commissionernew text end to determine whether the provider selected by a family applying for or
receiving child care assistance to care for that family's children meets the requirements
necessary for payment of child care assistance for care provided by that provider.new text begin The
commissioner shall create a process for statewide registration by April 28, 2025.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 2.

Minnesota Statutes 2022, section 119B.05, subdivision 1, is amended to read:

Subdivision 1.

Eligible participants.

Families eligible for child care assistance under
the MFIP child care program are:

(1) MFIP participants who are employed or in job search and meet the requirements of
section 119B.10;

(2) persons who are members of transition year families under section 119B.011,
subdivision 20, and meet the requirements of section 119B.10;

(3) families who are participating in employment orientation or job search, or other
employment or training activities that are included in an approved employability development
plan under section 256J.95;

(4) MFIP families who are participating in work job search, job support, employment,
or training activities as required in their employment plan, or in appeals, hearings,
assessments, or orientations according to chapter 256J;

(5) MFIP families who are participating in social services activities under chapter 256J
as required in their employment plan approved according to chapter 256J;

(6) families who are participating in services or activities that are included in an approved
family stabilization plan under section 256J.575;

new text begin (7) MFIP child-only families under section 256J.88, for up to 20 hours of child care per
week for children ages six and under, as recommended by the treating mental health
professional as defined in section 245I.04, subdivision 2, when the child's primary caregiver
has a diagnosis of a mental illness;
new text end

deleted text begin (7)deleted text end new text begin (8)new text end families who are participating in programs as required in tribal contracts under
section 119B.02, subdivision 2, or 256.01, subdivision 2;

deleted text begin (8)deleted text end new text begin (9)new text end families who are participating in the transition year extension under section
119B.011, subdivision 20a;

deleted text begin (9)deleted text end new text begin (10)new text end student parents as defined under section 119B.011, subdivision 19b; and

deleted text begin (10)deleted text end new text begin (11)new text end student parents who turn 21 years of age and who continue to meet the other
requirements under section 119B.011, subdivision 19b. A student parent continues to be
eligible until the student parent is approved for basic sliding fee child care assistance or
until the student parent's redetermination, whichever comes first. At the student parent's
redetermination, if the student parent was not approved for basic sliding fee child care
assistance, a student parent's eligibility ends following a 15-day adverse action notice.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective May 12, 2025.
new text end

Sec. 3.

Minnesota Statutes 2022, section 119B.125, subdivision 1, is amended to read:

Subdivision 1.

Authorization.

deleted text begin A county ordeleted text end The commissioner must authorize the provider
chosen by an applicant or a participant before the county can authorize payment for care
provided by that provider. The commissioner must establish the requirements necessary for
authorization of providers. A provider must be reauthorized every two years. deleted text begin A legal,
nonlicensed family child care provider also must be reauthorized when another person over
the age of 13 joins the household, a current household member turns 13, or there is reason
to believe that a household member has a factor that prevents authorization. The provider
is required to report all family changes that would require reauthorization. When a provider
has been authorized for payment for providing care for families in more than one county,
the county responsible for reauthorization of that provider is the county of the family with
a current authorization for that provider and who has used the provider for the longest length
of time.
deleted text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 4.

Minnesota Statutes 2022, section 119B.125, subdivision 1a, is amended to read:

Subd. 1a.

Background study required.

new text begin (a) new text end This subdivision only applies to legal,
nonlicensed family child care providers.

new text begin (b) new text end Prior to authorization, deleted text begin and as part of each reauthorization required in subdivision 1,
the countydeleted text end new text begin the commissionernew text end shall perform a background study on deleted text begin every member of the
provider's household who is age 13 and older. The county shall also perform a background
study on an individual who has reached age ten but is not yet age 13 and is living in the
household where the nonlicensed child care will be provided when the county has reasonable
cause as defined under section 245C.02, subdivision 15deleted text end new text begin individuals identified under section
245C.02, subdivision 6anew text end .

new text begin (c) After authorization, a background study shall also be performed when an individual
identified under section 245C.02, subdivision 6a, joins the household. The provider must
report all family changes that would require a new background study.
new text end

new text begin (d) At each reauthorization, the commissioner must ensure that a background study
through NETStudy 2.0 has been performed on all individuals in the provider's household
for whom a background study is required under paragraphs (b) and (c).
new text end

new text begin (e) Prior to a background study through NETStudy 2.0 expiring, another background
study must be completed on all individuals for whom the background study is expiring.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 5.

Minnesota Statutes 2022, section 119B.125, subdivision 1b, is amended to read:

Subd. 1b.

Training required.

(a) deleted text begin Effective November 1, 2011,deleted text end Prior to initial
authorization as required in subdivision 1, a legal nonlicensed family child care provider
must complete first aid and CPR training and provide the verification of first aid and CPR
training to the deleted text begin countydeleted text end new text begin commissionernew text end . The training documentation must have valid effective
dates as of the date the registration request is submitted to the deleted text begin countydeleted text end new text begin commissionernew text end . The
training must have been provided by an individual approved to provide first aid and CPR
instruction and have included CPR techniques for infants and children.

deleted text begin (b) Legal nonlicensed family child care providers with an authorization effective before
November 1, 2011, must be notified of the requirements before October 1, 2011, or at
authorization, and must meet the requirements upon renewal of an authorization that occurs
on or after January 1, 2012.
deleted text end

deleted text begin (c)deleted text end new text begin (b)new text end Upon each reauthorization after the authorization period when the initial first aid
and CPR training requirements are met, a legal nonlicensed family child care provider must
provide verification of at least eight hours of additional training listed in the Minnesota
Center for Professional Development Registry.

deleted text begin (d)deleted text end new text begin (c)new text end This subdivision only applies to legal nonlicensed family child care providers.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 6.

Minnesota Statutes 2022, section 119B.125, subdivision 2, is amended to read:

Subd. 2.

Persons who cannot be authorized.

(a) The provider seeking authorization
under this section shall collect the information required under section 245C.05deleted text begin , subdivision
1,deleted text end and forward the information to the deleted text begin county agencydeleted text end new text begin commissionernew text end . The background study
must include a review of the information required under section 245C.08, deleted text begin subdivisions 2,deleted text end new text begin
subdivisionnew text end 3deleted text begin , and 4, paragraph (b)deleted text end .

new text begin (b)new text end A new text begin legal new text end nonlicensed family child care provider is not authorized under this section
ifnew text begin :
new text end

new text begin (1) the commissioner determines thatnew text end any household member who is the subject of a
background study is deleted text begin determined to have a disqualifying characteristic under paragraphs (b)
to (e) or under section 245C.14 or 245C.15. If a county has determined that a provider is
able to be authorized in that county, and a family in another county later selects that provider,
the provider is able to be authorized in the second county without undergoing a new
background investigation unless one of the following conditions exists:deleted text end new text begin disqualified from
direct contact with, or from access to, persons served by the program and that disqualification
has not been set aside or a variance has not been granted under chapter 245C;
new text end

deleted text begin (1) two years have passed since the first authorization;
deleted text end

deleted text begin (2) another person age 13 or older has joined the provider's household since the last
authorization;
deleted text end

deleted text begin (3) a current household member has turned 13 since the last authorization; or
deleted text end

deleted text begin (4) there is reason to believe that a household member has a factor that prevents
authorization.
deleted text end

deleted text begin (b)deleted text end new text begin (2)new text end the person has refused to give written consent for disclosure of criminal history
recordsdeleted text begin .deleted text end new text begin ;
new text end

deleted text begin (c)deleted text end new text begin (3)new text end the person has been denied a family child care license deleted text begin or has received a fine or
a sanction as a licensed child care provider that has not been reversed on appeal.deleted text end new text begin ;
new text end

deleted text begin (d)deleted text end new text begin (4)new text end the person has a family child care licensing disqualification that has not been set
asidedeleted text begin .deleted text end new text begin ; or
new text end

deleted text begin (e)deleted text end new text begin (5)new text end the person has admitted or a county has found that there is a preponderance of
evidence that fraudulent information was given to the county for child care assistance
application purposes or was used in submitting child care assistance bills for payment.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 7.

Minnesota Statutes 2022, section 119B.125, subdivision 3, is amended to read:

Subd. 3.

Authorization exception.

When deleted text begin a countydeleted text end new text begin the commissionernew text end denies a person
authorization as a legal nonlicensed family child care provider under subdivision 2, the
deleted text begin countydeleted text end new text begin commissionernew text end later may authorize that person as a provider if the following conditions
are met:

(1) after receiving notice of the denial of the authorization, the person applies for and
obtains a valid child care license issued under chapter 245A, issued by a Tribe, or issued
by another state;

(2) the person maintains the valid child care license; and

(3) the person is providing child care in the state of licensure or in the area under the
jurisdiction of the licensing Tribe.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 8.

Minnesota Statutes 2022, section 119B.125, subdivision 4, is amended to read:

Subd. 4.

Unsafe care.

deleted text begin A countydeleted text end new text begin (a) The commissionernew text end may deny authorization as a child
care provider to any applicant or rescind authorization of any provider when deleted text begin thedeleted text end new text begin anew text end county
new text begin or the commissioner new text end knows or has reason to believe that the provider is unsafe or that the
circumstances of the chosen child care arrangement are unsafenew text begin , based on statewide criteria
developed by the commissionernew text end . deleted text begin The county must include the conditions under which a
provider or care arrangement will be determined to be unsafe in the county's child care fund
plan under section 119B.08, subdivision 3
deleted text end

new text begin (b) The commissioner shall develop and introduce statewide criteria for unsafe carenew text end .

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 9.

Minnesota Statutes 2022, section 119B.125, subdivision 6, is amended to read:

Subd. 6.

Record-keeping requirement.

(a) As a condition of payment, all providers
receiving child care assistance payments must:

(1) keep accurate and legible daily attendance records at the site where services are
delivered for children receiving child care assistance; and

(2) make those records available immediately to the county or the commissioner upon
request. Any records not provided to a county or the commissioner at the date and time of
the request are deemed inadmissible if offered as evidence by the provider in any proceeding
to contest an overpayment or disqualification of the provider.

(b) As a condition of payment, attendance records must be completed daily and include
the date, the first and last name of each child in attendance, and the times when each child
is dropped off and picked up. To the extent possible, the times that the child was dropped
off to and picked up from the child care provider must be entered by the person dropping
off or picking up the child. The daily attendance records must be retained at the site where
services are delivered for six years after the date of service.

(c) deleted text begin A county or the commissioner may deny or revoke a provider's authorization to
receive child care assistance payments under section 119B.13, subdivision 6, paragraph (d),
pursue a fraud disqualification under section 256.98, take an action against the provider
under chapter deleted text end deleted text begin 245Edeleted text end deleted text begin , or establish an attendance record overpayment under paragraph (d)
against a current or former provider,deleted text end When the county or the commissioner knows or has
reason to believe that deleted text begin thedeleted text end new text begin a current or formernew text end provider has not complied with the
record-keeping requirement in this subdivisiondeleted text begin .deleted text end new text begin :
new text end

new text begin (1) the commissioner may:
new text end

new text begin (i) deny or revoke a provider's authorization to receive child care assistance payments
under section 119B.13, subdivision 6, paragraph (d);
new text end

new text begin (ii) pursue an administrative disqualification under sections 256.046, subdivision 3, and
256.98; or
new text end

new text begin (iii) take an action against the provider under chapter 245E; or
new text end

new text begin (2) a county or the commissioner may establish an attendance record overpayment under
paragraph (d).
new text end

(d) To calculate an attendance record overpayment under this subdivision, the
commissioner or county agency shall subtract the maximum daily rate from the total amount
paid to a provider for each day that a child's attendance record is missing, unavailable,
incomplete, inaccurate, or otherwise inadequate.

(e) The commissioner shall develop criteria for a county to determine an attendance
record overpayment under this subdivision.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 10.

Minnesota Statutes 2022, section 119B.125, subdivision 7, is amended to read:

Subd. 7.

Failure to comply with attendance record requirements.

(a) In establishing
an overpayment claim for failure to provide attendance records in compliance with
subdivision 6, the county or commissioner is limited to the six years prior to the date the
county or the commissioner requested the attendance records.

(b) The commissioner new text begin or county new text end may periodically audit child care providers to determine
compliance with subdivision 6.

(c) When the commissioner or county establishes an overpayment claim against a current
or former provider, the commissioner or county must provide notice of the claim to the
provider. A notice of overpayment claim must specify the reason for the overpayment, the
authority for making the overpayment claim, the time period in which the overpayment
occurred, the amount of the overpayment, and the provider's right to appeal.

(d) The commissioner or county shall seek to recoup or recover overpayments paid to
a current or former provider.

(e) When a provider has been disqualified or convicted of fraud under section 256.98,
theft under section 609.52, or a federal crime relating to theft of state funds or fraudulent
billing for a program administered by the commissioner or a county, recoupment or recovery
must be sought regardless of the amount of overpayment.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 11.

Minnesota Statutes 2022, section 119B.13, subdivision 4, is amended to read:

Subd. 4.

Rates charged to publicly subsidized families.

Child care providers receiving
reimbursement under this chapter may not charge a rate to clients receiving assistance under
this chapter that is higher than the private, full-paying client rate.new text begin This subdivision shall not
prohibit a child care provider receiving reimbursement under this chapter from providing
discounts, scholarships, or other financial assistance to any clients.
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. 12.

Minnesota Statutes 2022, section 119B.13, subdivision 6, is amended to read:

Subd. 6.

Provider payments.

(a) A provider shall bill only for services documented
according to section 119B.125, subdivision 6. The provider shall bill for services provided
within ten days of the end of the service period. Payments under the child care fund shall
be made within 21 days of receiving a complete bill from the provider. Counties or the state
may establish policies that make payments on a more frequent basis.

(b) If a provider has received an authorization of care and been issued a billing form for
an eligible family, the bill must be submitted within 60 days of the last date of service on
the bill. A bill submitted more than 60 days after the last date of service must be paid if the
county determines that the provider has shown good cause why the bill was not submitted
within 60 days. Good cause must be defined in the county's child care fund plan under
section 119B.08, subdivision 3, and the definition of good cause must include county error.
Any bill submitted more than a year after the last date of service on the bill must not be
paid.

(c) If a provider provided care for a time period without receiving an authorization of
care and a billing form for an eligible family, payment of child care assistance may only be
made retroactively for a maximum of three months from the date the provider is issued an
authorization of care and a billing form. For a family at application, if a provider provided
child care during a time period without receiving an authorization of care and a billing form,
a county may only make child care assistance payments to the provider retroactively from
the date that child care began, or from the date that the family's eligibility began under
section 119B.09, subdivision 7, or from the date that the family meets authorization
requirements, not to exceed six months from the date that the provider is issued an
authorization of care and a billing form, whichever is later.

(d) deleted text begin A county ordeleted text end The commissioner may refuse to issue a child care authorization to a
certified, licensed, or legal nonlicensed provider, revoke an existing child care authorization
to a certified, licensed, or legal nonlicensed provider, stop payment issued to a certified,
licensed, or legal nonlicensed provider, or refuse to pay a bill submitted by a certified,
licensed, or legal nonlicensed provider if:

(1) the provider admits to intentionally giving the county materially false information
on the provider's billing forms;

(2) deleted text begin a county ordeleted text end the commissioner finds by a preponderance of the evidence that the
provider intentionally gave the county materially false information on the provider's billing
forms, or provided false attendance records to a county or the commissioner;

(3) the provider is in violation of child care assistance program rules, until the agency
determines those violations have been corrected;

(4) the provider is operating after:

(i) an order of suspension of the provider's license issued by the commissioner;

(ii) an order of revocation of the provider's license issued by the commissioner; or

(iii) an order of decertification issued to the provider;

(5) the provider submits false attendance reports or refuses to provide documentation
of the child's attendance upon request;

(6) the provider gives false child care price information; or

(7) the provider fails to report decreases in a child's attendance as required under section
119B.125, subdivision 9.

(e) For purposes of paragraph (d), clauses (3), (5), (6), and (7), deleted text begin the county ordeleted text end the
commissioner may withhold the provider's authorization or payment for a period of time
not to exceed three months beyond the time the condition has been corrected.

(f) A county's payment policies must be included in the county's child care plan under
section 119B.08, subdivision 3. If payments are made by the state, in addition to being in
compliance with this subdivision, the payments must be made in compliance with section
16A.124.

(g) If the commissioner deleted text begin or responsible county agencydeleted text end suspends or refuses payment to a
provider under paragraph (d), clause (1) or (2), or chapter 245E and the provider has:

(1) a disqualification for wrongfully obtaining assistance under section 256.98,
subdivision 8, paragraph (c);

(2) an administrative disqualification under section 256.046, subdivision 3; or

(3) a termination under section 245E.02, subdivision 4, paragraph (c), clause (4), or
245E.06;

then the provider forfeits the payment to the commissioner or the responsible county agency,
regardless of the amount assessed in an overpayment, charged in a criminal complaint, or
ordered as criminal restitution.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 13.

Minnesota Statutes 2022, section 119B.16, subdivision 1c, is amended to read:

Subd. 1c.

Notice to providers.

(a) Before taking an action appealable under subdivision
1a, paragraph (b), a county agency or the commissioner must mail written notice to the
provider against whom the action is being taken. Unless otherwise specified under this
chapter, chapter 245E, or Minnesota Rules, chapter 3400, a county agency or the
commissioner must mail the written notice at least 15 calendar days before the adverse
action's effective date.

(b) The notice shall state (1) the factual basis for the new text begin county agency or new text end department's
determination, (2) the action the new text begin county agency or new text end department intends to take, (3) the dollar
amount of the monetary recovery or recoupment, if known, and (4) the provider's right to
appeal the department's proposed action.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 14.

Minnesota Statutes 2022, section 119B.16, subdivision 3, is amended to read:

Subd. 3.

Fair hearing stayed.

(a) If deleted text begin a county agency ordeleted text end the commissioner denies or
revokes a provider's authorization based on a licensing action under section 245A.07, and
the provider appeals, the provider's fair hearing must be stayed until the commissioner issues
an order as required under section 245A.08, subdivision 5.

(b) If the commissioner denies or revokes a provider's authorization based on
decertification under section 245H.07, and the provider appeals, the provider's fair hearing
must be stayed until the commissioner issues a final order as required under section 245H.07.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 15.

Minnesota Statutes 2022, section 119B.161, subdivision 2, is amended to read:

Subd. 2.

Notice.

(a) deleted text begin A county agency ordeleted text end The commissioner must mail written notice to
a provider within five days of suspending payment or denying or revoking the provider's
authorization under subdivision 1.

(b) The notice must:

(1) state the provision under which deleted text begin a county agency ordeleted text end the commissioner is denying,
revoking, or suspending the provider's authorization or suspending payment to the provider;

(2) set forth the general allegations leading to the denial, revocation, or suspension of
the provider's authorization. The notice need not disclose any specific information concerning
an ongoing investigation;

(3) state that the denial, revocation, or suspension of the provider's authorization is for
a temporary period and explain the circumstances under which the action expires; and

(4) inform the provider of the right to submit written evidence and argument for
consideration by the commissioner.

(c) Notwithstanding Minnesota Rules, part 3400.0185, if deleted text begin a county agency ordeleted text end the
commissioner suspends payment to a provider under chapter 245E or denies or revokes a
provider's authorization under section 119B.13, subdivision 6, paragraph (d), clause (1) or
(2), a county agency or the commissioner must send notice of service authorization closure
to each affected family. The notice sent to an affected family is effective on the date the
notice is created.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 16.

Minnesota Statutes 2022, section 119B.161, subdivision 3, is amended to read:

Subd. 3.

Duration.

If a provider's payment is suspended under chapter 245E or a
provider's authorization is denied or revoked under section 119B.13, subdivision 6, paragraph
(d), clause (1) or (2), the provider's denial, revocation, temporary suspension, or payment
suspension remains in effect until:

(1) the commissioner or a law enforcement authority determines that there is insufficient
evidence warranting the action and deleted text begin a county agency ordeleted text end the commissioner does not pursue
an additional administrative remedy under chapter 245E or section 256.98; or

(2) all criminal, civil, and administrative proceedings related to the provider's alleged
misconduct conclude and any appeal rights are exhausted.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 17.

new text begin [119B.162] RECONSIDERATION OF CORRECTION ORDERS.
new text end

new text begin (a) If a provider believes that the contents of the commissioner's correction order issued
under chapter 245E are in error, the provider may ask the commissioner to reconsider the
parts of the correction order that are alleged to be in error. The request for reconsideration
must be made in writing and must be postmarked and sent to the commissioner or submitted
in the provider licensing and reporting hub within 30 calendar days from the date the
correction order was mailed or issued through the hub to the provider, and:
new text end

new text begin (1) specify the parts of the correction order that are alleged to be in error;
new text end

new text begin (2) explain why they are in error; and
new text end

new text begin (3) include documentation to support the allegation of error.
new text end

new text begin (b) Upon implementation of the provider licensing and reporting hub, the provider must
use the hub to request reconsideration.
new text end

new text begin (c) A request for reconsideration does not stay any provisions or requirements of the
correction order. The commissioner's disposition of a request for reconsideration is final
and not subject to appeal under chapter 14. The commissioner's decision is appealable by
petition for writ of certiorari under chapter 606.
new text end

Sec. 18.

Minnesota Statutes 2022, section 119B.19, subdivision 7, is amended to read:

Subd. 7.

Child care resource and referral programs.

Within each region, a child care
resource and referral program must:

(1) maintain one database of all existing child care resources and services and one
database of family referrals;

(2) provide a child care referral service for families;

(3) develop resources to meet the child care service needs of families;

(4) increase the capacity to provide culturally responsive child care services;

(5) coordinate professional development opportunities for child care and school-age
care providers;

(6) administer and award child care services grants;

(7) cooperate with the Minnesota Child Care Resource and Referral Network and its
member programs to develop effective child care services and child care resources; deleted text begin and
deleted text end

(8) assist in fostering coordination, collaboration, and planning among child care programs
and community programs such as school readiness, Head Start, early childhood family
education, local interagency early intervention committees, early childhood screening,
special education services, and other early childhood care and education services and
programs that provide flexible, family-focused services to families with young children to
the extent possibledeleted text begin .deleted text end new text begin ;
new text end

new text begin (9) administer the child care one-stop regional assistance network to assist child care
providers and individuals interested in becoming child care providers with establishing and
sustaining a licensed family child care or group family child care program or a child care
center; and
new text end

new text begin (10) provide supports that enable economically challenged individuals to obtain the job
skills training, career counseling, and job placement assistance necessary to begin a career
path in child care.
new text end

Sec. 19.

new text begin [119B.252] EARLY CHILDHOOD REGISTERED APPRENTICESHIP
GRANT PROGRAM.
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, in coordination
with the commissioner of labor and industry, establish an apprenticeship grant program to
provide employment-based training and mentoring opportunities for early childhood workers.
new text end

new text begin Subd. 2.new text end

new text begin Definitions.new text end

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

new text begin (b) "Apprentice" means an employee participating in an early childhood registered
apprenticeship program.
new text end

new text begin (c) "Early childhood registered apprenticeship program" means an organization holding
the TEACH license with the Department of Human Services that is registered with the
Department of Labor and Industry under chapter 178.
new text end

new text begin (d) "Early childhood signatory employer" means an employer that participates in an
early childhood registered apprenticeship program and employs an apprentice and that is:
new text end

new text begin (1) a licensed child care center under Minnesota Rules, chapter 9503;
new text end

new text begin (2) a licensed family and group family child care provider under Minnesota Rules,
chapter 9502;
new text end

new text begin (3) an early childhood family education program under section 124D.13; a school
readiness program under section 124D.15; a voluntary prekindergarten program under
section 124D.151; a special education program under chapter 125A; or a school readiness
plus program under Laws 2017, First Special Session chapter 5, article 8, section 9;
new text end

new text begin (4) a Head Start program under United States Code, title 42, section 9801, et seq.;
new text end

new text begin (5) a certified license-exempt child care center under chapter 245H; or
new text end

new text begin (6) a Tribally licensed child care program.
new text end

new text begin (e) "Mentor" means an early childhood registered apprenticeship program journeyworker
under section 178.011, subdivision 9, who has a career lattice step of nine or higher.
new text end

new text begin Subd. 3.new text end

new text begin Program components.new text end

new text begin The organization holding the TEACH license with the
Department of Human Services shall distribute the grant and must use the grant for:
new text end

new text begin (1) tuition scholarships for apprentices for courses leading to a higher education degree
in early childhood;
new text end

new text begin (2) stipends for mentors; or
new text end

new text begin (3) stipends for early childhood signatory employers.
new text end

new text begin Subd. 4.new text end

new text begin Grants to apprentices.new text end

new text begin An apprentice may receive a higher education
scholarship of up to $10,000 for up to 24 months under this section, provided the apprentice:
new text end

new text begin (1) enrolls in an early childhood registered apprenticeship program;
new text end

new text begin (2) is a current participant in good standing in the TEACH scholarship program under
section 119B.251;
new text end

new text begin (3) participates in meetings and on-the-job learning with a mentor consistent with the
requirements in the apprenticeship program standards;
new text end

new text begin (4) works toward meeting early childhood competencies identified in Minnesota's
Knowledge and Competency Framework for early childhood professionals, as observed by
a mentor; and
new text end

new text begin (5) works toward the attainment of a higher education degree in early childhood.
new text end

new text begin Subd. 5.new text end

new text begin Stipends for mentors.new text end

new text begin A mentor shall receive up to $4,000 for each apprentice
mentored under this section, provided the mentor complies with the requirements in the
apprenticeship program standard and completes eight weeks of mentor training and additional
training on observation. Mentors may use money received through stipends for personal
expenses. The training must be free of charge to mentors.
new text end

new text begin Subd. 6.new text end

new text begin Stipends for early childhood signatory employers.new text end

new text begin (a) An early childhood
signatory employer shall receive up to $5,000 for each apprentice employed under this
section, provided the early childhood signatory employer complies with the requirements
in the apprenticeship program standard and the following requirements:
new text end

new text begin (1) sponsor each apprentice's TEACH scholarship under section 119B.251; and
new text end

new text begin (2) provide each apprentice at least three hours a week of paid release time for
coursework.
new text end

new text begin (b) An early childhood signatory employer may not employ more than three apprentices
at one site in a 12-month period.
new text end

Sec. 20.

new text begin [119B.27] GREAT START COMPENSATION SUPPORT PAYMENTS.
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 and
administer the great start compensation support payment program to provide eligible child
care and early learning programs with payments to improve access to early care and learning
in Minnesota and to strengthen the ability of programs to recruit and retain early educators.
new text end

new text begin Subd. 2.new text end

new text begin Eligible programs.new text end

new text begin (a) The following programs are eligible to receive payments
under this section:
new text end

new text begin (1) family and group family child care homes licensed under Minnesota Rules, chapter
9502;
new text end

new text begin (2) child care centers licensed under Minnesota Rules, chapter 9503;
new text end

new text begin (3) certified license-exempt child care centers under chapter 245H;
new text end

new text begin (4) Tribally licensed child care programs; and
new text end

new text begin (5) other programs as determined by the commissioner.
new text end

new text begin (b) To be eligible, programs must not be:
new text end

new text begin (1) the subject of a finding of fraud for which the program or individual is currently
serving a penalty or exclusion;
new text end

new text begin (2) the subject of suspended, denied, or terminated payments to a provider under section
256.98, subdivision 1; 119B.13, subdivision 6, paragraph (d), clauses (1) and (2); or 245E.02,
subdivision 4, paragraph (c), clause (4), regardless of whether the action is under appeal;
new text end

new text begin (3) prohibited from receiving public funds under section 245.095, regardless of whether
the action is under appeal; or
new text end

new text begin (4) under license revocation, suspension, temporary immediate suspension, or
decertification, regardless of whether the action is under appeal.
new text end

new text begin Subd. 3.new text end

new text begin Requirements.new text end

new text begin (a) As a condition of payment under this section, a program
must:
new text end

new text begin (1) complete an application developed by the commissioner for each payment period
for which the program applies for funding;
new text end

new text begin (2) submit data on child enrollment and attendance to the commissioner in the form and
manner specified by the commissioner; and
new text end

new text begin (3) attest and agree in writing that the program was open and operating and served a
minimum number of children, as determined by the commissioner, during the funding
period, with the exceptions of:
new text end

new text begin (i) service disruptions that are necessary to protect the safety and health of children and
child care programs based on public health guidance issued by the Centers for Disease
Control and Prevention, the commissioner of health, the commissioner of human services,
or a local public health agency; and
new text end

new text begin (ii) planned temporary closures for provider vacation and holidays during each payment
period. The commissioner must establish the maximum allowed duration for vacations and
holidays.
new text end

new text begin (b) A program must expend money received under this section no later than six months
after the date the payment was received.
new text end

new text begin (c) A program that receives a payment under this section must comply with all
requirements listed in the application. The commissioner must establish methods to determine
that the application requirements have been met.
new text end

new text begin Subd. 4.new text end

new text begin Record retention.new text end

new text begin (a) A program that receives a payment under this section
must keep accurate and legible records of the following:
new text end

new text begin (1) use of money;
new text end

new text begin (2) staff employment, compensation, and benefits, which must include time sheets or
other records of daily hours worked; documentation of compensation and benefits;
documentation of written changes to employees' rate or rates of pay and basis thereof as a
result of payments received under this section, as required under section 181.032, paragraphs
(d) to (f); and any other records required to be maintained under section 177.30; and
new text end

new text begin (3) attendance. Daily attendance records must be completed every day and must include
the date, the first and last name of each child in attendance, and the time each child is dropped
off at and picked up from the program. To the extent possible, the person dropping off or
picking up the child must enter the times.
new text end

new text begin (b) The requirement to document compensation and benefits under paragraph (a), clause
(2), applies to family and group family child care homes only if a payment received under
this section is used for employee compensation or benefits.
new text end

new text begin (c) Records identified in paragraph (a) must be retained at the site where services are
delivered for six years after the date of receipt of payment and must be made immediately
available to the commissioner upon request. Any records not provided to the commissioner
at the date and time of request are deemed inadmissible if offered as evidence by a program
in any proceeding to contest an overpayment or disqualification of the program.
new text end

new text begin Subd. 5.new text end

new text begin Enforcement.new text end

new text begin A program that receives a payment under this section that fails
to meet the requirements of this section is subject to discontinuation of future installment
payments, recovery of overpayments, and actions under chapter 245E. Except when based
on a finding of fraud, actions to establish an overpayment must be made within six years
of receipt of the payments. Once an overpayment is established, collection may continue
until money has been repaid in full. The appeal process under section 119B.16 applies to
actions taken for failure to meet the requirements of this section.
new text end

new text begin Subd. 6.new text end

new text begin Payments.new text end

new text begin (a) The commissioner shall provide payments under this section to
all eligible programs on a noncompetitive basis. The payment amounts shall be based on
the number of full-time equivalent staff who regularly care for children in the program,
including any employees, sole proprietors, or independent contractors.
new text end

new text begin (b) For purposes of this section, "one full-time equivalent" is defined as an individual
caring for children 32 hours per week. An individual can count as more or less than one
full-time equivalent staff, but as no more than two full-time equivalent staff.
new text end

new text begin (c) The commissioner must establish an amount to award per full-time equivalent
individual who regularly cares for children in the program.
new text end

new text begin (d) Payments must be increased by ten percent for programs receiving child care
assistance payments under section 119B.03 or 119B.05 or early learning scholarships under
section 124D.165, or for programs located in a child care access equity area. The
commissioner must develop a method for establishing child care access equity areas. For
purposes of this section, "child care access equity area" means an area with low access to
child care, high poverty rates, high unemployment rates, low homeownership rates, and low
median household incomes.
new text end

new text begin (e) The commissioner shall establish the form, frequency, and manner for making
payments under this section.
new text end

new text begin Subd. 7.new text end

new text begin Eligible uses of money.new text end

new text begin (a) Child care centers licensed under Minnesota Rules,
chapter 9503, certified license-exempt child care centers under chapter 245H, and Tribally
licensed child care centers must use money received under this section to pay for increases
in compensation, benefits, premium pay, or additional federal taxes assessed on the
compensation of employees as a result of paying increased compensation or premium pay
to all paid employees or independent contractors regularly caring for children.
new text end

new text begin (b) Family and group family child care homes licensed under Minnesota Rules, chapter
9502, and Tribally licensed family child care homes must use money received under this
section for one or more of the following purposes:
new text end

new text begin (1) paying personnel costs, such as payroll, salaries, or similar compensation; employee
benefits; premium pay; or financial incentives for recruitment and retention for an employee,
a sole proprietor, or an independent contractor;
new text end

new text begin (2) paying rent, including rent under a lease agreement, or making payments on any
mortgage obligation, utilities, facility maintenance or improvements, property taxes, or
insurance;
new text end

new text begin (3) purchasing or updating equipment, supplies, goods, or services;
new text end

new text begin (4) providing mental health supports for children; or
new text end

new text begin (5) purchasing training or other professional development.
new text end

new text begin Subd. 8.new text end

new text begin Legal nonlicensed child care provider payments.new text end

new text begin (a) Legal nonlicensed child
care providers, as defined in section 119B.011, subdivision 16, are eligible to apply for a
payment of up to $500 for costs incurred before the first month when payments from the
child care assistance program are issued.
new text end

new text begin (b) A payment received under this subdivision must be used for one or more of the
following activities:
new text end

new text begin (1) purchasing or updating equipment, supplies, goods, or services; or
new text end

new text begin (2) purchasing training or other professional development.
new text end

new text begin (c) The commissioner shall determine the form and manner of the application for a
payment under this subdivision.
new text end

new text begin Subd. 9.new text end

new text begin Report.new text end

new text begin By January 1 each year, the commissioner must report to the chairs
and ranking minority members of the legislative committees with jurisdiction over child
care and early learning the number of payments provided to programs and related outcomes
since the last report. This subdivision expires January 31, 2033.
new text end

new text begin Subd. 10.new text end

new text begin Carryforward authority.new text end

new text begin Money appropriated under this section is available
until expended.
new text end

Sec. 21.

new text begin [119B.28] SHARED SERVICES GRANTS.
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 a
grant program to award money to public entities and private for-profit and nonprofit
organizations for planning, establishment, expansion, improvement, or operation of shared
services alliances.
new text end

new text begin Subd. 2.new text end

new text begin Shared services alliances.new text end

new text begin For purposes of this section, "shared services
alliances" are networks of eligible entities that share services to reduce costs and achieve
efficiencies. "Eligible entities" are:
new text end

new text begin (1) family and group family child care homes licensed under Minnesota Rules, chapter
9502;
new text end

new text begin (2) Tribally licensed family child care programs; and
new text end

new text begin (3) individuals in the process of starting a family or group family child care home.
new text end

new text begin Subd. 3.new text end

new text begin Eligible uses of money.new text end

new text begin Grantees must use money received under this section
to deliver one or more of the following services:
new text end

new text begin (1) pooling management of payroll and benefits, banking, janitorial services, food
services, and other operations;
new text end

new text begin (2) shared administrative staff for tasks such as record keeping and complying with
reporting requirements for programs, including but not limited to the child care assistance
program, Head Start, the child and adult care food program, and early learning scholarships;
new text end

new text begin (3) coordination of bulk purchasing;
new text end

new text begin (4) management of a substitute pool;
new text end

new text begin (5) support for implementing shared curriculum and assessments;
new text end

new text begin (6) mentoring of child care providers to improve business practices;
new text end

new text begin (7) provision of and training in child care management software to simplify processes
such as enrollment, billing, and tracking expenditures;
new text end

new text begin (8) support for a group of providers sharing one or more physical spaces within a larger
building; or
new text end

new text begin (9) other services as determined by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Administration; reporting.new text end

new text begin (a) The commissioner must develop a process to
award grants under this section that includes application forms, timelines, and standards for
renewals.
new text end

new text begin (b) The commissioner must develop a process by which grantees will report to the
department on how grant money was spent.
new text end

Sec. 22.

new text begin [119B.29] CHILD CARE PROVIDER ACCESS TO TECHNOLOGY
GRANTS.
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 award money
under this section to one or more eligible organizations to offer grants or other supports to
eligible child care providers for technology intended to improve the providers' business
practices.
new text end

new text begin Subd. 2.new text end

new text begin Eligibility.new text end

new text begin (a) To be eligible for a grant from the department under this section,
an organization must be a public entity or private for-profit or nonprofit organization with:
new text end

new text begin (1) the ability to develop technology products for child care business management; or
new text end

new text begin (2) the ability to offer training, technical assistance, coaching, or other supports to help
child care providers learn to use technology products for child care business management.
new text end

new text begin (b) Grantees may award grants or offer supports under this section to the following types
of child care providers:
new text end

new text begin (1) family or group family child care homes licensed under Minnesota Rules, chapter
9502;
new text end

new text begin (2) child care centers licensed under Minnesota Rules, chapter 9503; and
new text end

new text begin (3) Tribally licensed child care programs.
new text end

new text begin Subd. 3.new text end

new text begin Eligible uses of money.new text end

new text begin Grantees must use money received under this section,
either directly or through grants to eligible child care providers, for one or more of the
following purposes:
new text end

new text begin (1) the purchase of computers or mobile devices for use in business management;
new text end

new text begin (2) access to the Internet through the provision of necessary hardware such as routers
or modems or by covering the costs of monthly fees for Internet access;
new text end

new text begin (3) covering the costs of subscription to child care management software;
new text end

new text begin (4) covering the costs of training in the use of technology for business management
purposes; or
new text end

new text begin (5) other services as determined by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Administration.new text end

new text begin The commissioner must develop a process to award grants
under this section that includes application forms, timelines, reporting requirements, and
standards for renewal.
new text end

Sec. 23.

Minnesota Statutes 2022, section 256.046, subdivision 3, is amended to read:

Subd. 3.

Administrative disqualification of child care providers caring for children
receiving child care assistance.

(a) The department deleted text begin or local agencydeleted text end shall pursue an
administrative disqualification, if the child care provider is accused of committing an
intentional program violation, in lieu of a criminal action when it has not been pursued.
Intentional program violations include intentionally making false or misleading statements;
intentionally misrepresenting, concealing, or withholding facts; and repeatedly and
intentionally violating program regulations under chapters 119B and 245E. Intent may be
proven by demonstrating a pattern of conduct that violates program rules under chapters
119B and 245E.

(b) To initiate an administrative disqualification, deleted text begin a local agency ordeleted text end the commissioner
must mail written notice by certified mail to the provider against whom the action is being
taken. Unless otherwise specified under chapter 119B or 245E or Minnesota Rules, chapter
3400, deleted text begin a local agency ordeleted text end the commissioner must mail the written notice at least 15 calendar
days before the adverse action's effective date. The notice shall state (1) the factual basis
for the agency's determination, (2) the action the agency intends to take, (3) the dollar amount
of the monetary recovery or recoupment, if known, and (4) the provider's right to appeal
the agency's proposed action.

(c) The provider may appeal an administrative disqualification by submitting a written
request to the Department of Human Services, Appeals Division. A provider's request must
be received by the Appeals Division no later than 30 days after the date deleted text begin a local agency ordeleted text end
the commissioner mails the notice.

(d) The provider's appeal request must contain the following:

(1) each disputed item, the reason for the dispute, and, if applicable, an estimate of the
dollar amount involved for each disputed item;

(2) the computation the provider believes to be correct, if applicable;

(3) the statute or rule relied on for each disputed item; and

(4) the name, address, and telephone number of the person at the provider's place of
business with whom contact may be made regarding the appeal.

(e) On appeal, the issuing agency bears the burden of proof to demonstrate by a
preponderance of the evidence that the provider committed an intentional program violation.

(f) The hearing is subject to the requirements of sections 256.045 and 256.0451. The
human services judge may combine a fair hearing and administrative disqualification hearing
into a single hearing if the factual issues arise out of the same or related circumstances and
the provider receives prior notice that the hearings will be combined.

(g) A provider found to have committed an intentional program violation and is
administratively disqualified shall be disqualified, for a period of three years for the first
offense and permanently for any subsequent offense, from receiving any payments from
any child care program under chapter 119B.

(h) Unless a timely and proper appeal made under this section is received by the
department, the administrative determination of the department is final and binding.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 24.

Minnesota Statutes 2022, section 256.983, subdivision 5, is amended to read:

Subd. 5.

Child care providers; financial misconduct.

(a) A county or Tribal agency
may conduct investigations of financial misconduct by child care providers as described in
chapter 245E. Prior to opening an investigation, a county or Tribal agency must contact the
commissioner to determine whether an investigation under this chapter may compromise
an ongoing investigation.

(b) If, upon investigation, a preponderance of evidence shows a provider committed an
intentional program violation, intentionally gave the county or Tribe materially false
information on the provider's billing forms, provided false attendance records to a county,
Tribe, or the commissioner, or committed financial misconduct as described in section
245E.01, subdivision 8, the county or Tribal agency may new text begin recommend that the commissioner
new text end suspend a provider's payment pursuant to chapter 245E, or deny or revoke a provider's
authorization pursuant to section 119B.13, subdivision 6, paragraph (d), clause (2), prior to
pursuing other available remedies. deleted text begin The county or tribe must send notice in accordance with
the requirements of section 119B.161, subdivision 2. If a provider's payment is suspended
under this section, the payment suspension shall remain in effect until: (1) the commissioner,
county, tribe, or a law enforcement authority determines that there is insufficient evidence
warranting the action and a county, tribe, or the commissioner does not pursue an additional
administrative remedy under chapter deleted text end deleted text begin 119Bdeleted text end deleted text begin or deleted text end deleted text begin 245Edeleted text end deleted text begin , or section 256.046 or 256.98; or (2)
all criminal, civil, and administrative proceedings related to the provider's alleged misconduct
conclude and any appeal rights are exhausted.
deleted text end

deleted text begin (c) For the purposes of this section, an intentional program violation includes intentionally
making false or misleading statements; intentionally misrepresenting, concealing, or
withholding facts; and repeatedly and intentionally violating program regulations under
chapters deleted text end deleted text begin 119Bdeleted text end deleted text begin and deleted text end deleted text begin 245Edeleted text end deleted text begin .
deleted text end

deleted text begin (d) A provider has the right to administrative review under section 119B.161 if: (1)
payment is suspended under chapter deleted text end deleted text begin 245Edeleted text end deleted text begin ; or (2) the provider's authorization was denied
or revoked under section 119B.13, subdivision 6, paragraph (d), clause (2).
deleted text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective April 28, 2025.
new text end

Sec. 25. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; CHILD
CARE AND EARLY EDUCATION PROFESSIONAL WAGE SCALE.
new text end

new text begin (a) The commissioner of human services shall develop, in consultation with the
commissioners of employment and economic development and education, the Children's
Cabinet, and relevant stakeholders, a process for recognizing comparable competencies for
use in a wage scale and a child care and early education professional wage scale that:
new text end

new text begin (1) implements the wage scale recommendations made by the Great Start for All
Minnesota Children Task Force under Laws 2021, First Special Session chapter 7, article
14, section 18;
new text end

new text begin (2) provides recommended wages that are equivalent to elementary school educators
with similar credentials and experience;
new text end

new text begin (3) provides recommended levels of compensation and benefits, such as professional
development stipends, health care benefits, and retirement benefits, that vary based on child
care and early education professional roles and qualifications and other criteria established
by the commissioner;
new text end

new text begin (4) incorporates, to the extent feasible, qualifications inclusive of competencies attained
through experience, training, and educational attainment; and
new text end

new text begin (5) is applicable to the following types of child care and early education programs:
new text end

new text begin (i) licensed family and group family child care under Minnesota Rules, chapter 9502;
new text end

new text begin (ii) licensed child care centers under Minnesota Rules, chapter 9503;
new text end

new text begin (iii) certified, license-exempt child care centers under Minnesota Statutes, chapter 245H;
new text end

new text begin (iv) voluntary prekindergarten and school readiness plus programs;
new text end

new text begin (v) school readiness programs;
new text end

new text begin (vi) early childhood family education programs;
new text end

new text begin (vii) programs for children who are eligible for Part B or Part C of the Individuals with
Disabilities Education Act, Public Law 108-446; and
new text end

new text begin (viii) Head Start programs.
new text end

new text begin (b) By January 30, 2025, the commissioner shall report to the legislative committees
with jurisdiction over early childhood programs on the development of the wage scale, make
recommendations for implementing a process for recognizing comparable competencies,
and make recommendations about how the wage scale could be used to inform payment
rates for child care assistance under Minnesota Statutes, chapter 119B, and great start
scholarships under Minnesota Statutes, section 119C.01.
new text end

Sec. 26. new text begin DIRECTION TO COMMISSIONER; TRANSITION CHILD CARE
STABILIZATION GRANTS.
new text end

new text begin (a) The commissioner of human services must continue providing child care stabilization
grants under Laws 2021, First Special Session chapter 7, article 14, section 21, from July
1, 2023, through no later than December 31, 2023.
new text end

new text begin (b) The commissioner shall award transition child care stabilization grant amounts to
all eligible programs. The transition month grant amounts must be based on the number of
full-time equivalent staff who regularly care for children in the program, including employees,
sole proprietors, or independent contractors. One full-time equivalent staff is defined as an
individual caring for children 32 hours per week. An individual can count as more, or less,
than one full-time equivalent staff, but as no more than two full-time equivalent staff.
new text end

ARTICLE 14

CHILD SUPPORT, SAFETY, AND PERMANENCY

Section 1.

new text begin [245.0962] QUALITY PARENTING INITIATIVE GRANT PROGRAM.
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 must establish a
quality parenting initiative grant program to implement quality parenting initiative principles
and practices to support children and families experiencing foster care placements.
new text end

new text begin Subd. 2.new text end

new text begin Eligible applicants.new text end

new text begin To be eligible for a grant under this section, an applicant
must be a nonprofit organization or a nongovernmental organization and must have
experience providing training and technical assistance on how to implement quality parenting
initiative principles and practices.
new text end

new text begin Subd. 3.new text end

new text begin Application.new text end

new text begin An organization seeking a grant under this section must apply to
the commissioner in the time and manner specified by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Grant activities.new text end

new text begin Grant money must be used to provide training and technical
assistance to county and Tribal agencies, community-based agencies, and other stakeholders
on:
new text end

new text begin (1) conducting initial foster care telephone calls under section 260C.219, subdivision 6;
new text end

new text begin (2) supporting practices that create birth family to foster family partnerships; and
new text end

new text begin (3) informing child welfare practices by supporting youth leadership and the participation
of individuals with experience in the foster care system.
new text end

Sec. 2.

new text begin [256.4793] FAMILY FIRST PREVENTION SERVICES ACT SUPPORT
AND DEVELOPMENT GRANT PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Authorization.new text end

new text begin The commissioner shall establish a grant program to
support prevention and early intervention services in order to implement and build upon
Minnesota's Family First Prevention Services Act Title IV-E prevention services plan.
new text end

new text begin Subd. 2.new text end

new text begin Uses.new text end

new text begin Grant funds must be used to:
new text end

new text begin (1) implement or expand any Family First Prevention Services Act service or program
that is included in Minnesota's prevention services plan;
new text end

new text begin (2) implement or expand any proposed future Family First Prevention Services Act
service or program;
new text end

new text begin (3) implement or expand any prevention or family preservation service or programming;
or
new text end

new text begin (4) evaluate any of the programs or services listed in this subdivision.
new text end

new text begin Subd. 3.new text end

new text begin Special revenue account established.new text end

new text begin (a) Funds appropriated under this section
shall be transferred to a special revenue account. The commissioner shall retain federal
reimbursement generated under this section. Federal reimbursement shall be transferred to
the special revenue account and is appropriated to the commissioner for the purposes of
this section.
new text end

new text begin (b) The commissioner must provide an annual report to the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance that identifies the amount of funds appropriated and transferred to this
account under paragraph (a) and how the funds were used.
new text end

Sec. 3.

new text begin [256.4794] FAMILY FIRST PREVENTION SERVICES ACT KINSHIP
NAVIGATOR PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Authorization.new text end

new text begin The commissioner shall establish a grant program for
Kinship Navigator programs as outlined by the federal Family First Prevention Services
Act.
new text end

new text begin Subd. 2.new text end

new text begin Uses.new text end

new text begin Eligible grantees must use funds to assess kinship caregiver needs, provide
connections to local and statewide resources, provide case management to assist with
complex cases, and provide support to meet caregiver needs.
new text end

new text begin Subd. 3.new text end

new text begin Special revenue account established.new text end

Sec. 4.

Minnesota Statutes 2022, section 256N.24, subdivision 12, is amended to read:

Subd. 12.

Approval of initial assessments, special assessments, and reassessments.

(a)
Any agency completing initial assessments, special assessments, or reassessments must
designate one or more supervisors or other staff to examine and approve assessments
completed by others in the agency under subdivision 2. The person approving an assessment
must not be the case manager or staff member completing that assessment.

(b) In cases where a special assessment or reassessment for Northstar kinship assistance
and adoption assistance is required under subdivision 8 or 11, the commissioner shall review
and approve the assessment as part of the eligibility determination process outlined in section
256N.22, subdivision 7, for Northstar kinship assistance, or section 256N.23, subdivision
7, for adoption assistance. The assessment determines the maximum of the negotiated
agreement amount under section 256N.25.

(c) The new text begin effective date of the new text end new rate is deleted text begin effective the calendar month that the assessment
is approved, or the effective date of the agreement, whichever is later.deleted text end new text begin determined as follows:
new text end

new text begin (1) for initial assessments of children in foster care, the new rate is effective based on
the emergency foster care rate for initial placement pursuant to section 256N.26, subdivision
6;
new text end

new text begin (2) for special assessments, the new rate is effective on the date of the finalized adoption
decree or the date of the court order that transfers permanent legal and physical custody to
a relative;
new text end

new text begin (3) for postpermanency reassessments, the new rate is effective on the date that the
commissioner signs the amendment to the Northstar Adoption Assistance or Northstar
Kinship Assistance benefit agreement.
new text end

Sec. 5.

new text begin [260.014] FAMILY FIRST PREVENTION AND EARLY INTERVENTION
ALLOCATION PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Authorization.new text end

new text begin The commissioner shall establish a program that allocates
money to counties and federally recognized Tribes in Minnesota to provide prevention and
early intervention services under the Family First Prevention Services Act.
new text end

new text begin Subd. 2.new text end

new text begin Uses.new text end

new text begin (a) Money allocated to counties and Tribes may be used for the following
purposes:
new text end

new text begin (1) to implement or expand any service or program that is included in the state's
prevention plan;
new text end

new text begin (2) to implement or expand any proposed service or program;
new text end

new text begin (3) to implement or expand any existing service or program; and
new text end

new text begin (4) any other use approved by the commissioner.
new text end

new text begin A county or a Tribe must use at least ten percent of the allocation to provide services and
supports directly to families.
new text end

new text begin Subd. 3.new text end

new text begin Payments.new text end

new text begin (a) The commissioner shall allocate state money appropriated under
this section to each county board or Tribe on a calendar-year basis using a formula established
by the commissioner.
new text end

new text begin (b) A county agency or an initiative Tribe must submit a plan and report the use of money
as determined by the commissioner.
new text end

new text begin (c) The commissioner may distribute money under this section for a two-year period.
new text end

new text begin Subd. 4.new text end

new text begin Prohibition on supplanting existing money.new text end

new text begin Money received under this section
must be used to address prevention and early intervention staffing, programming, and other
activities as determined by the commissioner. Money must not be used to supplant current
county or Tribal expenditures for these purposes.
new text end

Sec. 6.

Minnesota Statutes 2022, section 260.761, subdivision 2, as amended by Laws
2023, chapter 16, section 16, is amended to read:

Subd. 2.

Notice to Tribes of services or court proceedings involving an Indian
child.

(a) When a child-placing agency has information that a family assessment deleted text begin ordeleted text end new text begin ,new text end
investigationnew text begin , or noncaregiver sex trafficking assessmentnew text end being conducted may involve an
Indian child, the child-placing agency shall notify the Indian child's Tribe of the family
assessment deleted text begin ordeleted text end new text begin ,new text end investigationnew text begin , or noncaregiver sex trafficking assessmentnew text end according to section
260E.18. new text begin The child-placing agency shall provide new text end initial notice deleted text begin shall be provideddeleted text end by telephone
and by email or facsimile and shall include the child's full name and date of birth; the full
names and dates of birth of the child's biological parents; and if known the full names and
dates of birth of the child's grandparents and of the child's Indian custodian. If information
regarding the child's grandparents or Indian custodian is not immediately available, the
child-placing agency shall continue to request this information and shall notify the Tribe
when it is received. Notice shall be provided to all Tribes to which the child may have any
Tribal lineage. The child-placing agency shall request that the Tribe or a designated Tribal
representative participate in evaluating the family circumstances, identifying family and
Tribal community resources, and developing case plans. The child-placing agency shall
continue to include the Tribe in service planning and updates as to the progress of the case.

(b) When a child-placing agency has information that a child receiving services may be
an Indian child, the child-placing agency shall notify the Tribe by telephone and by email
or facsimile of the child's full name and date of birth, the full names and dates of birth of
the child's biological parents, and, if known, the full names and dates of birth of the child's
grandparents and of the child's Indian custodian. This notification must be provided deleted text begin sodeleted text end new text begin fornew text end
the Tribe deleted text begin candeleted text end new text begin tonew text end determine if the child is a member or eligible for new text begin Tribal new text end membership deleted text begin in the
Tribedeleted text end , and deleted text begin must be provideddeleted text end new text begin the agency must provide this notification to the Tribenew text end within
seven daysnew text begin of receiving information that the child may be an Indian childnew text end . If information
regarding the child's grandparents or Indian custodian is not available within the seven-day
period, the child-placing agency shall continue to request this information and shall notify
the Tribe when it is received. Notice shall be provided to all Tribes to which the child may
have any Tribal lineage.

(c) In all child placement proceedings, when a court has reason to believe that a child
placed in emergency protective care is an Indian child, the court administrator or a designee
shall, as soon as possible and before a hearing takes place, notify the Tribal social services
agency by telephone and by email or facsimile of the date, time, and location of the
emergency protective care or other initial hearing. The court shall make efforts to allow
appearances by telephone or video conference for Tribal representatives, parents, and Indian
custodians.

(d) The child-placing agency or individual petitioner shall effect service of any petition
governed by sections 260.751 to 260.835 by certified mail or registered mail, return receipt
requested upon the Indian child's parents, Indian custodian, and Indian child's Tribe at least
10 days before the admit-deny hearing is held. If the identity or location of the Indian child's
parents or Indian custodian and Tribe cannot be determined, the child-placing agency shall
provide the notice required in this paragraph to the United States Secretary of the Interior,
Bureau of Indian Affairs by certified mail, return receipt requested.

(e) A Tribe, the Indian child's parents, or the Indian custodian may request up to 20
additional days to prepare for the admit-deny hearing. The court shall allow appearances
by telephone, video conference, or other electronic medium for Tribal representatives, the
Indian child's parents, or the Indian custodian.

(f) A child-placing agency or individual petitioner must provide the notices required
under this subdivision at the earliest possible time to facilitate involvement of the Indian
child's Tribe. Nothing in this subdivision is intended to hinder the ability of the child-placing
agency, individual petitioner, and the court to respond to an emergency situation. Lack of
participation by a Tribe shall not prevent the Tribe from intervening in services and
proceedings at a later date. A Tribe may participate new text begin in a case new text end at any time. At any stage of
the child-placing agency's involvement with an Indian child, the agency shall provide full
cooperation to the Tribal social services agency, including disclosure of all data concerning
the Indian child. Nothing in this subdivision relieves the child-placing agency of satisfying
the notice requirements in state or federal law.

new text begin EFFECTIVE DATE.new text end

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

Sec. 7.

new text begin [260.786] CHILD WELFARE STAFF ALLOCATION FOR TRIBES.
new text end

new text begin Subdivision 1.new text end

new text begin Allocations.new text end

new text begin The commissioner shall allocate $80,000 annually to each
of Minnesota's federally recognized Tribes that, at the beginning of the fiscal year, have not
joined and are not in the process of planning to join the American Indian Child welfare
initiative under section 256.01, subdivision 14b. Tribes not participating in or planning to
join the initiative as of July 1, 2023, are: Bois Fort Band of Chippewa, Fond du Lac Band
of Lake Superior Chippewa, Grand Portage Band of Lake Superior Chippewa, Lower Sioux
Indian Community, Prairie Island Indian Community, and Upper Sioux Indian Community.
new text end

new text begin Subd. 2.new text end

new text begin Purposes.new text end

new text begin Money must be used to address staffing for responding to notifications
under the Indian Child Welfare Act and the Minnesota Indian Family Preservation Act, to
the extent necessary, or to provide other child protection and child welfare services. Money
must not be used to supplant current Tribal expenditures for these purposes.
new text end

new text begin Subd. 3.new text end

new text begin Reporting.new text end

new text begin By June 1 each year, Tribes receiving this money shall provide a
report to the commissioner. The report shall be written in a manner prescribed by the
commissioner and must include an accounting of money spent, staff hired, job duties, and
other information as required by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Redistribution of money.new text end

new text begin If a Tribe joins the American Indian child welfare
initiative, the payment for that Tribe shall be distributed equally among the remaining Tribes
receiving an allocation under this section.
new text end

Sec. 8.

Minnesota Statutes 2022, section 260C.007, subdivision 14, is amended to read:

Subd. 14.

Egregious harm.

"Egregious harm" means the infliction of bodily harm to a
child or neglect of a child which demonstrates a grossly inadequate ability to provide
minimally adequate parental care. The egregious harm need not have occurred in the state
or in the county where a termination of parental rights action deleted text begin is otherwise properly venueddeleted text end new text begin
has proper venuenew text end . Egregious harm includes, but is not limited to:

(1) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutes a violation of sections 609.185 to
609.2114, 609.222, subdivision 2, 609.223, or any other similar law of any other state;

(2) the infliction of "substantial bodily harm" to a child, as defined in section 609.02,
subdivision 7a;

(3) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutes felony malicious punishment of a
child under section 609.377;

(4) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutes felony unreasonable restraint of a
child under section 609.255, subdivision 3;

(5) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutes felony neglect or endangerment of
a child under section 609.378;

(6) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutes assault under section 609.221, 609.222,
or 609.223;

(7) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutesnew text begin sex trafficking,new text end solicitation,
inducement, deleted text begin ordeleted text end promotion of, or receiving profit derived from prostitution under section
609.322;

(8) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutes murder or voluntary manslaughter
as defined by United States Code, title 18, section 1111(a) or 1112(a);

(9) conduct deleted text begin towardsdeleted text end new text begin towardnew text end a child that constitutes aiding or abetting, attempting,
conspiring, or soliciting to commit a murder or voluntary manslaughter that constitutes a
violation of United States Code, title 18, section 1111(a) or 1112(a); or

(10) conduct toward a child that constitutes criminal sexual conduct under sections
609.342 to 609.345 or sexual extortion under section 609.3458.

Sec. 9.

Minnesota Statutes 2022, section 260C.007, subdivision 26d, is amended to read:

Subd. 26d.

Qualified residential treatment program.

"Qualified residential treatment
program" means a children's residential treatment program licensed under chapter 245A or
licensed or approved by a tribe that is approved to receive foster care maintenance payments
under section 256.82 that:

(1) has a trauma-informed treatment model designed to address the needs of children
with serious emotional or behavioral disorders or disturbances;

(2) has registered or licensed nursing staff and other licensed clinical staff who:

(i) provide care within the scope of their practice; and

(ii) are available 24 hours per day and seven days per week;

(3) is accredited by any of the following independent, nonprofit organizations: the
Commission on Accreditation of Rehabilitation Facilities (CARF), the Joint Commission
on Accreditation of Healthcare Organizations (JCAHO), and the Council on Accreditation
(COA), or any other nonprofit accrediting organization approved by the United States
Department of Health and Human Services;

(4) if it is in the child's best interests, facilitates participation of the child's family members
in the child's treatment programming consistent with the child's out-of-home placement
plan under sections 260C.212, subdivision 1, and 260C.708;

(5) facilitates outreach to family members of the child, including siblings;

(6) documents how the facility facilitates outreach to the child's parents and relatives,
as well as documents the child's parents' and other relatives' contact information;

(7) documents how the facility includes family members in the child's treatment process,
including after the child's discharge, and how the facility maintains the child's sibling
connections; and

(8) provides the child and child's family with discharge planning and family-based
aftercare support for at least six months after the child's discharge.new text begin Aftercare support may
include clinical care consultation under section 256B.0671, subdivision 7, and mental health
certified family peer specialist services under section 256B.0616.
new text end

Sec. 10.

Minnesota Statutes 2022, section 260C.221, subdivision 1, is amended to read:

Subdivision 1.

Relative search requirements.

(a) The responsible social services agency
shall exercise due diligence to identify and notify adult relativesnew text begin , as defined in section
260C.007, subdivision 27,new text end and current caregivers of a child's sibling, prior to placement or
within 30 days after the child's removal from the parent, regardless of whether a child is
placed in a relative's home, as required under subdivision 2. The relative search required
by this section shall be comprehensive in scope.

(b) The relative search required by this section shall include both maternal and paternal
adult relatives of the child; all adult grandparents; all legal parents, guardians, or custodians
of the child's siblings; and any other adult relatives suggested by the child's parents, subject
to the exceptions due to family violence in subdivision 5, paragraph (b). The search shall
also include getting information from the child in an age-appropriate manner about who the
child considers to be family members and important friends with whom the child has resided
or had significant contact. The relative search required under this section must fulfill the
agency's duties under the Indian Child Welfare Act regarding active efforts to prevent the
breakup of the Indian family under United States Code, title 25, section 1912(d), and to
meet placement preferences under United States Code, title 25, section 1915.

(c) The responsible social services agency has a continuing responsibility to search for
and identify relatives of a child and send the notice to relatives that is required under
subdivision 2, unless the court has relieved the agency of this duty under subdivision 5,
paragraph (e).

Sec. 11.

Minnesota Statutes 2022, section 260C.317, subdivision 3, is amended to read:

Subd. 3.

Order; retention of jurisdiction.

(a) A certified copy of the findings and the
order terminating parental rights, and a summary of the court's information concerning the
child shall be furnished by the court to the commissioner or the agency to which guardianship
is transferred.

(b) The orders shall be on a document separate from the findings. The court shall furnish
the guardian a copy of the order terminating parental rights.

(c) When the court orders guardianship pursuant to this section, the guardian ad litem
and counsel for the child shall continue on the case until an adoption decree is entered. An
in-court appearance hearing must be held every 90 days following termination of parental
rights for the court to review progress toward an adoptive placement and the specific
recruitment efforts the agency has taken to find an adoptive family for the child and to
finalize the adoption or other permanency plan. Review of the progress toward adoption of
a child under guardianship of the commissioner of human services shall be conducted
according to section 260C.607.

(d) Upon terminating parental rights or upon a parent's consent to adoption under
deleted text begin Minnesota Statutes 2010, section 260C.201, subdivision 11, ordeleted text end section 260C.515, subdivision
deleted text begin 5deleted text end new text begin 3new text end , resulting in an order for guardianship to the commissioner of human services, the court
shall retain jurisdiction:

(1) until the child is adopted;

(2) through the child's minority; or

(3) as long as the child continues in or reenters foster care, until the individual becomes
21 years of age according to sections 260C.193, subdivision 6, and 260C.451.

Sec. 12.

Minnesota Statutes 2022, section 260C.80, subdivision 1, is amended to read:

Subdivision 1.

Office of the Foster Youth Ombudsperson.

The Office of the Foster
Youth Ombudsperson is hereby created. The ombudsperson serves deleted text begin at the pleasure of thedeleted text end
deleted text begin governordeleted text end in the unclassified service, must be selected without regard to political affiliation,
and must be a person highly competent and qualified to work to improve the lives of youth
in the foster care system, while understanding the administration and public policy related
to youth in the foster care system. new text begin The ombudsperson may be removed only for just cause.
new text end No person may serve as the foster youth ombudsperson while holding any other public
office. The foster youth ombudsperson is accountable to the governor and may investigate
decisions, acts, and other matters related to the health, safety, and welfare of youth in foster
care to promote the highest attainable standards of competence, efficiency, and justice for
youth who are in the care of the state.

Sec. 13.

Minnesota Statutes 2022, section 260E.01, is amended to read:

260E.01 POLICY.

deleted text begin (a)deleted text end The legislature hereby declares that the public policy of this state is to protect children
whose health or welfare may be jeopardized through maltreatment. While it is recognized
that most parents want to keep their children safe, sometimes circumstances or conditions
interfere with their ability to do so. When this occurs, the health and safety of the children
must be of paramount concern. Intervention and prevention efforts must address immediate
concerns for child safety and the ongoing risk of maltreatment and should engage the
protective capacities of families. In furtherance of this public policy, it is the intent of the
legislature under this chapter to:

(1) protect children and promote child safety;

(2) strengthen the family;

(3) make the home, school, and community safe for children by promoting responsible
child care in all settingsnew text begin , including through the reporting of child maltreatmentnew text end ; deleted text begin and
deleted text end

new text begin (4) provide protective, family support, and family preservation services when appropriate;
and
new text end

deleted text begin (4)deleted text end new text begin (5)new text end provide, when necessary, a safe temporary or permanent home environment for
maltreated children.

deleted text begin (b) In addition, it is the policy of this state to:
deleted text end

deleted text begin (1) require the reporting of maltreatment of children in the home, school, and community
deleted text end deleted text begin settings;
deleted text end

deleted text begin (2) provide for deleted text end deleted text begin thedeleted text end deleted text begin voluntary reporting of maltreatment of children;
deleted text end

deleted text begin (3) require an investigation when the report alleges sexual abuse or substantial child
deleted text end deleted text begin endangermentdeleted text end deleted text begin ;
deleted text end

deleted text begin (4) provide a family assessment, if appropriate, when the report does not allege sexual
deleted text end deleted text begin abuse or substantial child endangerment; deleted text end deleted text begin and
deleted text end

deleted text begin (5) provide protective, family support, and family preservation services when needed
in appropriate cases.
deleted text end

Sec. 14.

Minnesota Statutes 2022, section 260E.02, subdivision 1, is amended to read:

Subdivision 1.

Establishment of team.

A county shall establish a multidisciplinary
child protection team that may include, but new text begin is new text end not deleted text begin bedeleted text end limited to, the director of the local
welfare agency or designees, the county attorney or designees, the county sheriff or designees,
representatives of health and education, representatives of mental healthnew text begin , representatives of
agencies providing specialized services or responding to youth who experience or are at
risk of experiencing sex trafficking or sexual exploitation,new text end or other appropriate human
services or community-based agencies, and parent groups. As used in this section, a
"community-based agency" may include, but is not limited to, schools, social services
agencies, family service and mental health collaboratives, children's advocacy centers, early
childhood and family education programs, Head Start, or other agencies serving children
and families. A member of the team must be designated as the lead person of the team
responsible for the planning process to develop standards for the team's activities with
battered women's and domestic abuse programs and services.

Sec. 15.

Minnesota Statutes 2022, section 260E.03, is amended by adding a subdivision
to read:

new text begin Subd. 15a.new text end

new text begin Noncaregiver sex trafficker.new text end

new text begin "Noncaregiver sex trafficker" means an
individual who is alleged to have engaged in the act of sex trafficking a child and who is
not a person responsible for the child's care, who does not have a significant relationship
with the child as defined in section 609.341, and who is not a person in a current or recent
position of authority as defined in section 609.341, subdivision 10.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 16.

Minnesota Statutes 2022, section 260E.03, is amended by adding a subdivision
to read:

new text begin Subd. 15b.new text end

new text begin Noncaregiver sex trafficking assessment.new text end

new text begin "Noncaregiver sex trafficking
assessment" is a comprehensive assessment of child safety, the risk of subsequent child
maltreatment, and strengths and needs of the child and family. The local welfare agency
shall only perform a noncaregiver sex trafficking assessment when a maltreatment report
alleges sex trafficking of a child by someone other than the child's caregiver. A noncaregiver
sex trafficking assessment does not include a determination of whether child maltreatment
occurred. A noncaregiver sex trafficking assessment includes a determination of a family's
need for services to address the safety of the child or children, the safety of family members,
and the risk of subsequent child maltreatment.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 17.

Minnesota Statutes 2022, section 260E.03, subdivision 22, is amended to read:

Subd. 22.

Substantial child endangerment.

"Substantial child endangerment" means
that a person responsible for a child's care, by act or omission, commits or attempts to
commit an act against a child deleted text begin under theirdeleted text end new text begin in the person'snew text end care that constitutes any of the
following:

(1) egregious harm under subdivision 5;

(2) abandonment under section 260C.301, subdivision 2;

(3) neglect under subdivision 15, paragraph (a), clause (2), that substantially endangers
the child's physical or mental health, including a growth delay, which may be referred to
as failure to thrive, that has been diagnosed by a physician and is due to parental neglect;

(4) murder in the first, second, or third degree under section 609.185, 609.19, or 609.195;

(5) manslaughter in the first or second degree under section 609.20 or 609.205;

(6) assault in the first, second, or third degree under section 609.221, 609.222, or 609.223;

(7)new text begin sex trafficking,new text end solicitation, inducement, deleted text begin anddeleted text end new text begin ornew text end promotion of prostitution under
section 609.322;

(8) criminal sexual conduct under sections 609.342 to 609.3451;

(9) sexual extortion under section 609.3458;

(10) solicitation of children to engage in sexual conduct under section 609.352;

(11) malicious punishment or neglect or endangerment of a child under section 609.377
or 609.378;

(12) use of a minor in sexual performance under section 617.246; or

(13) parental behavior, status, or condition deleted text begin that mandates thatdeleted text end new text begin requiringnew text end the county
attorneynew text begin tonew text end file a termination of parental rights petition under section 260C.503, subdivision
2.

Sec. 18.

Minnesota Statutes 2022, section 260E.14, subdivision 2, is amended to read:

Subd. 2.

Sexual abuse.

(a) The local welfare agency is the agency responsible for
investigating an allegation of sexual abuse if the alleged offender is the parent, guardian,
sibling, or an individual functioning within the family unit as a person responsible for the
child's care, or a person with a significant relationship to the child if that person resides in
the child's household.

(b) The local welfare agency is also responsible for new text begin assessing or new text end investigating when a
child is identified as a victim of sex trafficking.

new text begin EFFECTIVE DATE.new text end

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

Sec. 19.

Minnesota Statutes 2022, section 260E.14, subdivision 5, is amended to read:

Subd. 5.

Law enforcement.

(a) The local law enforcement agency is the agency
responsible for investigating a report of maltreatment if a violation of a criminal statute is
alleged.

(b) Law enforcement and the responsible agency must coordinate their investigations
or assessments as required under this chapter when deleted text begin thedeleted text end new text begin : (1) anew text end report alleges maltreatment
that is a violation of a criminal statute by a person who is a parent, guardian, sibling, person
responsible for the child's care deleted text begin functioningdeleted text end within the family unit, ornew text begin by anew text end person who lives
in the child's household and who has a significant relationship to the childdeleted text begin ,deleted text end in a setting other
than a facility as defined in section 260E.03new text begin ; or (2) a report alleges sex trafficking of a childnew text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 20.

Minnesota Statutes 2022, section 260E.17, subdivision 1, is amended to read:

Subdivision 1.

Local welfare agency.

(a) Upon receipt of a report, the local welfare
agency shall determine whether to conduct a family assessment deleted text begin ordeleted text end new text begin ,new text end an investigationnew text begin , or a
noncaregiver sex trafficking assessmentnew text end as appropriate to prevent or provide a remedy for
maltreatment.

(b) The local welfare agency shall conduct an investigation when the report involves
sexual abusenew text begin , except as indicated in paragraph (f),new text end or substantial child endangerment.

(c) The local welfare agency shall begin an immediate investigation deleted text begin if,deleted text end at any time when
the local welfare agency is deleted text begin usingdeleted text end new text begin responding withnew text end a family assessment deleted text begin response,deleted text end new text begin andnew text end the
local welfare agency determines that there is reason to believe that sexual abuse deleted text begin ordeleted text end new text begin ,new text end substantial
child endangermentnew text begin ,new text end or a serious threat to the child's safety exists.

(d) The local welfare agency may conduct a family assessment for reports that do not
allege sexual abusenew text begin , except as indicated in paragraph (f),new text end or substantial child endangerment.
In determining that a family assessment is appropriate, the local welfare agency may consider
issues of child safety, parental cooperation, and the need for an immediate response.

(e) The local welfare agency may conduct a family assessment deleted text begin ondeleted text end new text begin fornew text end a report that was
initially screened and assigned for an investigation. In determining that a complete
investigation is not required, the local welfare agency must document the reason for
terminating the investigation and notify the local law enforcement agency if the local law
enforcement agency is conducting a joint investigation.

new text begin (f) The local welfare agency shall conduct a noncaregiver sex trafficking assessment
when a maltreatment report alleges sex trafficking of a child and the alleged offender is a
noncaregiver sex trafficker as defined by section 260E.03, subdivision 15a.
new text end

new text begin (g) During a noncaregiver sex trafficking assessment, the local welfare agency shall
initiate an immediate investigation if there is reason to believe that a child's parent, caregiver,
or household member allegedly engaged in the act of sex trafficking a child or was alleged
to have engaged in any conduct requiring the agency to conduct an investigation.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 21.

Minnesota Statutes 2022, section 260E.18, is amended to read:

260E.18 NOTICE TO CHILD'S TRIBE.

The local welfare agency shall provide immediate notice, according to section 260.761,
subdivision 2, to an Indian child's Tribe when the agency has reason to believe new text begin that new text end the
family assessment deleted text begin ordeleted text end new text begin ,new text end investigationnew text begin , or noncaregiver sex trafficking assessmentnew text end may involve
an Indian child. For purposes of this section, "immediate notice" means notice provided
within 24 hours.

new text begin EFFECTIVE DATE.new text end

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

Sec. 22.

Minnesota Statutes 2022, section 260E.20, subdivision 2, is amended to read:

Subd. 2.

Face-to-face contact.

(a) Upon receipt of a screened in report, the local welfare
agency shall deleted text begin conduct adeleted text end new text begin havenew text end face-to-face contact with the child reported to be maltreated
and with the child's primary caregiver sufficient to complete a safety assessment and ensure
the immediate safety of the child. When it is possible and the report alleges substantial child
endangerment or sexual abuse, the local welfare agency is not required to provide notice
before conducting the initial face-to-face contact with the child and the child's primary
caregiver.

(b)new text begin Except in a noncaregiver sex trafficking assessment,new text end thenew text begin local welfare agency shall
havenew text end face-to-face contact with the child and primary caregiver deleted text begin shall occurdeleted text end immediatelynew text begin after
the agency screens in a reportnew text end if sexual abuse or substantial child endangerment is alleged
and within five calendar daysnew text begin of a screened in reportnew text end for all other reports. If the alleged
offender was not already interviewed as the primary caregiver, the local welfare agency
shall also conduct a face-to-face interview with the alleged offender in the early stages of
the assessment or investigationnew text begin , except in a noncaregiver sex trafficking assessmentnew text end .
Face-to-face contact with the child and primary caregiver in response to a report alleging
sexual abuse or substantial child endangerment may be postponed for no more than five
calendar days if the child is residing in a location that is confirmed to restrict contact with
the alleged offender as established in guidelines issued by the commissioner, or if the local
welfare agency is pursuing a court order for the child's caregiver to produce the child for
questioning under section 260E.22, subdivision 5.

(c) At the initial contact with the alleged offender, the local welfare agency or the agency
responsible for assessing or investigating the report must inform the alleged offender of the
complaints or allegations made against the individual in a manner consistent with laws
protecting the rights of the person who made the report. The interview with the alleged
offender may be postponed if it would jeopardize an active law enforcement investigation.new text begin
In a noncaregiver sex trafficking assessment, the local child welfare agency is not required
to inform or interview the alleged offender.
new text end

(d) The local welfare agency or the agency responsible for assessing or investigating
the report must provide the alleged offender with an opportunity to make a statementnew text begin , except
in a noncaregiver sex trafficking assessmentnew text end . The alleged offender may submit supporting
documentation relevant to the assessment or investigation.

new text begin EFFECTIVE DATE.new text end

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

Sec. 23.

Minnesota Statutes 2022, section 260E.24, subdivision 2, is amended to read:

Subd. 2.

Determination after family assessmentnew text begin or a noncaregiver sex trafficking
assessmentnew text end .

After conducting a family assessmentnew text begin or a noncaregiver sex trafficking
assessmentnew text end , the local welfare agency shall determine whether child protective services are
needed to address the safety of the child and other family members and the risk of subsequent
maltreatment. The local welfare agency must document the information collected under
section 260E.20, subdivision 3, related to the completed family assessment in the child's or
family's case notes.

new text begin EFFECTIVE DATE.new text end

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

Sec. 24.

Minnesota Statutes 2022, section 260E.24, subdivision 7, is amended to read:

Subd. 7.

Notification at conclusion of family assessmentnew text begin or a noncaregiver sex
trafficking assessmentnew text end .

Within ten working days of the conclusion of a family assessmentnew text begin
or a noncaregiver sex trafficking assessmentnew text end , the local welfare agency shall notify the parent
or guardian of the child of the need for services to address child safety concerns or significant
risk of subsequent maltreatment. The local welfare agency and the family may also jointly
agree that family support and family preservation services are needed.

new text begin EFFECTIVE DATE.new text end

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

Sec. 25.

Minnesota Statutes 2022, section 260E.33, subdivision 1, is amended to read:

Subdivision 1.

Followingnew text begin anew text end family assessmentnew text begin or a noncaregiver sex trafficking
assessmentnew text end .

Administrative reconsideration is not applicable to a family assessment new text begin or
noncaregiver sex trafficking assessment new text end since no determination concerning maltreatment
is made.

new text begin EFFECTIVE DATE.new text end

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

Sec. 26.

Minnesota Statutes 2022, section 260E.35, subdivision 6, is amended to read:

Subd. 6.

Data retention.

(a) Notwithstanding sections 138.163 and 138.17, a record
maintained or a record derived from a report of maltreatment by a local welfare agency,
agency responsible for assessing or investigating the report, court services agency, or school
under this chapter shall be destroyed as provided in paragraphs (b) to (e) by the responsible
authority.

(b) For a report alleging maltreatment that was not accepted for new text begin an new text end assessment or new text begin an
new text end investigation, a family assessment case, new text begin a noncaregiver sex trafficking assessment case, new text end and
a case where an investigation results in no determination of maltreatment or the need for
child protective services, the record must be maintained for a period of five years after the
datenew text begin thatnew text end the report was not accepted for assessment or investigation or the date of the final
entry in the case record. A record of a report that was not accepted must contain sufficient
information to identify the subjects of the report, the nature of the alleged maltreatment,
and the reasons deleted text begin as todeleted text end why the report was not accepted. Records under this paragraph may
not be used for employment, background checks, or purposes other than to assist in future
screening decisions and risk and safety assessments.

(c) All records relating to reports that, upon investigation, indicate deleted text begin eitherdeleted text end maltreatment
or a need for child protective services shall be maintained for ten years after the date of the
final entry in the case record.

(d) All records regarding a report of maltreatment, including a notification of intent to
interview that was received by a school under section 260E.22, subdivision 7, shall be
destroyed by the school when ordered to do so by the agency conducting the assessment or
investigation. The agency shall order the destruction of the notification when other records
relating to the report under investigation or assessment are destroyed under this subdivision.

(e) Private or confidential data released to a court services agency under subdivision 3,
paragraph (d), must be destroyed by the court services agency when ordered to do so by the
local welfare agency that released the data. The local welfare agency or agency responsible
for assessing or investigating the report shall order destruction of the data when other records
relating to the assessment or investigation are destroyed under this subdivision.

new text begin EFFECTIVE DATE.new text end

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

Sec. 27.

Minnesota Statutes 2022, section 518A.31, is amended to read:

518A.31 SOCIAL SECURITY OR VETERANS' BENEFIT PAYMENTS
RECEIVED ON BEHALF OF THE CHILD.

(a) The amount of the monthly Social Security benefits or apportioned veterans' benefits
provided for a joint child shall be included in the gross income of the parent on whose
eligibility the benefits are based.

(b) The amount of the monthly survivors' and dependents' educational assistance provided
for a joint child shall be included in the gross income of the parent on whose eligibility the
benefits are based.

(c) If Social Security or apportioned veterans' benefits are provided for a joint child
based on the eligibility of the obligor, and are received by the obligee as a representative
payee for the child or by the child attending school, then the amount of the benefits shall
also be subtracted from the obligor's net child support obligation as calculated pursuant to
section 518A.34.

(d) If the survivors' and dependents' educational assistance is provided for a joint child
based on the eligibility of the obligor, and is received by the obligee as a representative
payee for the child or by the child attending school, then the amount of the assistance shall
also be subtracted from the obligor's net child support obligation as calculated under section
518A.34.

new text begin (e) Upon a motion to modify child support, any regular or lump sum payment of Social
Security or apportioned veterans' benefit received by the obligee for the benefit of the joint
child based upon the obligor's disability prior to filing the motion to modify may be used
to satisfy arrears that remain due for the period of time for which the benefit was received.
This paragraph applies only if the derivative benefit was not considered in the guidelines
calculation of the previous child support order.
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. 28.

Minnesota Statutes 2022, section 518A.32, subdivision 3, is amended to read:

Subd. 3.

Parent not considered voluntarily unemployed, underemployed, or employed
on a less than full-time basis.

A parent is not considered voluntarily unemployed,
underemployed, or employed on a less than full-time basis upon a showing by the parent
that:

(1) the unemployment, underemployment, or employment on a less than full-time basis
is temporary and will ultimately lead to an increase in income;

(2) the unemployment, underemployment, or employment on a less than full-time basis
represents a bona fide career change that outweighs the adverse effect of that parent's
diminished income on the child; deleted text begin or
deleted text end

(3) the unemployment, underemployment, or employment on a less than full-time basis
is because a parent is physically or mentally incapacitated or due to incarcerationdeleted text begin .deleted text end new text begin ; or
new text end

new text begin (4) a governmental agency authorized to determine eligibility for general assistance or
supplemental Social Security income has determined that the individual is eligible to receive
general assistance or supplemental Social Security income. Actual income earned by the
parent may be considered for the purpose of calculating child support.
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. 29.

Minnesota Statutes 2022, section 518A.32, subdivision 4, is amended to read:

Subd. 4.

TANF new text begin or MFIP new text end recipient.

If the parent of a joint child is a recipient of a
temporary assistance to a needy family (TANF) cash grantdeleted text begin ,deleted text end new text begin or comparable state-funded
Minnesota family investment program (MFIP) benefits,new text end no potential income is to be imputed
to that parent.

new text begin EFFECTIVE DATE.new text end

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

Sec. 30.

Minnesota Statutes 2022, section 518A.34, is amended to read:

518A.34 COMPUTATION OF CHILD SUPPORT OBLIGATIONS.

(a) To determine the presumptive child support obligation of a parent, the court shall
follow the procedure set forth in this section.

(b) To determine the obligor's basic support obligation, the court shall:

(1) determine the gross income of each parent under section 518A.29;

(2) calculate the parental income for determining child support (PICS) of each parent,
by subtracting from the gross income the credit, if any, for each parent's nonjoint children
under section 518A.33;

(3) determine the percentage contribution of each parent to the combined PICS by
dividing the combined PICS into each parent's PICS;

(4) determine the combined basic support obligation by application of the guidelines in
section 518A.35;

(5) determine each parent's share of the combined basic support obligation by multiplying
the percentage figure from clause (3) by the combined basic support obligation in clause
(4); and

(6) apply the parenting expense adjustment formula provided in section 518A.36 to
determine the obligor's basic support obligation.

(c) If the parents have split custody of joint children, child support must be calculated
for each joint child as follows:

(1) the court shall determine each parent's basic support obligation under paragraph (b)
and include the amount of each parent's obligation in the court order. If the basic support
calculation results in each parent owing support to the other, the court shall offset the higher
basic support obligation with the lower basic support obligation to determine the amount
to be paid by the parent with the higher obligation to the parent with the lower obligation.
For the purpose of the cost-of-living adjustment required under section 518A.75, the
adjustment must be based on each parent's basic support obligation prior to offset. For the
purposes of this paragraph, "split custody" means that there are two or more joint children
and each parent has at least one joint child more than 50 percent of the time;

(2) if each parent pays all child care expenses for at least one joint child, the court shall
calculate child care support for each joint child as provided in section 518A.40. The court
shall determine each parent's child care support obligation and include the amount of each
parent's obligation in the court order. If the child care support calculation results in each
parent owing support to the other, the court shall offset the higher child care support
obligation with the lower child care support obligation to determine the amount to be paid
by the parent with the higher obligation to the parent with the lower obligation; and

(3) if each parent pays all medical or dental insurance expenses for at least one joint
child, medical support shall be calculated for each joint child as provided in section 518A.41.
The court shall determine each parent's medical support obligation and include the amount
of each parent's obligation in the court order. If the medical support calculation results in
each parent owing support to the other, the court shall offset the higher medical support
obligation with the lower medical support obligation to determine the amount to be paid by
the parent with the higher obligation to the parent with the lower obligation. Unreimbursed
and uninsured medical expenses are not included in the presumptive amount of support
owed by a parent and are calculated and collected as provided in section 518A.41.

(d) The court shall determine the child care support obligation for the obligor as provided
in section 518A.40.

(e) The court shall determine the medical support obligation for each parent as provided
in section 518A.41. Unreimbursed and uninsured medical expenses are not included in the
presumptive amount of support owed by a parent and are calculated and collected as described
in section 518A.41.

(f) The court shall determine each parent's total child support obligation by adding
together each parent's basic support, child care support, and health care coverage obligations
as provided in this section.

(g) If Social Security benefits or veterans' benefits are received by one parent as a
representative payee for a joint child based on the other parent's eligibility, the court shall
subtract the amount of benefits from the other parent's net child support obligation, if any.new text begin
Any benefit received by the obligee for the benefit of the joint child based upon the obligor's
disability or past earnings in any given month in excess of the child support obligation must
not be treated as an arrearage payment or a future payment.
new text end

(h) The final child support order shall separately designate the amount owed for basic
support, child care support, and medical support. If applicable, the court shall use the
self-support adjustment and minimum support adjustment under section 518A.42 to determine
the obligor's child support obligation.

new text begin EFFECTIVE DATE.new text end

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

Sec. 31.

Minnesota Statutes 2022, section 518A.41, is amended to read:

518A.41 MEDICAL SUPPORT.

Subdivision 1.

Definitions.

The definitions in this subdivision apply to this chapter and
chapter 518.

(a) "Health care coverage" means deleted text begin medical, dental, or other health care benefits that are
provided by one or more health plans. Health care coverage does not include any form of
public coveragedeleted text end new text begin private health care coverage, including fee for service, health maintenance
organization, preferred provider organization, and other types of private health care coverage.
Health care coverage also means public health care coverage under which medical or dental
services could be provided to a dependent childnew text end .

deleted text begin (b) "Health carrier" means a carrier as defined in sections 62A.011, subdivision 2, and
62L.02, subdivision 16.
deleted text end

deleted text begin (c) "Health plan"deleted text end new text begin (b) "Private health care coverage"new text end means a new text begin health new text end plandeleted text begin , other than any
form of public coverage,deleted text end that provides medical, dental, or other health care benefits and is:

(1) provided on an individual or group basis;

(2) provided by an employer or union;

(3) purchased in the private market; deleted text begin or
deleted text end

new text begin (4) provided through MinnesotaCare under chapter 256L; or
new text end

deleted text begin (4)deleted text end new text begin (5)new text end available to a person eligible to carry insurance for the joint child, including a
party's spouse or parent.

deleted text begin Health plandeleted text end new text begin Private health care coveragenew text end includes, but is not limited to, a new text begin health new text end plan meeting
the definition under section 62A.011, subdivision 3, except that the exclusion of coverage
designed solely to provide dental or vision care under section 62A.011, subdivision 3, clause
(6), does not apply to the definition of deleted text begin health plandeleted text end new text begin private health care coveragenew text end under this
section; a group health plan governed under the federal Employee Retirement Income
Security Act of 1974 (ERISA); a self-insured plan under sections 43A.23 to 43A.317 and
471.617; and a policy, contract, or certificate issued by a community-integrated service
network licensed under chapter 62N.

new text begin (c) "Public health care coverage" means health care benefits provided by any form of
medical assistance under chapter 256B. Public health care coverage does not include
MinnesotaCare or health plans subsidized by federal premium tax credits or federal
cost-sharing reductions.
new text end

(d) "Medical support" means providing health care coverage for a joint child deleted text begin by carrying
health care coverage for the joint child ordeleted text end by contributing to the cost of health care coverage,deleted text begin
public coverage,deleted text end unreimbursed deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses, and uninsured deleted text begin medicaldeleted text end new text begin
health-relatednew text end expenses of the joint child.

(e) "National medical support notice" means an administrative notice issued by the public
authority to enforce health insurance provisions of a support order in accordance with Code
of Federal Regulations, title 45, section 303.32, in cases where the public authority provides
support enforcement services.

deleted text begin (f) "Public coverage" means health care benefits provided by any form of medical
assistance under chapter 256B. Public coverage does not include MinnesotaCare or health
plans subsidized by federal premium tax credits or federal cost-sharing reductions.
deleted text end

deleted text begin (g)deleted text end new text begin (f)new text end "Uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses" means a joint child's reasonable and
necessary deleted text begin health-relateddeleted text end new text begin medical and dentalnew text end expenses if the joint child is not covered by deleted text begin a
health plan or public coveragedeleted text end new text begin private health insurance carenew text end when the expenses are incurred.

deleted text begin (h)deleted text end new text begin (g)new text end "Unreimbursed deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses" means a joint child's reasonable
and necessary deleted text begin health-relateddeleted text end new text begin medical and dentalnew text end expenses if a joint child is covered by deleted text begin a
health plan or public coveragedeleted text end new text begin health care coveragenew text end and deleted text begin the plan ordeleted text end new text begin health carenew text end coverage
does not pay for the total cost of the expenses when the expenses are incurred. Unreimbursed
deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses do not include the cost of premiums. Unreimbursed deleted text begin medicaldeleted text end new text begin
health-relatednew text end expenses include, but are not limited to, deductibles, co-payments, and
expenses for orthodontia, and prescription eyeglasses and contact lenses, but not
over-the-counter medications if deleted text begin coverage is under a health plandeleted text end new text begin provided through health
care coveragenew text end .

Subd. 2.

Order.

(a) A completed national medical support notice issued by the public
authority or a court order that complies with this section is a qualified medical child support
order under the federal Employee Retirement Income Security Act of 1974 (ERISA), United
States Code, title 29, section 1169(a).

(b) Every order addressing child support must state:

(1) the names, last known addresses, and Social Security numbers of the parents and the
joint child that is a subject of the order unless the court prohibits the inclusion of an address
or Social Security number and orders the parents to provide the address and Social Security
number to the administrator of the health plan;

(2) deleted text begin if a joint child is not presently enrolled in health care coverage,deleted text end whether appropriate
health care coverage for the joint child is available and, if so, state:

(i) the parents' responsibilities for carrying health care coverage;

(ii) the cost of premiums and how the cost is allocated between the parents; deleted text begin and
deleted text end

(iii) the circumstances, if any, under which an obligation to provide new text begin private new text end health care
coverage for the joint child will shift from one parent to the other;new text begin and
new text end

deleted text begin (3) if appropriate health care coverage is not available for the joint child,deleted text end new text begin (iv)new text end whether
a contribution for deleted text begin medical supportdeleted text end new text begin public health care coveragenew text end is required; and

deleted text begin (4)deleted text end new text begin (3)new text end how unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses will be allocated
between the parents.

Subd. 3.

Determining appropriate health care coverage.

new text begin Public health care coverage
is presumed appropriate.new text end In determining whether a parent has appropriate new text begin private new text end health
care coverage for the joint child, the court must consider the following factors:

(1) comprehensiveness of new text begin private new text end health care coverage providing medical benefits.
Dependent new text begin private new text end health care coverage providing medical benefits is presumed
comprehensive if it includes medical and hospital coverage and provides for preventive,
emergency, acute, and chronic care; or if it meets the minimum essential coverage definition
in United States Code, title 26, section 5000A(f). If both parents have new text begin private new text end health care
coverage providing medical benefits that is presumed comprehensive under this paragraph,
the court must determine which parent's new text begin private health care new text end coverage is more comprehensive
by considering what other benefits are included in the new text begin private health care new text end coverage;

(2) accessibility. Dependent new text begin private new text end health care coverage is accessible if the covered
joint child can obtain services from a health plan provider with reasonable effort by the
parent with whom the joint child resides. new text begin Private new text end health care coverage is presumed accessible
if:

(i) primary care is available within 30 minutes or 30 miles of the joint child's residence
and specialty care is available within 60 minutes or 60 miles of the joint child's residence;

(ii) the new text begin private new text end health care coverage is available through an employer and the employee
can be expected to remain employed for a reasonable amount of time; and

(iii) no preexisting conditions exist to unduly delay enrollment in new text begin private new text end health care
coverage;

(3) the joint child's special medical needs, if any; and

(4) affordability. Dependent new text begin private new text end health care coverage is new text begin presumed new text end affordable if deleted text begin it is
reasonable in cost. If both parents have health care coverage available for a joint child that
is comparable with regard to comprehensiveness of medical benefits, accessibility, and the
joint child's special needs, the least costly health care coverage is presumed to be the most
appropriate health care coverage for the joint childdeleted text end new text begin the premium to cover the marginal cost
of the joint child does not exceed five percent of the parents' combined monthly PICS. A
court may additionally consider high deductibles and the cost to enroll the parent if the
parent must enroll themselves in private health care coverage to access private health care
coverage for the childnew text end .

Subd. 4.

Ordering health care coverage.

deleted text begin (a) If a joint child is presently enrolled in
health care coverage, the court must order that the parent who currently has the joint child
enrolled continue that enrollment unless the parties agree otherwise or a party requests a
change in coverage and the court determines that other health care coverage is more
appropriate.
deleted text end

deleted text begin (b) If a joint child is not presently enrolled in health care coverage providing medical
benefits, upon motion of a parent or the public authority, the court must determine whether
one or both parents have appropriate health care coverage providing medical benefits for
the joint child.
deleted text end

new text begin (a) If a joint child is presently enrolled in health care coverage, the court shall order that
the parent who currently has the joint child enrolled in health care coverage continue that
enrollment if the health care coverage is appropriate as defined under subdivision 3.
new text end

deleted text begin (c)deleted text end new text begin (b)new text end If only one parent has appropriate health care coverage providing medical benefits
available, the court must order that parent to carry the coverage for the joint child.

deleted text begin (d)deleted text end new text begin (c)new text end If both parents have appropriate health care coverage providing medical benefits
available, the court must order the parent with whom the joint child resides to carry the
new text begin health care new text end coverage for the joint child, unless:

(1) a party expresses a preference fornew text begin privatenew text end health care coverage providing medical
benefits available through the parent with whom the joint child does not reside;

(2) the parent with whom the joint child does not reside is already carrying dependent
new text begin private new text end health care coverage providing medical benefits for other children and the cost of
contributing to the premiums of the other parent's new text begin health care new text end coverage would cause the
parent with whom the joint child does not reside extreme hardship; or

(3) the parties agree as to which parent will carry health care coverage providing medical
benefits and agree on the allocation of costs.

deleted text begin (e)deleted text end new text begin (d)new text end If the exception in paragraph deleted text begin (d)deleted text end new text begin (c)new text end , clause (1) or (2), applies, the court must
determine which parent has the most appropriate new text begin health care new text end coverage providing medical
benefits available and order that parent to carry new text begin health care new text end coverage for the joint child.

deleted text begin (f)deleted text end new text begin (e)new text end If neither parent has appropriate health care coverage available, the court must
order the parents todeleted text begin :
deleted text end

deleted text begin (1)deleted text end contribute toward the actual health care costs of the joint children based on a pro
rata sharedeleted text begin ; ordeleted text end new text begin .
new text end

deleted text begin (2) if the joint child is receiving any form of public coverage, the parent with whom the
joint child does not reside shall contribute a monthly amount toward the actual cost of public
coverage. The amount of the noncustodial parent's contribution is determined by applying
the noncustodial parent's PICS to the premium scale for MinnesotaCare under section
256L.15, subdivision 2, paragraph (d). If the noncustodial parent's PICS meets the eligibility
requirements for MinnesotaCare, the contribution is the amount the noncustodial parent
would pay for the child's premium. If the noncustodial parent's PICS exceeds the eligibility
requirements, the contribution is the amount of the premium for the highest eligible income
on the premium scale for MinnesotaCare under section 256L.15, subdivision 2, paragraph
(d). For purposes of determining the premium amount, the noncustodial parent's household
size is equal to one parent plus the child or children who are the subject of the child support
order. The custodial parent's obligation is determined under the requirements for public
coverage as set forth in chapter 256B; or
deleted text end

deleted text begin (3) if the noncustodial parent's PICS meet the eligibility requirement for public coverage
under chapter 256B or the noncustodial parent receives public assistance, the noncustodial
parent must not be ordered to contribute toward the cost of public coverage.
deleted text end

deleted text begin (g)deleted text end new text begin (f)new text end If neither parent has appropriate health care coverage available, the court may
order the parent with whom the child resides to apply for publicnew text begin health carenew text end coverage for
the child.

deleted text begin (h) The commissioner of human services must publish a table with the premium schedule
for public coverage and update the chart for changes to the schedule by July 1 of each year.
deleted text end

deleted text begin (i)deleted text end new text begin (g)new text end If a joint child is not presently enrolled in new text begin private new text end health care coverage providing
dental benefits, upon motion of a parent or the public authority, the court must determine
whether one or both parents have appropriate deleted text begin dentaldeleted text end new text begin private new text end health care coverage new text begin providing
dental benefits new text end for the joint child, and the court may order a parent with appropriate deleted text begin dentaldeleted text end new text begin
privatenew text end health care coverage new text begin providing dental benefits new text end available to carry the new text begin health care
new text end coverage for the joint child.

deleted text begin (j)deleted text end new text begin (h)new text end If a joint child is not presently enrolled in available new text begin private new text end health care coverage
providing benefits other than medical benefits or dental benefits, upon motion of a parent
or the public authority, the court may determine whether deleted text begin that otherdeleted text end new text begin privatenew text end health care
coverage new text begin providing other health benefits new text end for the joint child is appropriate, and the court may
order a parent with that appropriate new text begin private new text end health care coverage available to carry the
coverage for the joint child.

Subd. 5.

Medical support costs; unreimbursed and uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end
expenses.

(a) Unless otherwise agreed to by the parties and approved by the court, the court
must order that the cost of new text begin private new text end health care coverage and all unreimbursed and uninsured
deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses deleted text begin under the health plandeleted text end be divided between the obligor and
obligee based on their proportionate share of the parties' combined monthly PICS. The
amount allocated for medical support is considered child support but is not subject to a
cost-of-living adjustment under section 518A.75.

(b) If a party owes a deleted text begin joint childdeleted text end new text begin basicnew text end support obligation for a new text begin joint new text end child and is ordered
to carry new text begin private new text end health care coverage for the joint child, and the other party is ordered to
contribute to the carrying party's cost for coverage, the carrying party's deleted text begin childdeleted text end new text begin basicnew text end support
payment must be reduced by the amount of the contributing party's contribution.

(c) If a party owes a deleted text begin joint childdeleted text end new text begin basic new text end support obligation for a new text begin joint new text end child and is ordered
to contribute to the other party's cost for carrying new text begin private new text end health care coverage for the joint
child, the contributing party's child support payment must be increased by the amount of
the contribution.new text begin The contribution toward private health care coverage must not be charged
in any month in which the party ordered to carry private health care coverage fails to maintain
private coverage.
new text end

(d) If the party ordered to carry new text begin private new text end health care coverage for the joint child already
carries dependent new text begin private new text end health care coverage for other dependents and would incur no
additional premium costs to add the joint child to the existing new text begin health care new text end coverage, the court
must not order the other party to contribute to the premium costs for new text begin health care new text end coverage
of the joint child.

(e) If a party ordered to carrynew text begin privatenew text end health care coverage for the joint child does not
already carry dependent new text begin private new text end health care coverage but has other dependents who may be
added to the ordered new text begin health care new text end coverage, the full premium costs of the dependent new text begin private
new text end health care coverage must be allocated between the parties in proportion to the party's share
of the parties' combined new text begin monthly new text end PICS, unless the parties agree otherwise.

(f) If a party ordered to carry new text begin private new text end health care coverage for the joint child is required
to enroll in a health plan so that the joint child can be enrolled in dependent new text begin private new text end health
care coverage under the plan, the court must allocate the costs of the dependent new text begin private
new text end health care coverage between the parties. The costs of thenew text begin privatenew text end health care coverage for
the party ordered to carry the new text begin health care new text end coverage for the joint child must not be allocated
between the parties.

new text begin (g) If the joint child is receiving any form of public health care coverage:
new text end

new text begin (1) the parent with whom the joint child does not reside shall contribute a monthly
amount toward the actual cost of public health care coverage. The amount of the noncustodial
parent's contribution is determined by applying the noncustodial parent's PICS to the premium
scale for MinnesotaCare under section 256L.15, subdivision 2, paragraph (d). If the
noncustodial parent's PICS meets the eligibility requirements for MinnesotaCare, the
contribution is the amount that the noncustodial parent would pay for the child's premium;
new text end

new text begin (2) if the noncustodial parent's PICS exceeds the eligibility requirements, the contribution
is the amount of the premium for the highest eligible income on the premium scale for
MinnesotaCare under section 256L.15, subdivision 2, paragraph (d). For purposes of
determining the premium amount, the noncustodial parent's household size is equal to one
parent plus the child or children who are the subject of the order;
new text end

new text begin (3) the custodial parent's obligation is determined under the requirements for public
health care coverage in chapter 256B; or
new text end

new text begin (4) if the noncustodial parent's PICS is less than 200 percent of the federal poverty
guidelines for one person or the noncustodial parent receives public assistance, the
noncustodial parent must not be ordered to contribute toward the cost of public health care
coverage.
new text end

new text begin (h) The commissioner of human services must publish a table for section 256L.15,
subdivision 2, paragraph (d), and update the table with changes to the schedule by July 1
of each year.
new text end

Subd. 6.

Notice or court order sent to party's employer, union, or health carrier.

(a)
The public authority must forward a copy of the national medical support notice or court
order for new text begin private new text end health care coverage to the party's employer within two business days after
the date the party is entered into the work reporting system under section 256.998.

(b) The public authority or a party seeking to enforce an order for new text begin private new text end health care
coverage must forward a copy of the national medical support notice or court order to the
obligor's employer or union, or to the health carrier under the following circumstances:

(1) the party ordered to carry new text begin private new text end health care coverage for the joint child fails to
provide written proof to the other party or the public authority, within 30 days of the effective
date of the court order, that the party has applied for new text begin private new text end health care coverage for the
joint child;

(2) the party seeking to enforce the order or the public authority gives written notice to
the party ordered to carry new text begin private new text end health care coverage for the joint child of its intent to
enforce medical support. The party seeking to enforce the order or public authority must
mail the written notice to the last known address of the party ordered to carry new text begin private new text end health
care coverage for the joint child; and

(3) the party ordered to carry new text begin private new text end health care coverage for the joint child fails, within
15 days after the date on which the written notice under clause (2) was mailed, to provide
written proof to the other party or the public authority that the party has applied for new text begin private
new text end health care coverage for the joint child.

(c) The public authority is not required to forward a copy of the national medical support
notice or court order to the obligor's employer or union, or to the health carrier, if the court
orders new text begin private new text end health care coverage for the joint child that is not employer-based or
union-based coverage.

Subd. 7.

Employer or union requirements.

(a) An employer or union must forward
the national medical support notice or court order to its health plan within 20 business days
after the date on the national medical support notice or after receipt of the court order.

(b) Upon determination by an employer's or union's health plan administrator that a joint
child is eligible to be covered under the health plan, the employer or union and health plan
must enroll the joint child as a beneficiary in the health plan, and the employer must withhold
any required premiums from the income or wages of the party ordered to carry health care
coverage for the joint child.

(c) If enrollment of the party ordered to carry new text begin private new text end health care coverage for a joint
child is necessary to obtain dependent new text begin private new text end health care coverage under the plan, and the
party is not enrolled in the health plan, the employer or union must enroll the party in the
plan.

(d) Enrollment of dependents and, if necessary, the party ordered to carry new text begin private new text end health
care coverage for the joint child must be immediate and not dependent upon open enrollment
periods. Enrollment is not subject to the underwriting policies under section 62A.048.

(e) Failure of the party ordered to carry new text begin private new text end health care coverage for the joint child
to execute any documents necessary to enroll the dependent in the health plan does not
affect the obligation of the employer or union and health plan to enroll the dependent in a
plan. Information and authorization provided by the public authority, or by a party or
guardian, is valid for the purposes of meeting enrollment requirements of the health plan.

(f) An employer or union that is included under the federal Employee Retirement Income
Security Act of 1974 (ERISA), United States Code, title 29, section 1169(a), may not deny
enrollment to the joint child or to the parent if necessary to enroll the joint child based on
exclusionary clauses described in section 62A.048.

(g) A new employer or union of a party who is ordered to provide new text begin private new text end health care
coverage for a joint child must enroll the joint child in the party's health plan as required
by a national medical support notice or court order.

Subd. 8.

Health plan requirements.

(a) If a health plan administrator receives a
completed national medical support notice or court order, the plan administrator must notify
the parties, and the public authority if the public authority provides support enforcement
services, within 40 business days after the date of the notice or after receipt of the court
order, of the following:

(1) whether new text begin health care new text end coverage is available to the joint child under the terms of the
health plan and, if not, the reason why new text begin health care new text end coverage is not available;

(2) whether the joint child is covered under the health plan;

(3) the effective date of the joint child's coverage under the health plan; and

(4) what steps, if any, are required to effectuate the joint child's coverage under the health
plan.

(b) If the employer or union offers more than one plan and the national medical support
notice or court order does not specify the plan to be carried, the plan administrator must
notify the parents and the public authority if the public authority provides support
enforcement services. When there is more than one option available under the plan, the
public authority, in consultation with the parent with whom the joint child resides, must
promptly select from available plan options.

(c) The plan administrator must provide the parents and public authority, if the public
authority provides support enforcement services, with a notice of the joint child's enrollment,
description of the new text begin health care new text end coverage, and any documents necessary to effectuate coverage.

(d) The health plan must send copies of all correspondence regarding the new text begin private new text end health
care coverage to the parents.

(e) An insured joint child's parent's signature is a valid authorization to a health plan for
purposes of processing an insurance reimbursement payment to the medical services provider
or to the parent, if medical services have been prepaid by that parent.

Subd. 9.

Employer or union liability.

(a) An employer or union that willfully fails to
comply with the order or notice is liable for any uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses
incurred by the dependents while the dependents were eligible to be enrolled in the health
plan and for any other premium costs incurred because the employer or union willfully
failed to comply with the order or notice.

(b) An employer or union that fails to comply with the order or notice is subject to a
contempt finding, a $250 civil penalty under section 518A.73, and is subject to a civil penalty
of $500 to be paid to the party entitled to reimbursement or the public authority. Penalties
paid to the public authority are designated for child support enforcement services.

Subd. 10.

Contesting enrollment.

(a) A party may contest a joint child's enrollment in
a health plan on the limited grounds that the enrollment is improper due to mistake of fact
or that the enrollment meets the requirements of section 518.145.

(b) If the party chooses to contest the enrollment, the party must do so no later than 15
days after the employer notifies the party of the enrollment by doing the following:

(1) filing a motion in district court or according to section 484.702 and the expedited
child support process rules if the public authority provides support enforcement services;

(2) serving the motion on the other party and public authority if the public authority
provides support enforcement services; and

(3) securing a date for the matter to be heard no later than 45 days after the notice of
enrollment.

Subd. 11.

Disenrollment; continuation of coverage; coverage options.

(a) Unless a
court order provides otherwise, a child for whom a party is required to provide new text begin private new text end health
care coverage under this section must be covered as a dependent of the party until the child
is emancipated, until further order of the court, or as consistent with the terms of the new text begin health
care new text end coverage.

(b) The health carrier, employer, or union may not disenroll or eliminate new text begin health care
new text end coverage for the child unless:

(1) the health carrier, employer, or union is provided satisfactory written evidence that
the court order is no longer in effect;

(2) the joint child is or will be enrolled in comparable new text begin private new text end health care coverage
through another health plan that will take effect no later than the effective date of the
disenrollment;

(3) the employee is no longer eligible for dependent new text begin health care new text end coverage; or

(4) the required premium has not been paid by or on behalf of the joint child.

(c) The health plan must provide 30 days' written notice to the joint child's parents, and
the public authority if the public authority provides support enforcement services, before
the health plan disenrolls or eliminates the joint child's new text begin health care new text end coverage.

(d) A joint child enrolled in new text begin private new text end health care coverage under a qualified medical child
support order, including a national medical support notice, under this section is a dependent
and a qualified beneficiary under the Consolidated Omnibus Budget and Reconciliation Act
of 1985 (COBRA), Public Law 99-272. Upon expiration of the order, the joint child is
entitled to the opportunity to elect continued new text begin health care new text end coverage that is available under
the health plan. The employer or union must provide notice to the parties and the public
authority, if it provides support services, within ten days of the termination date.

(e) If the public authority provides support enforcement services and a plan administrator
reports to the public authority that there is more than one coverage option available under
the health plan, the public authority, in consultation with the parent with whom the joint
child resides, must promptly select new text begin health care new text end coverage from the available options.

Subd. 12.

Spousal or former spousal coverage.

The court must require the parent with
whom the joint child does not reside to provide dependent new text begin private new text end health care coverage for
the benefit of the parent with whom the joint child resides if the parent with whom the child
does not reside is ordered to provide dependent new text begin private new text end health care coverage for the parties'
joint child and adding the other parent to the new text begin health care new text end coverage results in no additional
premium cost.

Subd. 13.

Disclosure of information.

(a) If the public authority provides support
enforcement services, the parties must provide the public authority with the following
information:

(1) information relating to dependent health care coverage deleted text begin or public coveragedeleted text end available
for the benefit of the joint child for whom support is sought, including all information
required to be included in a medical support order under this section;

(2) verification that application for court-ordered health care coverage was made within
30 days of the court's order; and

(3) the reason that a joint child is not enrolled in court-ordered health care coverage, if
a joint child is not enrolled in new text begin health care new text end coverage or subsequently loses new text begin health care new text end coverage.

(b) Upon request from the public authority under section 256.978, an employer, union,
or plan administrator, including an employer subject to the federal Employee Retirement
Income Security Act of 1974 (ERISA), United States Code, title 29, section 1169(a), must
provide the public authority the following information:

(1) information relating to dependent new text begin private new text end health care coverage available to a party
for the benefit of the joint child for whom support is sought, including all information
required to be included in a medical support order under this section; and

(2) information that will enable the public authority to determine whether a health plan
is appropriate for a joint child, including, but not limited to, all available plan options, any
geographic service restrictions, and the location of service providers.

(c) The employer, union, or plan administrator must not release information regarding
one party to the other party. The employer, union, or plan administrator must provide both
parties with insurance identification cards and all necessary written information to enable
the parties to utilize the insurance benefits for the covered dependent.

(d) The public authority is authorized to release to a party's employer, union, or health
plan information necessary to verify availability of dependent new text begin private new text end health care coverage,
or to establish, modify, or enforce medical support.

(e) An employee must disclose to an employer if medical support is required to be
withheld under this section and the employer must begin withholding according to the terms
of the order and under section 518A.53. If an employee discloses an obligation to obtain
new text begin private new text end health care coverage and new text begin health care new text end coverage is available through the employer,
the employer must make all application processes known to the individual and enroll the
employee and dependent in the plan.

Subd. 14.

Child support enforcement services.

The public authority must take necessary
steps to establish, enforce, and modify an order for medical support if the joint child receives
public assistance or a party completes an application for services from the public authority
under section 518A.51.

Subd. 15.

Enforcement.

(a) Remedies available for collecting and enforcing child
support apply to medical support.

(b) For the purpose of enforcement, the following are additional support:

(1) the costs of individual or group health or hospitalization coverage;

(2) dental coverage;

(3) medical costs ordered by the court to be paid by either party, including health care
coverage premiums paid by the obligee because of the obligor's failure to obtain new text begin health care
new text end coverage as ordered; and

(4) liabilities established under this subdivision.

(c) A party who fails to carry court-ordered dependent new text begin private new text end health care coverage is
liable for the joint child's uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses unless a court order
provides otherwise. A party's failure to carry court-ordered new text begin health care new text end coverage, or to
provide other medical support as ordered, is a basis for modification of medical support
under section 518A.39, subdivision 8, unless it meets the presumption in section 518A.39,
subdivision 2.

(d) Payments by the health carrier or employer for services rendered to the dependents
that are directed to a party not owed reimbursement must be endorsed over to and forwarded
to the vendor or appropriate party or the public authority. A party retaining insurance
reimbursement not owed to the party is liable for the amount of the reimbursement.

Subd. 16.

Offset.

(a) If a party is the parent with primary physical custody as defined
in section 518A.26, subdivision 17, and is an obligor ordered to contribute to the other
party's cost for carrying health care coverage for the joint child, the other party's child
support and spousal maintenance obligations are subject to an offset under subdivision 5.

(b) The public authority, if the public authority provides child support enforcement
services, may remove the offset to a party's child support obligation when:

(1) the party's court-ordered new text begin private new text end health care coverage for the joint child terminates;

(2) the party does not enroll the joint child in other new text begin private new text end health care coverage; and

(3) a modification motion is not pending.

The public authority must provide notice to the parties of the action. If neither party requests
a hearing, the public authority must remove the offset effective the first day of the month
following termination of the joint child's new text begin private new text end health care coverage.

(c) The public authority, if the public authority provides child support enforcement
services, may resume the offset when the party ordered to provide new text begin private new text end health care
coverage for the joint child has resumed the court-ordered new text begin private new text end health care coverage or
enrolled the joint child in other new text begin private new text end health care coverage. The public authority must
provide notice to the parties of the action. If neither party requests a hearing, the public
authority must resume the offset effective the first day of the month following certification
that new text begin private new text end health care coverage is in place for the joint child.

(d) A party may contest the public authority's action to remove or resume the offset to
the child support obligation if the party makes a written request for a hearing within 30 days
after receiving written notice. If a party makes a timely request for a hearing, the public
authority must schedule a hearing and send written notice of the hearing to the parties by
mail to the parties' last known addresses at least 14 days before the hearing. The hearing
must be conducted in district court or in the expedited child support process if section
484.702 applies. The district court or child support magistrate must determine whether
removing or resuming the offset is appropriate and, if appropriate, the effective date for the
removal or resumption.

new text begin Subd. 16a.new text end

new text begin Suspension or reinstatement of medical support contribution. new text end

new text begin (a) If a
party is the parent with primary physical custody, as defined in section 518A.26, subdivision
17, and is ordered to carry private health care coverage for the joint child but fails to carry
the court-ordered private health care coverage, the public authority may suspend the medical
support obligation of the other party if that party has been court-ordered to contribute to the
cost of the private health care coverage carried by the parent with primary physical custody
of the joint child.
new text end

new text begin (b) If the public authority provides child support enforcement services, the public
authority may suspend the other party's medical support contribution toward private health
care coverage when:
new text end

new text begin (1) the party's court-ordered private health care coverage for the joint child terminates;
new text end

new text begin (2) the party does not enroll the joint child in other private health care coverage; and
new text end

new text begin (3) a modification motion is not pending.
new text end

new text begin The public authority must provide notice to the parties of the action. If neither party requests
a hearing, the public authority must remove the medical support contribution effective the
first day of the month following the termination of the joint child's private health care
coverage.
new text end

new text begin (c) If the public authority provides child support enforcement services, the public authority
may reinstate the medical support contribution when the party ordered to provide private
health care coverage for the joint child has resumed the joint child's court-ordered private
health care coverage or has enrolled the joint child in other private health care coverage.
The public authority must provide notice to the parties of the action. If neither party requests
a hearing, the public authority must resume the medical support contribution effective the
first day of the month following certification that the joint child is enrolled in private health
care coverage.
new text end

new text begin (d) A party may contest the public authority's action to suspend or reinstate the medical
support contribution if the party makes a written request for a hearing within 30 days after
receiving written notice. If a party makes a timely request for a hearing, the public authority
must schedule a hearing and send written notice of the hearing to the parties by mail to the
parties' last known addresses at least 14 days before the hearing. The hearing must be
conducted in district court or in the expedited child support process if section 484.702
applies. The district court or child support magistrate must determine whether suspending
or reinstating the medical support contribution is appropriate and, if appropriate, the effective
date of the removal or reinstatement of the medical support contribution.
new text end

Subd. 17.

Collecting unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses.

(a)
This subdivision and subdivision 18 apply when a court order has determined and ordered
the parties' proportionate share and responsibility to contribute to unreimbursed or uninsured
deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses.

(b) A party requesting reimbursement of unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin
health-relatednew text end expenses must initiate a request to the other party within two years of the
date that the requesting party incurred the unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-related
new text end expenses. If a court order has been signed ordering the contribution deleted text begin towardsdeleted text end new text begin towardnew text end
unreimbursed or uninsured expenses, a two-year limitations provision must be applied to
any requests made on or after January 1, 2007. The provisions of this section apply
retroactively to court orders signed before January 1, 2007. Requests for unreimbursed or
uninsured expenses made on or after January 1, 2007, may include expenses incurred before
January 1, 2007, and on or after January 1, 2005.

(c) A requesting party must mail a written notice of intent to collect the unreimbursed
or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses and a copy of an affidavit of health care
expenses to the other party at the other party's last known address.

(d) The written notice must include a statement that the other party has 30 days from
the date the notice was mailed to (1) pay in full; (2) agree to a payment schedule; or (3) file
a motion requesting a hearing to contest the amount due or to set a court-ordered monthly
payment amount. If the public authority provides services, the written notice also must
include a statement that, if the other party does not respond within the 30 days, the requesting
party may submit the amount due to the public authority for collection.

(e) The affidavit of health care expenses must itemize and document the joint child's
unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses and include copies of all bills,
receipts, and insurance company explanations of benefits.

(f) If the other party does not respond to the request for reimbursement within 30 days,
the requesting party may commence enforcement against the other party under subdivision
18; file a motion for a court-ordered monthly payment amount under paragraph (i); or notify
the public authority, if the public authority provides services, that the other party has not
responded.

(g) The notice to the public authority must include: a copy of the written notice, a copy
of the affidavit of health care expenses, and copies of all bills, receipts, and insurance
company explanations of benefits.

(h) If noticed under paragraph (f), the public authority must serve the other party with
a notice of intent to enforce unreimbursed and uninsured deleted text begin medicaldeleted text end new text begin health-related new text end expenses
and file an affidavit of service by mail with the district court administrator. The notice must
state that the other party has 14 days to (1) pay in full; or (2) file a motion to contest the
amount due or to set a court-ordered monthly payment amount. The notice must also state
that if there is no response within 14 days, the public authority will commence enforcement
of the expenses as arrears under subdivision 18.

(i) To contest the amount due or set a court-ordered monthly payment amount, a party
must file a timely motion and schedule a hearing in district court or in the expedited child
support process if section 484.702 applies. The moving party must provide the other party
and the public authority, if the public authority provides services, with written notice at
least 14 days before the hearing by mailing notice of the hearing to the public authority and
to the requesting party at the requesting party's last known address. The moving party must
file the affidavit of health care expenses with the court at least five days before the hearing.
The district court or child support magistrate must determine liability for the expenses and
order that the liable party is subject to enforcement of the expenses as arrears under
subdivision 18 or set a court-ordered monthly payment amount.

Subd. 18.

Enforcing unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses
as arrears.

(a) Unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses enforced under
this subdivision are collected as arrears.

(b) If the liable party is the parent with primary physical custody as defined in section
518A.26, subdivision 17, the unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses
must be deducted from any arrears the requesting party owes the liable party. If unreimbursed
or uninsured expenses remain after the deduction, the expenses must be collected as follows:

(1) If the requesting party owes a current child support obligation to the liable party, 20
percent of each payment received from the requesting party must be returned to the requesting
party. The total amount returned to the requesting party each month must not exceed 20
percent of the current monthly support obligation.

(2) If the requesting party does not owe current child support or arrears, a payment
agreement under section 518A.69 is required. If the liable party fails to enter into or comply
with a payment agreement, the requesting party or the public authority, if the public authority
provides services, may schedule a hearing to set a court-ordered payment. The requesting
party or the public authority must provide the liable party with written notice of the hearing
at least 14 days before the hearing.

(c) If the liable party is not the parent with primary physical custody as defined in section
518A.26, subdivision 17, the unreimbursed or uninsured deleted text begin medicaldeleted text end new text begin health-relatednew text end expenses
must be deducted from any arrears the requesting party owes the liable party. If unreimbursed
or uninsured expenses remain after the deduction, the expenses must be added and collected
as arrears owed by the liable party.

new text begin EFFECTIVE DATE.new text end

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

Sec. 32.

Minnesota Statutes 2022, section 518A.42, subdivision 1, is amended to read:

Subdivision 1.

Ability to pay.

(a) It is a rebuttable presumption that a child support
order should not exceed the obligor's ability to pay. To determine the amount of child support
the obligor has the ability to pay, the court shall follow the procedure set out in this section.

(b) The court shall calculate the obligor's income available for support by subtracting a
monthly self-support reserve equal to 120 percent of the federal poverty guidelines for one
person from the obligor's parental income for determining child support (PICS).new text begin If benefits
under section 518A.31 are received by the obligee as a representative payee for a joint child
or are received by the child attending school, based on the other parent's eligibility, the court
shall subtract the amount of benefits from the obligor's PICS before subtracting the
self-support reserve.new text end If the obligor's income available for support calculated under this
paragraph is equal to or greater than the obligor's support obligation calculated under section
518A.34, the court shall order child support under section 518A.34.

(c) If the obligor's income available for support calculated under paragraph (b) is more
than the minimum support amount under subdivision 2, but less than the guideline amount
under section 518A.34, then the court shall apply a reduction to the child support obligation
in the following order, until the support order is equal to the obligor's income available for
support:

(1) medical support obligation;

(2) child care support obligation; and

(3) basic support obligation.

(d) If the obligor's income available for support calculated under paragraph (b) is equal
to or less than the minimum support amount under subdivision 2 or if the obligor's gross
income is less than 120 percent of the federal poverty guidelines for one person, the minimum
support amount under subdivision 2 applies.

new text begin EFFECTIVE DATE.new text end

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

Sec. 33.

Minnesota Statutes 2022, section 518A.42, subdivision 3, is amended to read:

Subd. 3.

Exception.

(a) This section does not apply to an obligor who is incarceratednew text begin
or is a recipient of a general assistance grant, Supplemental Security Income, temporary
assistance for needy families (TANF) grant, or comparable state-funded Minnesota family
investment program (MFIP) benefitsnew text end .

(b) If the court finds the obligor receives no income and completely lacks the ability to
earn income, the minimum basic support amount under this subdivision does not apply.

(c) If the obligor's basic support amount is reduced below the minimum basic support
amount due to the application of the parenting expense adjustment, the minimum basic
support amount under this subdivision does not apply and the lesser amount is the guideline
basic support.

new text begin EFFECTIVE DATE.new text end

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

Sec. 34.

Minnesota Statutes 2022, section 518A.43, subdivision 1b, is amended to read:

Subd. 1b.

Increase in income of custodial parent.

In a modification of support under
section 518A.39, the court may deviate from the presumptive child support obligation under
section 518A.34 when the only change in circumstances is an increase to the custodial
parent's income anddeleted text begin :
deleted text end

deleted text begin (1)deleted text end the basic support increasesdeleted text begin ;deleted text end new text begin .
new text end

deleted text begin (2)deleted text end deleted text begin the parties' combined gross income is $6,000 or less; or
deleted text end

deleted text begin (3)deleted text end deleted text begin the obligor's income is $2,000 or less.
deleted 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. 35.

Minnesota Statutes 2022, section 518A.65, is amended to read:

518A.65 DRIVER'S LICENSE SUSPENSION.

(a) Upon motion of an obligee, which has been properly served on the obligor and upon
which there has been an opportunity for hearing, if a court finds that the obligor has been
or may be issued a driver's license by the commissioner of public safety and the obligor is
in arrears in court-ordered child support or maintenance payments, or both, in an amount
equal to or greater than three times the obligor's total monthly support and maintenance
payments and is not in compliance with a written payment agreement pursuant to section
518A.69 that is approved by the court, a child support magistrate, or the public authority,
the court deleted text begin shalldeleted text end new text begin maynew text end order the commissioner of public safety to suspend the obligor's driver's
license. new text begin The court may consider the circumstances in paragraph (i) to determine whether
driver's license suspension is an appropriate remedy that is likely to induce the payment of
child support. The court may consider whether driver's license suspension would have a
direct harmful effect on the obligor or joint children that would make driver's license
suspension an inappropriate remedy. The public authority may not administratively reinstate
a driver's license suspended by the court unless specifically authorized to do so in the court
order. This paragraph expires December 31, 2025.
new text end

new text begin (b) This paragraph is effective January 1, 2026. Upon the motion of an obligee that has
been properly served on the obligor and for which there has been an opportunity for a
hearing, if a court finds that the obligor has a valid driver's license issued by the commissioner
of public safety and the obligor is in arrears in court-ordered child support or maintenance
payments, or both, in an amount equal to or greater than three times the obligor's total
monthly support and maintenance payments and is not in compliance with a written payment
agreement pursuant to section 518A.69 that is approved by the court, a child support
magistrate, or the public authority, the court may order the commissioner of public safety
to suspend the obligor's driver's license. The court may consider the circumstances in
paragraph (i) to determine whether driver's license suspension is an appropriate remedy that
is likely to induce the payment of child support. The court may consider whether driver's
license suspension would have a direct harmful effect on the obligor or joint children that
would make driver's license suspension an inappropriate remedy. The public authority may
not administratively reinstate a driver's license suspended by the court unless specifically
authorized to do so in the court order.
new text end

new text begin (c) new text end The court's order must be stayed for 90 days in order to allow the obligor to execute
a written payment agreement pursuant to section 518A.69. The payment agreement must
be approved by either the court or the public authority responsible for child support
enforcement. If the obligor has not executed or is not in compliance with a written payment
agreement pursuant to section 518A.69 after the 90 days expires, the court's order becomes
effective and the commissioner of public safety shall suspend the obligor's driver's license.
The remedy under this section is in addition to any other enforcement remedy available to
the court. An obligee may not bring a motion under this paragraph within 12 months of a
denial of a previous motion under this paragraph.

deleted text begin (b)deleted text end new text begin (d)new text end If a public authority responsible for child support enforcement determines that
the obligor has been or may be issued a driver's license by the commissioner of public safety
deleted text begin anddeleted text end new text begin ;new text end the obligor is in arrears in court-ordered child support or maintenance payments or
both in an amount equal to or greater than three times the obligor's total monthly support
and maintenance payments and not in compliance with a written payment agreement pursuant
to section 518A.69 that is approved by the court, a child support magistrate, or the public
authority, the public authority shall direct the commissioner of public safety to suspend the
obligor's driver's licensenew text begin unless exercising administrative discretion under paragraph (i)new text end .
The remedy under this section is in addition to any other enforcement remedy available to
the public authority.new text begin This paragraph expires December 31, 2025.
new text end

new text begin (e) This paragraph is effective January 1, 2026. If a public authority responsible for child
support enforcement determines that:
new text end

new text begin (1) the obligor has a valid driver's license issued by the commissioner of public safety;
new text end

new text begin (2) the obligor is in arrears in court-ordered child support or maintenance payments or
both in an amount equal to or greater than three times the obligor's total monthly support
and maintenance payments;
new text end

new text begin (3) the obligor is not in compliance with a written payment agreement pursuant to section
518A.69 that is approved by the court, a child support magistrate, or the public authority;
and
new text end

new text begin (4) the obligor's mailing address is known to the public authority;
new text end

new text begin then the public authority shall direct the commissioner of public safety to suspend the
obligor's driver's license unless exercising administrative discretion under paragraph (i).
The remedy under this section is in addition to any other enforcement remedy available to
the public authority.
new text end

deleted text begin (c)deleted text end new text begin (f)new text end At least 90 days prior to notifying the commissioner of public safety according
to paragraph deleted text begin (b)deleted text end new text begin (d)new text end , the public authority must mail a written notice to the obligor at the
obligor's last known address, that it intends to seek suspension of the obligor's driver's
license and that the obligor must request a hearing within 30 days in order to contest the
suspension. If the obligor makes a written request for a hearing within 30 days of the date
of the notice, a court hearing must be held. Notwithstanding any law to the contrary, the
obligor must be served with 14 days' notice in writing specifying the time and place of the
hearing and the allegations against the obligor. The notice must include information that
apprises the obligor of the requirement to develop a written payment agreement that is
approved by a court, a child support magistrate, or the public authority responsible for child
support enforcement regarding child support, maintenance, and any arrearages in order to
avoid license suspension. The notice may be served personally or by mail. If the public
authority does not receive a request for a hearing within 30 days of the date of the notice,
and the obligor does not execute a written payment agreement pursuant to section 518A.69
that is approved by the public authority within 90 days of the date of the notice, the public
authority shall direct the commissioner of public safety to suspend the obligor's driver's
license under paragraph deleted text begin (b)deleted text end new text begin (d)new text end .

deleted text begin (d)deleted text end new text begin (g)new text end At a hearing requested by the obligor under paragraph deleted text begin (c)deleted text end new text begin (f)new text end , and on finding that
the obligor is in arrears in court-ordered child support or maintenance payments or both in
an amount equal to or greater than three times the obligor's total monthly support and
maintenance payments, the district court or child support magistrate shall order the
commissioner of public safety to suspend the obligor's driver's license or operating privileges
unlessnew text begin :
new text end

new text begin (1)new text end the court or child support magistrate determines that the obligor has executed and is
in compliance with a written payment agreement pursuant to section 518A.69 that is approved
by the court, a child support magistrate, or the public authoritydeleted text begin .deleted text end new text begin ; or
new text end

new text begin (2) the court, in its discretion, determines that driver's license suspension is unlikely to
induce the payment of child support or would have direct harmful effects on the obligor or
joint child that make driver's license suspension an inappropriate remedy. The court may
consider the circumstances in paragraph (i) in exercising the court's discretion.
new text end

deleted text begin (e)deleted text end new text begin (h)new text end An obligor whose driver's license or operating privileges are suspended may:

(1) provide proof to the public authority responsible for child support enforcement that
the obligor is in compliance with all written payment agreements pursuant to section 518A.69;

(2) bring a motion for reinstatement of the driver's license. At the hearing, if the court
or child support magistrate orders reinstatement of the driver's license, the court or child
support magistrate must establish a written payment agreement pursuant to section 518A.69;
or

(3) seek a limited license under section 171.30. A limited license issued to an obligor
under section 171.30 expires 90 days after the date it is issued.

Within 15 days of the receipt of that proof or a court order, the public authority shall
inform the commissioner of public safety that the obligor's driver's license or operating
privileges should no longer be suspended.

new text begin (i) Prior to notifying the commissioner of public safety that an obligor's driver's license
should be suspended or after an obligor's driving privileges have been suspended, the public
authority responsible for child support enforcement may use administrative authority to end
the suspension process or inform the commissioner of public safety that the obligor's driving
privileges should no longer be suspended under any of the following circumstances:
new text end

new text begin (1) the full amount of court-ordered payments have been received for at least one month;
new text end

new text begin (2) an income withholding notice has been sent to an employer or payor of money;
new text end

new text begin (3) payments less than the full court-ordered amount have been received and the
circumstances of the obligor demonstrate the obligor's substantial intent to comply with the
order;
new text end

new text begin (4) the obligor receives public assistance;
new text end

new text begin (5) the case is being reviewed by the public authority for downward modification due
to changes in the obligor's financial circumstances or a party has filed a motion to modify
the child support order;
new text end

new text begin (6) the obligor no longer lives in the state and the child support case is in the process of
interstate enforcement;
new text end

new text begin (7) the obligor is currently incarcerated for one week or more or is receiving in-patient
treatment for physical health, mental health, chemical dependency, or other treatment. This
clause applies for six months after the obligor is no longer incarcerated or receiving in-patient
treatment;
new text end

new text begin (8) the obligor is temporarily or permanently disabled and unable to pay child support;
new text end

new text begin (9) the obligor has presented evidence to the public authority that the obligor needs
driving privileges to maintain or obtain the obligor's employment;
new text end

new text begin (10) the obligor has not had a meaningful opportunity to pay toward arrears; or
new text end

new text begin (11) other circumstances of the obligor indicate that a temporary condition exists for
which the suspension of the obligor's driver's license for the nonpayment of child support
is not appropriate. When considering whether the suspension of the obligor's driver's license
is appropriate, the public authority must assess: (i) whether the suspension of the obligor's
driver's license is likely to induce the payment of child support; and (ii) whether the
suspension of the obligor's driver's license would have direct harmful effects on the obligor
or joint children that make driver's license suspension an inappropriate remedy.
new text end

new text begin The presence of circumstances in this paragraph does not prevent the public authority from
proceeding with a suspension of the obligor's driver's license.
new text end

deleted text begin (f)deleted text end new text begin (j)new text end In addition to the criteria established under this section for the suspension of an
obligor's driver's license, a court, a child support magistrate, or the public authority may
direct the commissioner of public safety to suspend the license of a party who has failed,
after receiving notice, to comply with a subpoena relating to a paternity or child support
proceeding. Notice to an obligor of intent to suspend must be served by first class mail at
the obligor's last known address. The notice must inform the obligor of the right to request
a hearing. If the obligor makes a written request within ten days of the date of the hearing,
a hearing must be held. At the hearing, the only issues to be considered are mistake of fact
and whether the obligor received the subpoena.

deleted text begin (g)deleted text end new text begin (k)new text end The license of an obligor who fails to remain in compliance with an approved
written payment agreement may be suspended. Prior to suspending a license for
noncompliance with an approved written payment agreement, the public authority must
mail to the obligor's last known address a written notice that (1) the public authority intends
to seek suspension of the obligor's driver's license under this paragraph, and (2) the obligor
must request a hearing, within 30 days of the date of the notice, to contest the suspension.
If, within 30 days of the date of the notice, the public authority does not receive a written
request for a hearing and the obligor does not comply with an approved written payment
agreement, the public authority must direct the Department of Public Safety to suspend the
obligor's license under paragraph deleted text begin (b)deleted text end new text begin (d)new text end . If the obligor makes a written request for a hearing
within 30 days of the date of the notice, a court hearing must be held. Notwithstanding any
law to the contrary, the obligor must be served with 14 days' notice in writing specifying
the time and place of the hearing and the allegations against the obligor. The notice may be
served personally or by mail at the obligor's last known address. If the obligor appears at
the hearing and the court determines that the obligor has failed to comply with an approved
written payment agreement, the court or public authority shall notify the Department of
Public Safety to suspend the obligor's license under paragraph deleted text begin (b)deleted text end new text begin (d)new text end . If the obligor fails
to appear at the hearing, the court or public authority must notify the Department of Public
Safety to suspend the obligor's license under paragraph deleted text begin (b)deleted text end new text begin (d)new text end .

Sec. 36.

Minnesota Statutes 2022, section 518A.77, is amended to read:

518A.77 GUIDELINES REVIEW.

deleted text begin (a)deleted text end No later than 2006 and every four years after that, the Department of Human Services
must conduct a review of the child support guidelinesnew text begin as required under Code of Federal
Regulations, title 45, section 302.56(h)new text end .

deleted text begin (b) This section expires January 1, 2032.
deleted text end

Sec. 37. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FOSTER
CARE FEDERAL CASH ASSISTANCE BENEFITS PRESERVATION.
new text end

new text begin (a) The commissioner of human services must develop a plan to preserve and make
available the income and resources attributable to a child in foster care to meet the best
interests of the child. The plan must include recommendations on:
new text end

new text begin (1) policies for youth and caregiver access to preserved federal cash assistance benefit
payments;
new text end

new text begin (2) representative payees for children in voluntary foster care for treatment pursuant to
Minnesota Statutes, chapter 260D; and
new text end

new text begin (3) family preservation and reunification.
new text end

new text begin (b) For purposes of this section, "income and resources attributed to a child" means all
benefits from programs administered by the Social Security Administration, including but
not limited to retirement, survivors benefits, disability insurance programs, Supplemental
Security Income, veterans benefits, and railroad retirement benefits.
new text end

new text begin (c) When developing the plan under this section, the commissioner shall consult or
engage with:
new text end

new text begin (1) individuals or entities with experience in managing trusts and investment;
new text end

new text begin (2) individuals or entities with expertise in providing tax advice;
new text end

new text begin (3) individuals or entities with expertise in preserving assets to avoid any negative impact
on public assistance eligibility;
new text end

new text begin (4) other relevant state agencies;
new text end

new text begin (5) Tribal social services agencies;
new text end

new text begin (6) counties;
new text end

new text begin (7) the Children's Justice Initiative;
new text end

new text begin (8) organizations that serve and advocate for children and families in the child protection
system;
new text end

new text begin (9) parents, legal custodians, foster families, and kinship caregivers, to the extent possible;
new text end

new text begin (10) youth who have been or are currently in out-of-home placement; and
new text end

new text begin (11) other relevant stakeholders.
new text end

new text begin (d) By December 15, 2023, each county shall provide the following data for fiscal years
2018 to 2022 to the commissioner or the commissioner's designee in a form prescribed by
the commissioner:
new text end

new text begin (1) the nonduplicated number of children in foster care in the county who received
income and resources attributable to a child as defined in paragraph (b);
new text end

new text begin (2) the nonduplicated number of children for whom the county was the representative
payee for income and resources attributable to a child;
new text end

new text begin (3) the amount of money that the county received from income and resources attributable
to children in out-of-home placement for whom the county served as the representative
payee;
new text end

new text begin (4) the county's policies and standards regarding collection and use of this money,
including but not limited to:
new text end

new text begin (i) how long after a child enters out-of-home placement does the county agency become
the representative payee;
new text end

new text begin (ii) the disposition of income and resources attributable to a child that exceeds the costs
for out-of-home placement for a child;
new text end

new text begin (iii) how the county complies with federal reporting requirements related to the use of
income and resources attributable to a child;
new text end

new text begin (iv) whether the county uses income and resources attributable to a child for out-of-home
placement costs for other children who do not receive federal cash assistance benefit
payments; and
new text end

new text begin (v) whether the county seeks repayment of federal income and resources attributable to
a child from the child's parents, who may have received such payments or resources while
the child is in out-of-home placement, and the ratio of requests for repayment to money
collected on an annual basis;
new text end

new text begin (5) to the extent available, demographic information on the children in out-of-home
placement for whom the county serves as the representative payee; and
new text end

new text begin (6) other information as determined by the commissioner.
new text end

new text begin (e) By January 15, 2025, the commissioner shall submit a report to the chairs and ranking
minority members of the legislative committees with jurisdiction over human services and
child welfare outlining the plan developed under this section. The report must include a
projected timeline for implementing the plan, estimated implementation costs, and any
legislative actions that may be required to implement the plan. The report must also include
data provided by counties related to the requirements for the parent or custodian of a child
to reimburse a county for the cost of care, examination, or treatment in subdivision (f), and
a list of counties that failed to provide complete information and data to the commissioner
or the commissioner's designee as required under paragraph (d).
new text end

new text begin (f) By December 15, 2023, every county shall provide the commissioner of human
services with the following data from fiscal years 2018 to 2022 in a form prescribed by the
commissioner:
new text end

new text begin (1) the nonduplicated number of cases in which the county charged parental fees to the
parents or custodians of a child to reimburse the cost of care, examination, or treatment;
and
new text end

new text begin (2) the nonduplicated number of cases in which the county received parental fee payments
from a parent or custodian of a child to reimburse the cost of care, examination, or treatment,
and the total amount collected in those cases.
new text end

new text begin (g) The commissioner may contract with an individual or entity to collect and analyze
financial data reported by counties in paragraphs (d) and (f).
new text end

Sec. 38. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES; CHILD
PROTECTION INFORMATION TECHNOLOGY SYSTEM REVIEW.
new text end

new text begin (a) The commissioner of human services must contract with an independent consultant
to perform a thorough evaluation of the social services information system (SSIS) that
supports the child protection system in Minnesota. The consultant must make
recommendations for improving the current system for usability, system performance, and
federal Comprehensive Child Welfare Information System compliance, and must address
technical problems and identify any unnecessary or unduly burdensome data entry
requirements that have contributed to system capacity issues. The consultant must assist
the commissioner with selecting a platform for future development of an information
technology system for child protection.
new text end

new text begin (b) The commissioner of human services must conduct a study and develop
recommendations to streamline and reduce SSIS data entry requirements for child protection
cases. The study must review all input fields required on current reporting forms and
determine which input fields and information are required under state or federal law. The
study must be completed in partnership with local social services agencies and other entities,
as determined by the commissioner. By June 30, 2024, the commissioner must provide a
status report and an implementation timeline to the chairs and ranking minority members
of the legislative committees with jurisdiction over child protection. The status report must
include information about the procedures used for soliciting ongoing user input from
stakeholders, the progress made on soliciting and hiring a consultant to conduct the system
evaluation required under paragraph (a), and a report on the progress and completed efforts
to streamline data entry requirements and improve user experiences.
new text end

Sec. 39. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
MALTREATMENT SCREENING UPDATES.
new text end

new text begin (a) The commissioner of human services must send a formal communication to all
hospital systems and children's residential facilities located in Minnesota informing the
hospital systems and facilities that the 2023 Minnesota child maltreatment intake, screening,
and response path guidelines, issued under Minnesota Statutes, section 260E.15, have been
updated to address situations in which parents or legal guardians of a child are actively
seeking services needed to keep the child safe but are unable to access the necessary services.
The communication must clearly state that the 2023 guidelines indicate that such situations
should not be reported or screened in as maltreatment and must include information on how
hospital system and children's residential facility administrators and staff can access the
2023 Minnesota child maltreatment intake, screening, and response path guidelines.
new text end

new text begin (b) The commissioner must consult with stakeholders to assess and suggest modifications
to the maltreatment screening guidelines issued under Minnesota Statutes, section 260E.15,
so that the parents or legal guardians of a child who is in an emergency department or
hospital setting due to mental illness, emotional disturbance, or a disability and who cannot
be safely discharged to the child's parents due to the lack of access to necessary services
are not considered to be neglecting or abandoning the child, absent other factors or
circumstances that may indicate neglect or abandonment.
new text end

Sec. 40. new text begin DIRECTION TO THE COMMISSIONER OF HUMAN SERVICES;
SURVEY OF OUT-OF-STATE CHILDREN'S RESIDENTIAL FACILITY
PLACEMENTS.
new text end

new text begin (a) By September 1, 2023, the commissioner of human services shall develop and make
available a survey of all county social services agencies to gather the following data for
fiscal years 2018 to 2022:
new text end

new text begin (1) the aggregate number of children who were placed for any period in a children's
residential facility under Minnesota Statutes, section 260.93, that is located in another state;
and
new text end

new text begin (2) the total cost for these placements, including county, state, and federal contributions.
new text end

new text begin (b) All county social services agencies shall complete the survey and submit responses
as prescribed by the commissioner by January 31, 2024.
new text end

new text begin (c) By March 1, 2024, the commissioner shall submit all survey responses and a list of
the counties that complied and the counties that failed to comply with the requirements
under this section to the chairs and ranking minority members of the legislative committees
with jurisdiction over human services and child protection.
new text end

Sec. 41.

new text begin INDEPENDENT LIVING SKILLS FOR FOSTER YOUTH GRANTS.
new text end

new text begin Subdivision 1.new text end

new text begin Program established.new text end

new text begin The commissioner shall establish direct grants to
local social service agencies, Tribes, and other organizations to provide independent living
services to eligible foster youth.
new text end

new text begin Subd. 2.new text end

new text begin Grant awards.new text end

new text begin The commissioner shall request proposals and make grants to
eligible applicants. The commissioner shall determine the timing and form of the application
and the criteria for making grant awards to eligible applicants.
new text end

new text begin Subd. 3.new text end

new text begin Program reporting.new text end

new text begin Grant recipients shall provide the commissioner with a
report that describes all of the activities and outcomes of the services funded by the grant
program in a format and at a time determined by the commissioner.
new text end

new text begin Subd. 4.new text end

new text begin Undistributed funds.new text end

new text begin Undistributed funds must be reallocated by the
commissioner for the goals of the grant program. Undistributed funds are available until
expended.
new text end

Sec. 42. new text begin COMMUNITY RESOURCE CENTERS.
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 definitions
apply.
new text end

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

new text begin (c) "Communities and families who lack opportunities" means any community or family
that experiences inequities in accessing supports and services due to the community's or
family's circumstances, including but not limited to racism, income, disability, language,
gender, and geography.
new text end

new text begin (d) "Community resource center" means a community-based coordinated point of entry
that provides culturally responsive, relationship-based service navigation and other supportive
services for expecting and parenting families and youth.
new text end

new text begin (e) "Culturally responsive, relationship-based service navigation" means the aiding of
families in finding services and supports that are meaningful to the families in ways that
are built on trust and that use cultural values, beliefs, and practices of families, communities,
indigenous families, and Tribal Nations for case planning, service design, and
decision-making processes.
new text end

new text begin (f) "Expecting and parenting family" means any configuration of parents, grandparents,
guardians, foster parents, kinship caregivers, and youth who are pregnant or expecting or
have children and youth that they care for and support.
new text end

new text begin (g) "Protective factors" means conditions, attributes, or strengths of individuals, families,
and communities, and in society that mitigate risk, promote the healthy development and
well-being of children, youth, and families, and help support families.
new text end

new text begin Subd. 2.new text end

new text begin Community resource centers established.new text end

new text begin The commissioner, in consultation
with other state agencies, partners, and the Community Resource Center Advisory Council,
may award grants to support the planning, implementation, and evaluation of community
resource centers to provide culturally responsive, relationship-based service navigation,
parent, family, and caregiver supports to expecting and parenting families with a focus on
ensuring equitable access to programs and services that promote protective factors and
support children and families.
new text end

new text begin Subd. 3.new text end

new text begin Commissioner's duties; related infrastructure.new text end

new text begin The commissioner, in
consultation with the Community Resource Center Advisory Council, shall:
new text end

new text begin (1) develop a request for proposals to support community resource centers;
new text end

new text begin (2) provide outreach and technical assistance to support applicants with data or other
matters pertaining to the equity of access to funding;
new text end

new text begin (3) provide technical assistance to grantees, including but not limited to skill building
and professional development, trainings, evaluations, communities of practice, networking,
and trauma informed mental health consultation; and
new text end

new text begin (4) provide grant coordination and management focused on promoting equity and
accountability.
new text end

new text begin Subd. 4.new text end

new text begin Grantee duties.new text end

new text begin At a minimum, grantees shall:
new text end

new text begin (1) provide culturally responsive, relationship-based service navigation and supports for
expecting and parenting families;
new text end

new text begin (2) improve community engagement and feedback gathering to support continuous
improvement and program planning to better promote protective factors;
new text end

new text begin (3) demonstrate community-based planning with multiple partners;
new text end

new text begin (4) develop or use an existing parent and family advisory council consisting of community
members with lived expertise to advise the work of the grantee; and
new text end

new text begin (5) participate in program evaluation, data collection, and technical assistance activities.
new text end

new text begin Subd. 5.new text end

new text begin Eligibility.new text end

new text begin Organizations eligible to receive grant funding under this section
include:
new text end

new text begin (1) community-based organizations, Tribal Nations, urban Indian organizations, local
and county government agencies, schools, nonprofit agencies or any cooperative of these
organizations; and
new text end

new text begin (2) organizations or cooperatives supporting communities and families who lack
opportunities.
new text end

new text begin Subd. 6.new text end

new text begin Community Resource Center Advisory Council; establishment and
duties.new text end

new text begin (a) The commissioner, in consultation with other relevant state agencies, shall appoint
members to the Community Resource Center Advisory Council.
new text end

new text begin (b) Membership must be demographically and geographically diverse and include:
new text end

new text begin (1) parents and family members with lived experience who lack opportunities;
new text end

new text begin (2) community-based organizations serving families who lack opportunities;
new text end

new text begin (3) Tribal and urban American Indian representatives;
new text end

new text begin (4) county government representatives;
new text end

new text begin (5) school and school district representatives; and
new text end

new text begin (6) state partner representatives.
new text end

new text begin (c) Duties of the Community Resource Center Advisory Council include but are not
limited to:
new text end

new text begin (1) advising the commissioner on the development and funding of a network of
community resource centers;
new text end

new text begin (2) advising the commissioner on the development of requests for proposals and grant
award processes;
new text end

new text begin (3) advising the commissioner on the development of program outcomes and
accountability measures; and
new text end

new text begin (4) advising the commissioner on ongoing governance and necessary support in the
implementation of community resource centers.
new text end

new text begin Subd. 7.new text end

new text begin Grantee reporting.new text end

new text begin Grantees must report program data and outcomes to the
commissioner in a manner determined by the commissioner and the Community Resource
Center Advisory Council.
new text end

new text begin Subd. 8.new text end

new text begin Evaluation.new text end

new text begin The commissioner, in partnership with the Community Resource
Center Advisory Council, shall develop an outcome and evaluation plan. By July 1, 2025,
the Community Resource Center Advisory Council must provide a report to the commissioner
and the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services that reflects the duties of the Community Resource Center
Advisory Council in subdivision 6 and may describe outcomes and impacts related to equity,
community partnerships, program and service availability, child development, family
well-being, and child welfare system involvement.
new text end

Sec. 43. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2022, section 518A.59,new text end new text begin is repealed.
new text end

new text begin EFFECTIVE DATE.new text end

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

ARTICLE 15

MISCELLANEOUS

Section 1.

Minnesota Statutes 2022, section 246.54, subdivision 1a, as amended by 2023
S.F. No. 2934, article 8, section 5, if enacted, is amended to read:

Subd. 1a.

Anoka-Metro Regional Treatment Center.

(a) A county's payment of the
cost of care provided at Anoka-Metro Regional Treatment Center shall be according to the
following schedule:

(1) zero percent for the first 30 days;

(2) 20 percent for days 31 and over if the stay is determined to be clinically appropriate
for the client; and

(3) 100 percent for each day during the stay, including the day of admission, when the
facility determines that it is clinically appropriate for the client to be discharged.

(b) If payments received by the state under sections 246.50 to 246.53 exceed 80 percent
of the cost of care for days over 31 for clients who meet the criteria in paragraph (a), clause
(2), the county shall be responsible for paying the state only the remaining amount. The
county shall not be entitled to reimbursement from the client, the client's estate, or from the
client's relatives, except as provided in section 246.53.

(c) Between July 1, 2023, and June 30, 2025, the county is not responsible for the cost
of care under paragraph (a), clause (3), for a person who is committed as a person who has
a mental illness and is dangerous to the public under section 253B.18 and who is awaiting
transfer to another state-operated facility or program. This paragraph expires June 30, 2025.

new text begin (d) Notwithstanding any law to the contrary, the client is not responsible for payment
of the cost of care under this subdivision.
new text end

Sec. 2.

Minnesota Statutes 2022, section 256B.0652, subdivision 5, is amended to read:

Subd. 5.

Authorization; home care nursing services.

(a) All home care nursing services
shall be authorized by the commissioner or the commissioner's designee. Authorization for
home care nursing services shall be based on medical necessity and cost-effectiveness when
compared with alternative care options. The commissioner may authorize medically necessary
home care nursing services in quarter-hour units when:

(1) the recipient requires more individual and continuous care than can be provided
during a skilled nurse visit; or

(2) the cares are outside of the scope of services that can be provided by a home health
aide or personal care assistant.

(b) The commissioner may authorize:

(1) up to two times the average amount of direct care hours provided in nursing facilities
statewide for case mix classification "K" as established by the annual cost report submitted
to the department by nursing facilities in May 1992;

(2) home care nursing in combination with other home care services new text begin and community
first services and supports as defined in section 256B.85 new text end up to the total cost allowed under
this subdivision and subdivision 7;

(3) up to 16 hours per day if the recipient requires more nursing than the maximum
number of direct care hours as established in clause (1) and, but for the provision of the
nursing services, the recipient would require a hospital level of care as defined in Code of
Federal Regulations, title 42, section 440.10.

(c) The commissioner may authorize up to 16 hours per day of medically necessary
home care nursing services or up to 24 hours per day of medically necessary home care
nursing services until such time as the commissioner is able to make a determination of
eligibility for recipients who are cooperatively applying for home care services under the
community alternative care program developed under section 256B.49, or until it is
determined by the appropriate regulatory agency that a health benefit plan is or is not required
to pay for appropriate medically necessary health care services. Recipients or their
representatives must cooperatively assist the commissioner in obtaining this determination.
Recipients who are eligible for the community alternative care program may not receive
more hours of nursing under this section and sections 256B.0651, 256B.0653, and 256B.0659
than would otherwise be authorized under section 256B.49.

new text begin EFFECTIVE DATE.new text end

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

Sec. 3.

Laws 2021, First Special Session chapter 7, article 2, section 84, is amended to
read:

Sec. 84. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FEDERAL
FUND AND CHILD CARE AND DEVELOPMENT BLOCK GRANT
ALLOCATIONS.

(a) The commissioner of human services shall allocate $3,000,000 in fiscal year 2022
from the child care and development block grant for grants to organizations operating child
care resource and referral programs under Minnesota Statutes, section 119B.19, to offer a
child care one-stop regional assistance network.

(b) The commissioner of human services shall allocate $50,000 in fiscal year 2022 from
the child care and development block grant for modifications to the family child care provider
frequently asked questions website.

(c) The commissioner of human services shall allocate $4,500,000 in fiscal year 2022
from the child care and development block grant for costs to cover the fees related to
administering child care background studies.

(d) The commissioner of human services shall allocate $2,059,000 in fiscal year 2022
from the child care and development block grant for the child care center regulation
modernization project.

(e) The commissioner of human services shall allocate $1,719,000 in fiscal year 2022
from the child care and development block grant for the family child care regulation
modernization project.

(f) The commissioner of human services shall allocate $100,000 in fiscal year 2022 from
the federal fund for a working group to review alternative child care licensing models.

(g) The commissioner of human services shall allocate $59,000 in fiscal year 2022 from
the child care and development block grant for the family child care training advisory
committee.

(h) The commissioner of human services shall allocate $7,650,000 in fiscal year 2022
from the child care and development block grant for child care information technology and
system improvements.

(i) deleted text begin The allocations in this section are available until June 30, 2025deleted text end new text begin Any funds that the
commissioner of human services determines by June 30, 2023, will not be fully expended
by the end of the federal award may be used for other allowable activities under United
States Code, title 42, section 9857 et seq.; Code of Federal Regulations, title 45, parts 98
and 99; and Public Law 117-2, known as The American Rescue Plan Act of 2021new text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 4.

Laws 2021, First Special Session chapter 7, article 14, section 23, is amended to
read:

Sec. 23. DIRECTION TO COMMISSIONER OF HUMAN SERVICES; FEDERAL
FUND AND CHILD CARE AND DEVELOPMENT BLOCK GRANT
ALLOCATIONS.

(a) The commissioner of human services shall allocate $1,435,000 in fiscal year 2022
from the child care and development block grant for the quality rating and improvement
system evaluation and equity report under Minnesota Statutes, section 124D.142, subdivisions
3 and 4.

(b) The commissioner of human services shall allocate $499,000 in fiscal year 2022
from the child care and development block grant for the ombudsperson for family child
care providers under Minnesota Statutes, section 245.975.

(c) The commissioner of human services shall allocate $858,000 in fiscal year 2022
from the child care and development block grant for transfer to the commissioner of
management and budget for the affordable high-quality child care and early education for
all families working group.

(d) The commissioner of human services shall allocate $200,000 in fiscal year 2022
from the child care and development block grant for transfer to the commissioner of
management and budget for completion of the early childhood governance report.

(e) The commissioner of human services shall allocate $150,000 in fiscal year 2022
from the child care and development block grant to develop recommendations for
implementing a family supports and improvement program.

(f) The commissioner of human services shall allocate $1,000,000 in fiscal year 2022
from the child care and development block grant for REETAIN grants under Minnesota
Statutes, section 119B.195.

(g) The commissioner of human services shall allocate $2,000,000 in fiscal year 2022
from the child care and development block grant for the TEACH program under Minnesota
Statutes, section 136A.128.

(h) The commissioner of human services shall allocate $304,398,000 in fiscal year 2022
from the federal fund for child care stabilization grants, including up to $5,000,000 for
administration.

(i) The commissioner of human services shall allocate $200,000 in fiscal year 2022 from
the federal fund for the shared services pilot program for family child care providers.

(j) The commissioner of human services shall allocate $290,000 in fiscal year 2022 from
the child care and development block grant for a report on participation in early care and
education programs by children in foster care.

(k) The commissioner of human services shall allocate $3,500,000 in fiscal year 2022
from the child care and development block grant for the commissioner of human services
to administer the child care and development block grant allocations in this act.

(l) deleted text begin The allocations in this section are available until June 30, 2025deleted text end new text begin Any funds that the
commissioner of human services determines by June 30, 2023, will not be fully expended
by the end of the federal award may be used for other allowable activities under United
States Code, title 42, section 9857 et seq.; Code of Federal Regulations, title 45, parts 98
and 99; and Public Law 117-2, known as The American Rescue Plan Act of 2021new 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. 5.

Laws 2023, chapter 52, article 7, section 12, is amended to read:

Sec. 12.

609A.015 AUTOMATIC EXPUNGEMENT OF RECORDS.

Subdivision 1.

Eligibility; dismissal; exoneration.

(a) A person who is the subject of
a criminal record or delinquency record is eligible for a grant of expungement relief without
the filing of a petition:

(1) if the person was arrested and all charges were dismissed after a case was filed unless
dismissal was based on a finding that the defendant was incompetent to proceed;

(2) upon the dismissal and discharge of proceedings against a person under section
152.18, subdivision 1, for violation of section 152.024, 152.025, or 152.027 for possession
of a controlled substance; or

(3) if all pending actions or proceedings were resolved in favor of the person.

(b) For purposes of this chapter, a verdict of not guilty by reason of mental illness is not
a resolution in favor of the person. For purposes of this chapter, an action or proceeding is
resolved in favor of the person if the petitioner received an order under section 590.11
determining that the person is eligible for compensation based on exoneration.

new text begin (c) The service requirements in section 609A.03, subdivision 8, do not apply to any
expungements ordered under this subdivision.
new text end

new text begin (d) An expungement order does not apply to records held by the commissioners of health
and human services.
new text end

Subd. 2.

Eligibility; diversion and stay of adjudication.

new text begin (a) new text end A person is eligible for a
grant of expungement relief if the person has successfully completed the terms of a diversion
program or stay of adjudication for a qualifying offense that is not a felony and has not been
petitioned or charged with a new offense, other than an offense that would be a petty
misdemeanor, in Minnesota:

(1) for one year immediately following completion of the diversion program or stay of
adjudication; or

(2) for one year immediately preceding a subsequent review performed pursuant to
subdivision 5, paragraph (a).

new text begin (b) The service requirements in section 609A.03, subdivision 8, do not apply to any
expungements ordered under this subdivision.
new text end

new text begin (c) An expungement order does not apply to records held by the commissioners of health
and human services.
new text end

Subd. 3.

Eligibility; certain criminal proceedings.

(a) A person is eligible for a grant
of expungement relief if the person:

(1) was convicted of a qualifying offense;

(2) has not been convicted of a new offense, other than an offense that would be a petty
misdemeanor, in Minnesota:

(i) during the applicable waiting period immediately following discharge of the disposition
or sentence for the crime; or

(ii) during the applicable waiting period immediately preceding a subsequent review
performed pursuant to subdivision 5, paragraph (a); and

(3) is not charged with an offense, other than an offense that would be a petty
misdemeanor, in Minnesota at the time the person reaches the end of the applicable waiting
period or at the time of a subsequent review.

(b) As used in this subdivision, "qualifying offense" means a conviction for:

(1) any petty misdemeanor offense other than a violation of a traffic regulation relating
to the operation or parking of motor vehicles;

(2) any misdemeanor offense other than:

(i) section 169A.20 under the terms described in section 169A.27 (fourth-degree driving
while impaired);

(ii) section 518B.01, subdivision 14 (violation of an order for protection);

(iii) section 609.224 (assault in the fifth degree);

(iv) section 609.2242 (domestic assault);

(v) section 609.748 (violation of a harassment restraining order);

(vi) section 609.78 (interference with emergency call);

(vii) section 609.79 (obscene or harassing phone calls);

(viii) section 617.23 (indecent exposure);

(ix) section 609.746 (interference with privacy); or

(x) section 629.75 (violation of domestic abuse no contact order);

(3) any gross misdemeanor offense other than:

(i) section 169A.25 (second-degree driving while impaired);

(ii) section 169A.26 (third-degree driving while impaired);

(iii) section 518B.01, subdivision 14 (violation of an order for protection);

(iv) section 609.2113, subdivision 3 (criminal vehicular operation);

(v) section 609.2231 (assault in the fourth degree);

(vi) section 609.224 (assault in the fifth degree);

(vii) section 609.2242 (domestic assault);

(viii) section 609.233 (criminal neglect);

(ix) section 609.3451 (criminal sexual conduct in the fifth degree);

(x) section 609.377 (malicious punishment of child);

(xi) section 609.485 (escape from custody);

(xii) section 609.498 (tampering with witness);

(xiii) section 609.582, subdivision 4 (burglary in the fourth degree);

(xiv) section 609.746 (interference with privacy);

(xv) section 609.748 (violation of a harassment restraining order);

(xvi) section 609.749 (harassment; stalking);

(xvii) section 609.78 (interference with emergency call);

(xviii) section 617.23 (indecent exposure);

(xix) section 617.261 (nonconsensual dissemination of private sexual images); or

(xx) section 629.75 (violation of domestic abuse no contact order); or

(4) any felony offense listed in section 609A.02, subdivision 3, paragraph (b), other
than:

(i) section 152.023, subdivision 2 (possession of a controlled substance in the third
degree);

(ii) 152.024, subdivision 2 (possession of a controlled substance in the fourth degree);

(iii) section 609.485, subdivision 4, paragraph (a), clause (2) or (4) (escape from civil
commitment for mental illness); or

(iv) section 609.746, subdivision 1, paragraph (e) (interference with privacy; subsequent
violation or minor victim).

(1) if the offense was a petty misdemeanor, two years since discharge of the sentence;

(2) if the offense was a misdemeanor, two years since discharge of the sentence for the
crime;

(3) if the offense was a gross misdemeanor, three years since discharge of the sentence
for the crime;

(4) if the offense was a felony violation of section 152.025, four years since the discharge
of the sentence for the crime; and

(5) if the offense was any other felony, five years since discharge of the sentence for the
crime.

(d) Felony offenses deemed to be a gross misdemeanor or misdemeanor pursuant to
section 609.13, subdivision 1, remain ineligible for expungement under this section. Gross
misdemeanor offenses ineligible for a grant of expungement under this section remain
ineligible if deemed to be for a misdemeanor pursuant to section 609.13, subdivision 2.

new text begin (e) The service requirements in section 609A.03, subdivision 8, do not apply to any
expungements ordered under this subdivision.
new text end

new text begin (f) An expungement order does not apply to records held by the commissioners of health
and human services.
new text end

Subd. 4.

Notice.

(a) The court shall notify a person who may become eligible for an
automatic expungement under this section of that eligibility at any hearing where the court
dismisses and discharges proceedings against a person under section 152.18, subdivision
1, for violation of section 152.024, 152.025, or 152.027 for possession of a controlled
substance; concludes that all pending actions or proceedings were resolved in favor of the
person; grants a person's placement into a diversion program; or sentences a person or
otherwise imposes a consequence for a qualifying offense.

(b) To the extent possible, prosecutors, defense counsel, supervising agents, and
coordinators or supervisors of a diversion program shall notify a person who may become
eligible for an automatic expungement under this section of that eligibility.

(1) a record expunged under this section may be opened for purposes of a background
study by the Department of Human Services new text begin or the Department of Health new text end under section
245C.08 and for purposes of a background check by the Professional Educator Licensing
and Standards Board as required under section 122A.18, subdivision 8; and

(2) the person can file a petition new text begin under section 609A.03, subject to the process in section
609A.03 and the limitations in section 609A.02, new text end to expunge the deleted text begin record and request that the
petition be directed todeleted text end new text begin records held bynew text end the commissioner of human servicesnew text begin , the commissioner
of health,new text end and the Professional Educator Licensing and Standards Board.

Subd. 5.

Bureau of Criminal Apprehension to identify eligible persons and grant
expungement relief.

(a) The Bureau of Criminal Apprehension shall identify any records
that qualify for a grant of expungement relief pursuant to this subdivision or subdivision 1,
2, or 3. The Bureau of Criminal Apprehension shall make an initial determination of
eligibility within 30 days of the end of the applicable waiting period. If a record is not
eligible for a grant of expungement at the time of the initial determination, the Bureau of
Criminal Apprehension shall make subsequent eligibility determinations annually until the
record is eligible for a grant of expungement.

(b) In making the determination under paragraph (a), the Bureau of Criminal
Apprehension shall identify individuals who are the subject of relevant records through the
use of fingerprints and thumbprints where fingerprints and thumbprints are available. Where
fingerprints and thumbprints are not available, the Bureau of Criminal Apprehension shall
identify individuals through the use of the person's name and date of birth. Records containing
the same name and date of birth shall be presumed to refer to the same individual unless
other evidence establishes, by a preponderance of the evidence, that they do not refer to the
same individual. The Bureau of Criminal Apprehension is not required to review any other
evidence in making a determination.

(c) The Bureau of Criminal Apprehension shall grant expungement relief to qualifying
persons and seal its own records without requiring an application, petition, or motion.
Records shall be sealed 60 days after notice is sent to the judicial branch pursuant to
paragraph (e) unless an order of the judicial branch prohibits sealing the records or additional
information establishes that the records are not eligible for expungement.

(d) Nonpublic criminal records maintained by the Bureau of Criminal Apprehension
and subject to a grant of expungement relief shall display a notation stating "expungement
relief granted pursuant to section 609A.015."

(e) The Bureau of Criminal Apprehension shall inform the judicial branch of all cases
for which expungement relief was granted pursuant to this section. Notification may be
through electronic means and may be made in real time or in the form of a monthly report.
Upon receipt of notice, the judicial branch shall seal all records relating to an arrest,
indictment or information, trial, verdict, or dismissal and discharge for any case in which
expungement relief was granted and shall issue any order deemed necessary to achieve this
purpose.

(f) The Bureau of Criminal Apprehension shall inform each law enforcement agency
that its records may be affected by a grant of expungement relief. Notification may be
through electronic means. Each notified law enforcement agency that receives a request to
produce records shall first determine if the records were subject to a grant of expungement
under this section. The law enforcement agency must not disclose records relating to an
arrest, indictment or information, trial, verdict, or dismissal and discharge for any case in
which expungement relief was granted and must maintain the data consistent with the
classification in paragraph (g). This paragraph does not apply to requests from a criminal
justice agency as defined in section 609A.03, subdivision 7a, paragraph (f).

(g) Data on the person whose offense has been expunged under this subdivision, including
any notice sent pursuant to paragraph (f), are private data on individuals as defined in section
13.02, subdivision 12.

(h) The prosecuting attorney shall notify the victim that an offense qualifies for automatic
expungement under this section in the manner provided in section 611A.03, subdivisions
1 and 2.

(i) In any subsequent prosecution of a person granted expungement relief, the expunged
criminal record may be pleaded and has the same effect as if the relief had not been granted.

(j) The Bureau of Criminal Apprehension is directed to develop, modify, or update a
system to provide criminal justice agencies with uniform statewide access to criminal records
sealed by expungement.

Subd. 6.

Immunity from civil liability.

Employees of the Bureau of Criminal
Apprehension shall not be held civilly liable for the exercise or the failure to exercise, or
the decision to exercise or the decision to decline to exercise, the powers granted by this
section or for any act or omission occurring within the scope of the performance of their
duties under this section.

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2025, and applies to offenses
that meet the eligibility criteria on or after that date and applies retroactively to offenses
that met the eligibility criteria before January 1, 2025, and are stored in the Bureau of
Criminal Apprehension's criminal history system as of January 1, 2025.
new text end

Sec. 6.

Laws 2023, chapter 52, article 7, section 16, as amended by:

Sec. 16.

Minnesota Statutes 2022, section 609A.03, subdivision 7a, as amended by:

Subd. 7a.

Limitations of order effective January 1, 2015, and later.

(a) Upon issuance
of an expungement order related to a charge supported by probable cause, the DNA samples
and DNA records held by the Bureau of Criminal Apprehension and collected under authority
other than section 299C.105 shall not be sealed, returned to the subject of the record, or
destroyed.

(b) Notwithstanding the issuance of an expungement order:

(1) except as provided in clause (2), an expunged record may be opened, used, or
exchanged between criminal justice agencies without a court order for the purposes of
initiating, furthering, or completing a criminal investigation or prosecution or for sentencing
purposes or providing probation or other correctional services;

(2) when a criminal justice agency seeks access to a record that was sealed under section
609A.02, subdivision 3, paragraph (a), clause (1), after an acquittal or a court order dismissing
for lack of probable cause, for purposes of a criminal investigation, prosecution, or
sentencing, the requesting agency must obtain an ex parte court order after stating a
good-faith basis to believe that opening the record may lead to relevant information;

(3) an expunged record of a conviction may be opened for purposes of evaluating a
prospective employee in a criminal justice agency without a court order;

(4) an expunged record of a conviction may be opened for purposes of a background
study under section 245C.08 unless the commissioner had been properly served with notice
of the petition for expungement and the court order for expungement is directed specifically
to the commissioner of human services following proper service of a petition, or following
proceedings under section new text begin 609A.017, new text end 609A.025new text begin ,new text end or 609A.035 upon service of an order to
the commissioner of human services;

(5) an expunged record of a conviction may be opened for purposes of a background
check required under section 122A.18, subdivision 8, unless the court order for expungement
is directed specifically to the Professional Educator Licensing and Standards Board;

(6) the court may order an expunged record opened upon request by the victim of the
underlying offense if the court determines that the record is substantially related to a matter
for which the victim is before the court;

(7) a prosecutor may request, and the district court shall provide, certified records of
conviction for a record expunged pursuant to sections 609A.015, 609A.017, 609A.02,
609A.025, and 609A.035, and the certified records of conviction may be disclosed and
introduced in criminal court proceedings as provided by the rules of court and applicable
law; and

(8) the subject of an expunged record may request, and the court shall provide, certified
or uncertified records of conviction for a record expunged pursuant to sections 609A.015,
609A.017, 609A.02, 609A.025, and 609A.035.

(c) An agency or jurisdiction subject to an expungement order shall maintain the record
in a manner that provides access to the record by a criminal justice agency under paragraph
(b), clause (1) or (2), but notifies the recipient that the record has been sealed. The Bureau
of Criminal Apprehension shall notify the commissioner of human services or the
Professional Educator Licensing and Standards Board of the existence of a sealed record
and of the right to obtain access under paragraph (b), clause (4) or (5). Upon request, the
agency or jurisdiction subject to the expungement order shall provide access to the record
to the commissioner of human services or the Professional Educator Licensing and Standards
Board under paragraph (b), clause (4) or (5).

(d) An expunged record that is opened or exchanged under this subdivision remains
subject to the expungement order in the hands of the person receiving the record.

(e) A criminal justice agency that receives an expunged record under paragraph (b),
clause (1) or (2), must maintain and store the record in a manner that restricts the use of the
record to the investigation, prosecution, or sentencing for which it was obtained.

(f) For purposes of this section, a "criminal justice agency" means a court or government
agency that performs the administration of criminal justice under statutory authority.

(g) This subdivision applies to expungement orders subject to its limitations and effective
on or after January 1, 2015, and grants of expungement relief issued on or after January 1,
2025.

new text begin EFFECTIVE DATE.new text end

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

Sec. 7.

Minnesota Statutes 2022, section 245D.261, subdivision 3, as added by 2023 S.F.
No. 2934, article 1, section 6, if enacted, is amended to read:

Subd. 3.

Provider requirements for remote overnight supervision; commissioner
notification.

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

(1) use technology;

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

(i) indicate a start date for the use of technology; and

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

(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;

(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

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

(b) deleted text begin 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.deleted text end new text begin Upon being notified via technology that an
incident has occurred that jeopardizes 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
and determine whether a physical presence is needed in a time that is less than the maximum
permissible response time under paragraph (a), clause (5). If it is determined that a physical
presence is needed that requires a response time less than the maximum response time under
paragraph (a), clause (5), the plan under subdivision 4, paragraph (a), clause (6), must be
deployed.
new text end

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

(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.

Sec. 8.

2023 S.F. No. 2934, article 9, section 2, subdivision 16, if enacted, is amended to
read:

Subd. 16.

Grant Programs; Disabilities Grants

113,684,000

30,377,000

(a) Temporary Grants for Small
Customized Living Providers. $5,450,000
in fiscal year 2024 is for grants to assist small
customized living providers to transition to
community residential services licensure or
integrated community supports licensure.
Notwithstanding Minnesota Statutes, section
16A.28, this appropriation is available until
June 30, 2027. This is a onetime appropriation.

(b) Lead Agency Capacity Building Grants.
$444,000 in fiscal year 2024 and $2,396,000
in fiscal year 2025 are for grants to assist
organizations, counties, and Tribes to build
capacity for employment opportunities for
people with disabilities. The base for this
appropriation is $2,413,000 in fiscal year 2026
and $2,411,000 in fiscal year 2027.

(c) Employment and Technical Assistance
Center Grants. $450,000 in fiscal year 2024
and $1,800,000 in fiscal year 2025 are for
employment and technical assistance grants
to assist organizations and employers in
promoting a more inclusive workplace for
people with disabilities.

(d) Case Management Training Grants.
$37,000 in fiscal year 2024 and $123,000 in
fiscal year 2025 are for grants to provide case
management training to organizations and
employers to support the state's disability
employment supports system. The base for
this appropriation is $45,000 in fiscal year
2026 and $45,000 in fiscal year 2027.

(e) Self-Directed Bargaining Agreement;
Electronic Visit Verification Stipends.
$6,095,000 in fiscal year 2024 is for onetime
stipends of $200 to bargaining members to
offset the potential costs related to people
using individual devices to access the
electronic visit verification system. Of this
amount, $5,600,000 is for stipends and
$495,000 is for administration. This is a
onetime appropriation and is available until
June 30, 2025.

(f) Self-Directed Collective Bargaining
Agreement; Temporary Rate Increase
Memorandum of Understanding. $1,600,000
in fiscal year 2024 is for onetime stipends for
individual providers covered by the SEIU
collective bargaining agreement based on the
memorandum of understanding related to the
temporary rate increase in effect between
December 1, 2020, and February 7, 2021. Of
this amount, $1,400,000 of the appropriation
is for stipends and $200,000 is for
administration. This is a onetime
appropriation.

(g) Self-Directed Collective Bargaining
Agreement; Retention Bonuses. $50,750,000
in fiscal year 2024 is for onetime retention
bonuses covered by the SEIU collective
bargaining agreement. Of this amount,
$50,000,000 is for retention bonuses and
$750,000 is for administration of the bonuses.
This is a onetime appropriation and is
available until June 30, 2025.

(h) Self-Directed Bargaining Agreement;
Training Stipends. $2,100,000 in fiscal year
2024 and $100,000 in fiscal year 2025 are for
onetime stipends of $500 for collective
bargaining unit members who complete
designated, voluntary trainings made available
through or recommended by the State Provider
Cooperation Committee. Of this amount,
$2,000,000 in fiscal year 2024 is for stipends,
and $100,000 in fiscal year 2024 and $100,000
in fiscal year 2025 are for administration. This
is a onetime appropriation.

(i) Self-Directed Bargaining Agreement;
Orientation Program. $2,000,000 in fiscal
year 2024 and $2,000,000 in fiscal year 2025
are for onetime $100 payments to collective
bargaining unit members who complete
voluntary orientation requirements. Of this
amount, $1,500,000 in fiscal year 2024 and
$1,500,000 in fiscal year 2025 are for the
onetime $100 payments, and $500,000 in
fiscal year 2024 and $500,000 in fiscal year
2025 are for orientation-related costs. This is
a onetime appropriation.

(j) Self-Directed Bargaining Agreement;
Home Care Orientation Trust. $1,000,000
in fiscal year 2024 is for the Home Care
Orientation Trust under Minnesota Statutes,
section 179A.54, subdivision 11. The
commissioner shall disburse the appropriation
to the board of trustees of the Home Care
Orientation Trust for deposit into an account
designated by the board of trustees outside the
state treasury and state's accounting system.
This is a onetime appropriation.

(k) HIV/AIDS Supportive Services.
$12,100,000 in fiscal year 2024 is for grants
to community-based HIV/AIDS supportive
services providers as defined in Minnesota
Statutes, section 256.01, subdivision 19, and
for payment of allowed health care costs as
defined in Minnesota Statutes, section deleted text begin 256.935deleted text end new text begin
256.9365new text end . This is a onetime appropriation and
is available until June 30, 2025.

(l) Motion Analysis Advancements Clinical
Study and Patient Care. $400,000 is fiscal
year 2024 is for a grant to the Mayo Clinic
Motion Analysis Laboratory and Limb Lab
for continued research in motion analysis
advancements and patient care. This is a
onetime appropriation and is available through
June 30, 2025.

(m) Grant to Family Voices in Minnesota.
$75,000 in fiscal year 2024 and $75,000 in
fiscal year 2025 are for a grant to Family
Voices in Minnesota under Minnesota
Statutes, section 256.4776.

(n) Parent-to-Parent Programs.

(1) $550,000 in fiscal year 2024 and $550,000
in fiscal year 2025 are for grants to
organizations that provide services to
underserved communities with a high
prevalence of autism spectrum disorder. This
is a onetime appropriation and is available
until June 30, 2025.

(2) The commissioner shall give priority to
organizations that provide culturally specific
and culturally responsive services.

(3) Eligible organizations must:

(i) conduct outreach and provide support to
newly identified parents or guardians of a child
with special health care needs;

(ii) provide training to educate parents and
guardians in ways to support their child and
navigate the health, education, and human
services systems;

(iii) facilitate ongoing peer support for parents
and guardians from trained volunteer support
parents; and

(iv) communicate regularly with other
parent-to-parent programs and national
organizations to ensure that best practices are
implemented.

(4) Grant recipients must use grant money for
the activities identified in clause (3).

(5) For purposes of this paragraph, "special
health care needs" means disabilities, chronic
illnesses or conditions, health-related
educational or behavioral problems, or the risk
of developing disabilities, illnesses, conditions,
or problems.

(6) Each grant recipient must report to the
commissioner of human services annually by
January 15 with measurable outcomes from
programs and services funded by this
appropriation the previous year including the
number of families served and the number of
volunteer support parents trained by the
organization's parent-to-parent program.

(o) Self-Advocacy Grants for Persons with
Intellectual and Developmental Disabilities.
$323,000 in fiscal year 2024 and $323,000 in
fiscal year 2025 are for self-advocacy grants
under Minnesota Statutes, section 256.477.
Of these amounts, $218,000 in fiscal year
2024 and $218,000 in fiscal year 2025 are for
the activities under Minnesota Statutes, section
256.477, subdivision 1, paragraph (a), clauses
(5) to (7), and for administrative costs, and
$105,000 in fiscal year 2024 and $105,000 in
fiscal year 2025 are for the activities under
Minnesota Statutes, section 256.477,
subdivision 2.

(p) Technology for Home Grants. $300,000
in fiscal year 2024 and $300,000 in fiscal year
2025 are for technology for home grants under
Minnesota Statutes, section 256.4773.

(q) Community Residential Setting
Transition. $500,000 in fiscal year 2024 is
for a grant to Hennepin County to expedite
approval of community residential setting
licenses subject to the corporate foster care
moratorium exception under Minnesota
Statutes, section 245A.03, subdivision 7,
paragraph (a), clause (5).

(r) Base Level Adjustment. The general fund
base is $27,343,000 in fiscal year 2026 and
$27,016,000 in fiscal year 2027.

Sec. 9. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES; CHILD
CARE AND DEVELOPMENT BLOCK GRANT ALLOCATIONS.
new text end

new text begin (a) The commissioner of human services shall allocate $22,000,000 in fiscal year 2024,
$8,000,000 in fiscal year 2025, $8,000,000 in fiscal year 2026, and $8,000,000 in fiscal
year 2027 from the child care and development block grant for the child care assistance
program rates under Minnesota Statutes, section 119B.13.
new text end

new text begin (b) The commissioner of human services shall allocate $7,824,000 in fiscal year 2025,
$8,406,000 in fiscal year 2026, and $8,960,000 in fiscal year 2027 from the child care and
development block grant for basic sliding fee program reprioritization under Minnesota
Statutes, section 119B.03.
new text end

new text begin (c) The commissioner of human services shall allocate $11,250,000 in fiscal year 2024,
$11,500,000 in fiscal year 2025, $11,500,000 in fiscal year 2026, and $11,500,000 in fiscal
year 2027 for additional funding for the basic sliding fee program under Minnesota Statutes,
section 119B.03
new text end

new text begin (d) The commissioner of human services shall allocate $2,920,000 in fiscal year 2025,
$2,920,000 in fiscal year 2026, and $2,920,000 in fiscal year 2027 from the child care and
development block grant for the child care one-stop shop regional assistance network under
Minnesota Statutes, section 119B.19, subdivision 7, clause (9).
new text end

new text begin (e) The commissioner of human services shall allocate $500,000 in fiscal year 2024,
$500,000 in fiscal year 2025, $500,000 in fiscal year 2026, and $500,000 in fiscal year 2027
from the child care and development block grant for the shared services grants under
Minnesota Statutes, section 119B.28.
new text end

new text begin (f) The commissioner of human services shall allocate $300,000 in fiscal year 2024,
$300,000 in fiscal year 2025, $300,000 in fiscal year 2026, and $300,000 in fiscal year 2027
from the child care and development block grant for child care provider access to technology
grants under Minnesota Statutes, section 119B.29.
new text end

Sec. 10. new text begin INFORMATION TECHNOLOGY PROJECTS FOR SERVICE DELIVERY
TRANSFORMATION.
new text end

new text begin Subdivision 1.new text end

new text begin Uses of appropriations.new text end

new text begin Amounts appropriated to the commissioner of
human services for subdivisions 3 to 7 must be expended only to achieve the outcomes
identified in each subdivision. The commissioner must allocate available appropriations to
maximize federal funding and achieve the outcomes specified in subdivisions 3 to 7.
new text end

new text begin Subd. 2.new text end

new text begin Reports required.new text end

new text begin (a) The commissioner of human services, in consultation
with the commissioner of information technology services, must submit a report to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
and human services policy and finance by October 1, 2023, that identifies:
new text end

new text begin (1) a schedule of planned completion dates for the projects included in subdivisions 3
to 7;
new text end

new text begin (2) the projected budget amount for each project included in subdivisions 3 to 7; and
new text end

new text begin (3) baseline metrics and other performance indicators against which progress will be
measured so that the outcomes identified in subdivisions 3 to 7 are achieved.
new text end

new text begin (b) To the extent practicable, the metrics and performance indicators required under
paragraph (a) must be specific and expressed in easily understood terms; measurable;
achievable; relevant; and time bound. Any changes to the outcomes, metrics, or other
performance indicators under this subdivision must be developed in consultation with the
commissioner of information technology services and reported to the chairs and ranking
minority members of the legislative committees with jurisdiction over health and human
services policy and finance in the report submitted under paragraph (c).
new text end

new text begin (c) By October 1, 2024, and each October 1 thereafter, until all funds are expended or
all outcomes are achieved, whichever occurs first, the commissioner must submit a report
to the chairs and ranking minority members of the legislative committees with jurisdiction
over health and human services policy and finance that identifies the actual amounts expended
for each project in subdivisions 3 to 7, including a description of the types and purposes of
expenditures. The report must also describe progress toward achieving the outcomes for
each project based on the baseline metrics and performance indicators established in the
report required under paragraph (a) during the previous fiscal year.
new text end

new text begin Subd. 3.new text end

new text begin Transforming service delivery.new text end

new text begin Any amount appropriated for this subdivision
is to advance efforts to develop and maintain a person-centered human services system by
increasing the ease, speed, and simplicity of accessing human services for Minnesotans,
and for county, Tribal, and state human services workers. Outcomes to be achieved include:
new text end

new text begin (1) funding foundational work and persistent cross-functional product teams of business
and technology resources to support ongoing iterative development that:
new text end

new text begin (i) improves the experience of Minnesotans interacting with the human services system,
including reducing the overall time from an application to the determination of eligibility
and receiving of benefits;
new text end

new text begin (ii) improves information technology delivery times and efficiency of software
development by increasing business agility to respond to new or shifting needs; and
new text end

new text begin (iii) improves the experience of county and Tribal human services workers;
new text end

new text begin (2) developing and hosting dashboards, visualizations, or analytics that can be shared
with external partners and the public to foster data-driven decision making; and
new text end

new text begin (3) other outcomes identified by the commissioner under subdivision 2, paragraph (b).
new text end

new text begin Subd. 4.new text end

new text begin Integrated services for children and families.new text end

new text begin (a) Any amount appropriated
for this subdivision is to stabilize and update legacy information technology systems,
modernize systems, and develop a plan for the future of information technology systems
for the programs that serve children and families. Outcomes to be achieved include:
new text end

new text begin (1) reducing unscheduled downtime on Social Services Information System by at least
20 percent;
new text end

new text begin (2) completing the transition of automated child support systems from mainframe
technology to a web-based environment;
new text end

new text begin (3) making information received regarding an individual's eligibility for benefits easier
to understand;
new text end

new text begin (4) enhancing the child support participant portal to provide additional options for
uploading and updating information, making payments, exchanging data securely, and
providing other features requested by users of the portal; and
new text end

new text begin (5) other outcomes identified by the commissioner under subdivision 2, paragraph (b).
new text end

new text begin (b) The commissioner must contract with an independent consultant to perform a thorough
evaluation of the SSIS, which supports the child protection system in Minnesota. The
consultant must make recommendations for improving the current system for usability,
system performance, and federal Comprehensive Child Welfare Information System
compliance and must address technical problems and identify any unnecessary or unduly
burdensome data entry requirements that have contributed to system capacity issues. The
consultant must assist the commissioner with selecting a platform for future development
of an information technology system for child protection.
new text end

new text begin (c) The commissioner of human services must conduct a study and develop
recommendations to streamline and reduce SSIS data entry requirements for child protection
cases. The study must be completed in partnership with local social services agencies and
others, as determined by the commissioner. The study must review all input fields required
on current reporting forms and determine which input fields and information are required
under state or federal law. By June 30, 2024, the commissioner must provide a status report
and an implementation timeline to the chairs and ranking minority members of the legislative
committees with jurisdiction over child protection. The status report must include information
about procedures for soliciting ongoing user input from stakeholders, progress on solicitation
and hiring of a consultant to conduct the system evaluation required under paragraph (a),
and a report on the progress and completed efforts to streamline data entry requirements
and improve user experience.
new text end

new text begin Subd. 5.new text end

new text begin Medicaid Management Information System modernization.new text end

new text begin Any amount
appropriated for this subdivision is to meet federal compliance requirements and enhance,
modernize, and stabilize the functionality of Minnesota's Medicaid Management Information
System. Outcomes to be achieved include:
new text end

new text begin (1) reducing disruptions and delays in filling prescriptions for medical assistance and
MinnesotaCare enrollees, and improving call center support for pharmacies and enrollees
to ensure prompt resolution of issues;
new text end

new text begin (2) improving the timeliness and accuracy of claims processing and approval of prior
authorization requests;
new text end

new text begin (3) advancing the exchange of health information between providers and trusted partners
so that enrollee care is timely, coordinated, proactive, and reflects the preferences and culture
of the enrollee and their family; and
new text end

new text begin (4) other outcomes identified by the commissioner under subdivision 2, paragraph (b).
new text end

new text begin Subd. 6.new text end

new text begin Provider licensing and reporting hub.new text end

new text begin Any amount appropriated for this
subdivision is to develop, implement, and support ongoing maintenance and operations of
an integrated human services provider licensing and reporting hub. Outcomes to be achieved
include:
new text end

new text begin (1) creating and maintaining user personas for all provider licensing and reporting hub
users that document the unique requirements for each user;
new text end

new text begin (2) creating an electronic licensing application within the provider licensing and reporting
hub to ensure efficient data collection and analysis;
new text end

new text begin (3) creating a persistent, cross-functional product team of business and technology
resources to support the ongoing iterative development of the provider licensing and reporting
hub; and
new text end

new text begin (4) other outcomes identified by the commissioner under subdivision 2, paragraph (b).
new text end

new text begin Subd. 7.new text end

new text begin Improving the Minnesota Eligibility Technology System functionality.new text end

new text begin Any
amount appropriated for this subdivision is to meet federal compliance requirements and
for necessary repairs to improve the core functionality of the Minnesota Eligibility
Technology System to improve the speed and accuracy of eligibility determinations and
reduce the administrative burden for state, county, and Tribal workers. Outcomes to be
achieved include:
new text end

new text begin (1) implementing the capability for medical assistance and MinnesotaCare enrollees to
apply, renew, and make changes to their eligibility and select health plans online;
new text end

new text begin (2) reducing manual data entry and other steps taken by county and Tribal eligibility
workers to improve the accuracy and timeliness of eligibility determinations;
new text end

new text begin (3) completing necessary changes to comply with federal requirements; and
new text end

new text begin (4) other outcomes identified by the commissioner under subdivision 2, paragraph (b).
new text end

Sec. 11. new text begin OUTCOMES AND EVALUATION CONSULTATION REQUIREMENTS.
new text end

new text begin Before implementing any new grant program established in this act that includes program
outcomes, evaluation metrics or requirements, progress indicators, or other related
measurements and with a budget of $750,000 or more per fiscal year, the commissioner
administering the program shall submit to the commissioner of management and budget
draft measurements and consult with the commissioner of management and budget on those
measurements. The consultation required under this section must be completed within 30
days after the consultation is requested. After consultation, the commissioner must
incorporate measurements agreed upon through consultation with the commissioner of
management and budget into grant applications, requests for proposals, contracts, and any
reports to the legislature.
new text end

Sec. 12. new text begin EFFECTIVE DATE CHANGES.
new text end

new text begin (a) The effective date for 2023 S.F. No. 2934, article 3, section 5, if enacted during the
2023 regular legislative session, is January 1, 2024, or upon federal approval, whichever
occurs later, except that paragraph (a), clause (6), is effective the day following final
enactment. The commissioner of human services shall notify the revisor of statutes when
federal approval is obtained. This paragraph prevails over any contrary effective date for
2023 S.F. No. 2934, article 3, section 5, enacted during the 2023 regular legislative session,
regardless of order of enactment.
new text end

new text begin (b) The effective date for 2023 S.F. No. 2934, article 5, section 10, if enacted during the
2023 regular legislative session, is the day following final enactment, except for paragraph
(p), which is effective retroactive to June 30, 2022. This paragraph prevails over any contrary
effective date for 2023 S.F. No. 2934, article 5, section 10, enacted during the 2023 regular
legislative session, regardless of order of enactment.
new text end

new text begin (c) The effective date for 2023 S.F. No. 2934, article 5, section 11, if enacted during the
2023 regular legislative session, is the day following final enactment, except for paragraph
(g), which is effective retroactive to June 30, 2022. This paragraph prevails over any contrary
effective date for 2023 S.F. No. 2934, article 5, section 11, enacted during the 2023 regular
legislative session, regardless of order of enactment.
new text end

ARTICLE 16

HEALTH CARE AFFORDABILITY AND DELIVERY

Section 1.

new text begin [4.047] HEALTH SUBCABINET.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The Health Subcabinet is established.
new text end

new text begin Subd. 2.new text end

new text begin Membership.new text end

new text begin The Health Subcabinet shall consist of the commissioners of
human services, commerce, management and budget, and health and the executive director
of MNsure.
new text end

new text begin Subd. 3.new text end

new text begin Director; staffing and administrative support.new text end

new text begin An executive director must
be hired to manage the activities of the Health Subcabinet and serve as its chair. The
commissioner of management and budget, in coordination with other state agencies and
boards, as applicable, must provide staffing and administrative support to the executive
director and the subcabinet established in this section.
new text end

new text begin Subd. 4.new text end

new text begin Duties.new text end

new text begin The Health Subcabinet shall coordinate state agency and, as applicable,
private sector efforts to reform the health care delivery and payment systems; foster
sustainability in health care spending; ensure the availability of affordable and comprehensive
health care coverage and health care; ensure access to high-quality health care services; and
reduce disparities and inequities in the experience or outcomes of health care.
new text end

Sec. 2.

Minnesota Statutes 2022, section 62J.03, is amended by adding a subdivision to
read:

new text begin Subd. 11.new text end

new text begin Health care entity.new text end

new text begin "Health care entity" includes clinics, hospitals, ambulatory
surgical centers, physician organizations, accountable care organizations, integrated provider
and plan systems, county-based purchasing plans, health carriers, health care providers as
defined under section 62J.03, subdivision 8, and entities required to report under section
62J.84.
new text end

Sec. 3.

new text begin [62J.0416] IDENTIFY STRATEGIES FOR REDUCTION OF
ADMINISTRATIVE SPENDING AND LOW-VALUE CARE.
new text end

new text begin (a) The commissioner of health shall develop recommendations for strategies to reduce
the volume and growth of administrative spending by health care organizations and group
purchasers, and the magnitude of low-value care delivered to Minnesota residents. The
commissioner shall:
new text end

new text begin (1) review the availability of data and identify gaps in the data infrastructure to estimate
aggregated and disaggregated administrative spending and low-value care;
new text end

new text begin (2) based on available data, estimate the volume and change over time of administrative
spending and low-value care in Minnesota;
new text end

new text begin (3) conduct an environmental scan and key informant interviews with experts in health
care finance, health economics, health care management or administration, and the
administration of health insurance benefits to determine drivers of spending growth for
spending on administrative services or the provision of low-value care; and
new text end

new text begin (4) convene a clinical learning community and an employer task force to review the
evidence from clauses (1) to (3) and develop a set of actionable strategies to address
administrative spending volume and growth and the magnitude of the volume of low-value
care.
new text end

new text begin (b) By March 31, 2025, the commissioner shall deliver the recommendations 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. 4.

new text begin [62J.0417] PAYMENT MECHANISMS IN RURAL HEALTH CARE.
new text end

new text begin (a) The commissioner shall develop a plan to assess readiness of rural communities and
rural health care providers to adopt value based, global budgeting or alternative payment
systems and recommend steps needed to implement them. The commissioner may use the
development of case studies and modeling of alternate payment systems to demonstrate
value-based payment systems that ensure a baseline level of essential community or regional
health services and address population health needs.
new text end

new text begin (b) The commissioner shall develop recommendations for pilot projects with the aim of
ensuring financial viability of rural health care entities in the context of spending growth
targets. The commissioner shall include the plan, recommendations, and related findings
in the reports required under section 62J.312, subdivision 3.
new text end

Sec. 5.

new text begin [62J.312] CENTER FOR HEALTH CARE AFFORDABILITY.
new text end

new text begin Subdivision 1.new text end

new text begin Center establishment; research and analysis.new text end

new text begin (a) The commissioner
shall establish a center for health care affordability within the Minnesota Department of
Health. The commissioner, through the center, shall carry out the duties assigned under this
section.
new text end

new text begin (b) The commissioner shall conduct research on and analyze the drivers of health care
spending growth in order to increase transparency and identify strategies that help to reduce
waste and low-value care; eliminate unproductive administrative spending; enhance the
provision of effective, high-value care; consider the sustainability of health care spending
growth and the relationship of health care spending growth to health equity; and identify
delivery system, payment, and health care market reforms to increase health care
affordability.
new text end

new text begin (c) To perform the duties under paragraph (b), the commissioner shall:
new text end

new text begin (1) identify additional data needed from health care entities and the level of granularity
of required reporting, while limiting additional reporting burdens to the extent possible by
ensuring effective use of existing data and reporting mechanisms;
new text end

new text begin (2) establish the form and manner for data reporting, including but not limited to data
specifications, methods of reporting, and reporting schedules;
new text end

new text begin (3) assist reporting entities in submitting data and information; and
new text end

new text begin (4) conduct background research and environmental scans, perform qualitative and
quantitative analyses, and perform economic modeling.
new text end

new text begin Subd. 2.new text end

new text begin Public input.new text end

new text begin (a) The commissioner shall obtain public feedback on the research
agenda for the center for health care affordability and on the research activities conducted
under this section by consulting with health care entities, licensed physicians and other
health care providers, employers and other purchasers, the commissioners of human services
and management and budget, patients and patient advocates, individuals with expertise in
health care spending or health economics, and other stakeholders. The commissioner may
convene an advisory body or bodies to obtain public feedback.
new text end

new text begin (b) The commissioner shall hold public hearings, at least annually, to share initial and
final analyses conducted under this section, solicit community input on strategies to
strengthen health care affordability, and hear testimony about experiences and challenges
related to health care affordability.
new text end

new text begin Subd. 3.new text end

new text begin Reporting.new text end

new text begin The commissioner shall provide periodic reports to the chairs and
ranking minority members of the legislative committees with jurisdiction over health care
finance and policy describing the analyses conducted under this section and making
recommendations for strategies to address unsustainable rates of health care spending growth.
new text end

new text begin Subd. 4.new text end

new text begin Contracting.new text end

new text begin In carrying out the duties required by this section, the
commissioner may contract with entities with expertise in health economics, health care
finance, accounting, and actuarial science.
new text end

new text begin Subd. 5.new text end

new text begin Access to information.new text end

new text begin (a) The commissioner may request that a state agency
provide data in a usable format as requested by the commissioner at no cost to the
commissioner.
new text end

new text begin (b) The commissioner may also request from a state agency unique or custom data sets.
That agency may charge the commissioner for providing the data at the same rate the agency
would charge any other public or private entity.
new text end

new text begin (c) Unless specified elsewhere in statute, any information provided to the commissioner
by a state agency must be de-identified. For purposes of this requirement, "de-identified"
means that a process was used to prevent the identity of a person from being connected with
information and to ensure that all identifiable information has been removed.
new text end

new text begin (d) Notwithstanding any provisions to the contrary, the commissioner may use data
collected and maintained under section 62U.04 to carry out the duties required under this
section.
new text end

new text begin (e) Any health care entity subject to reporting under this section that fails to provide
data in the form and manner prescribed by the commissioner is subject to a fine paid to the
commissioner of up to $500 for each day the data are past due. The commissioner may grant
an extension of the reporting deadlines upon a showing of good cause by the entity. Any
fine levied against the entity under this subdivision is subject to the contested case and
judicial review provisions of sections 14.57 and 14.69.
new text end

new text begin (f) Any data submitted to the commissioner must retain their original classification under
the Minnesota Data Practices Act under chapter 13.
new text end

new text begin Subd. 6.new text end

new text begin 340B covered entity report.new text end

new text begin (a) Beginning April 1, 2024, each 340B covered
entity, as defined by section 340B(a)(4) of the Public Health Service Act, must report to
the commissioner of health by April 1 of each year the following information related to its
participation in the federal 340B program for the previous calendar year:
new text end

new text begin (1) the National Provider Identification (NPI) number;
new text end

new text begin (2) the name of the 340B covered entity;
new text end

new text begin (3) the servicing address of the 340B covered entity;
new text end

new text begin (4) the classification of the 340B covered entity;
new text end

new text begin (5) the aggregated acquisition cost for prescription drugs obtained under the 340B
program;
new text end

new text begin (6) the aggregated payment amount received for drugs obtained under the 340B program
and dispensed to patients;
new text end

new text begin (7) the aggregated payment made to pharmacies under contract to dispense drugs obtained
under the 340B program; and
new text end

new text begin (8) the number of claims for prescription drugs described in clause (6).
new text end

new text begin (b) The information required under paragraph (a) must be reported by payer type,
including commercial insurance, medical assistance and MinnesotaCare, and Medicare, in
the form and manner defined by the commissioner. For covered entities that are hospitals,
the information required under paragraph (a), clauses (5) to (8), must also be reported at
the national drug code level for the 50 most frequently dispensed drugs by the facility under
the 340B program.
new text end

new text begin (c) Data submitted under paragraph (a) must include prescription drugs dispensed by
outpatient facilities that are identified as child facilities under the federal 340B program
based on their inclusion on the hospital's Medicare cost report.
new text end

new text begin (d) Data submitted to the commissioner under paragraph (a) must be classified as
nonpublic data as defined in section 13.02, subdivision 9.
new text end

new text begin (e) Beginning November 15, 2024, and by November 15 of each year thereafter, the
commissioner shall prepare a report that aggregates the data submitted under paragraph (a).
The commissioner shall submit this report to the chairs and ranking minority members of
the legislative committees with jurisdiction over health care finance and policy.
new text end

Sec. 6.

Minnesota Statutes 2022, section 62K.15, is amended to read:

62K.15 ANNUAL OPEN ENROLLMENT PERIODS; SPECIAL ENROLLMENT
PERIODS.

(a) Health carriers offering individual health plans must limit annual enrollment in the
individual market to the annual open enrollment periods for MNsure. Nothing in this section
limits the application of special or limited open enrollment periods as defined under the
Affordable Care Act.

(b) Health carriers offering individual health plans must inform all applicants at the time
of application and enrollees at least annually of the open and special enrollment periods as
defined under the Affordable Care Act.

(c) Health carriers offering individual health plans must provide a special enrollment
period for enrollment in the individual market by employees of a small employer that offers
a qualified small employer health reimbursement arrangement in accordance with United
States Code, title 26, section 9831(d). The special enrollment period deleted text begin shalldeleted text end new text begin mustnew text end be available
only to employees newly hired by a small employer offering a qualified small employer
health reimbursement arrangement, and to employees employed by the small employer at
the time the small employer initially offers a qualified small employer health reimbursement
arrangement. For employees newly hired by the small employer, the special enrollment
period shall last for 30 days after the employee's first day of employment. For employees
employed by the small employer at the time the small employer initially offers a qualified
small employer health reimbursement arrangement, the special enrollment period shall last
for 30 days after the date the arrangement is initially offered to employees.

(d) The commissioner of commerce shall enforce this section.

new text begin (e) Health carriers offering individual health plans through MNsure must provide a
special enrollment period as required under the easy enrollment health insurance outreach
program under section 62V.13.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective for taxable years beginning after December
31, 2023, and applies to health plans offered, issued, or sold on or after January 1, 2024.
new text end

Sec. 7.

new text begin [62V.13] EASY ENROLLMENT HEALTH INSURANCE OUTREACH
PROGRAM.
new text end

new text begin Subdivision 1.new text end

new text begin Establishment.new text end

new text begin The board, in cooperation with the commissioner of
revenue, must establish the easy enrollment health insurance outreach program to:
new text end

new text begin (1) reduce the number of uninsured Minnesotans and increase access to affordable health
insurance coverage;
new text end

new text begin (2) allow the commissioner of revenue to provide return information, at the request of
the taxpayer, to MNsure to provide the taxpayer with information about the taxpayer's
potential eligibility for financial assistance and health insurance enrollment options through
MNsure;
new text end

new text begin (3) allow MNsure to estimate taxpayer potential eligibility for financial assistance for
health insurance coverage; and
new text end

new text begin (4) allow MNsure to conduct targeted outreach to assist interested taxpayer households
in applying for and enrolling in affordable health insurance options through MNsure,
including connecting interested taxpayer households with a navigator or broker for free
enrollment assistance.
new text end

new text begin Subd. 2.new text end

new text begin Screening for eligibility for insurance assistance.new text end

new text begin Upon receipt of and based
on return information received from the commissioner of revenue under section 270B.14,
subdivision 22, MNsure may make a projected assessment on whether the interested
taxpayer's household may qualify for a financial assistance program for health insurance
coverage.
new text end

new text begin Subd. 3.new text end

new text begin Outreach letter and special enrollment period.new text end

new text begin (a) MNsure must provide a
written letter of the projected assessment under subdivision 2 to a taxpayer who indicates
to the commissioner of revenue that the taxpayer is interested in obtaining information on
access to health insurance.
new text end

new text begin (b) MNsure must allow a special enrollment period for taxpayers who receive the outreach
letter in paragraph (a) and are determined eligible to enroll in a qualified health plan through
MNsure. The triggering event for the special enrollment period is the day the outreach letter
under this subdivision is mailed to the taxpayer. An eligible individual, and their dependents,
have 65 days from the triggering event to select a qualifying health plan and coverage for
the qualifying health plan is effective the first day of the month after plan selection.
new text end

new text begin (c) Taxpayers who have a member of the taxpayer's household currently enrolled in a
qualified health plan through MNsure are not eligible for the special enrollment under
paragraph (b).
new text end

new text begin (d) MNsure must provide information to the general public about the easy enrollment
health insurance outreach program and the special enrollment period described in this
subdivision.
new text end

new text begin Subd. 4.new text end

new text begin Appeals.new text end

new text begin (a) Projected eligibility assessments for financial assistance under
this section are not appealable.
new text end

new text begin (b) Qualification for the special enrollment period under this section is appealable to
MNsure under this chapter and Minnesota Rules, chapter 7700.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective for taxable years beginning after December
31, 2023, and applies to health plans offered, issued, or sold on or after January 1, 2024.
new text end

Sec. 8.

Minnesota Statutes 2022, section 256.962, subdivision 5, is amended to read:

Subd. 5.

Incentive program.

Beginning January 1, 2008, the commissioner shall establish
an incentive program for organizations and licensed insurance producers under chapter 60K
that directly identify and assist potential enrollees in filling out and submitting an application.
For each applicant who is successfully enrolled in MinnesotaCare or medical assistance,
the commissioner, within the available appropriation, shall pay the organization or licensed
insurance producer a deleted text begin $70deleted text end new text begin $100new text end application assistance bonus. The organization or licensed
insurance producer may provide an applicant a gift certificate or other incentive upon
enrollment.

new text begin EFFECTIVE DATE.new text end

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

Sec. 9.

new text begin [256.9631] DIRECT PAYMENT SYSTEM FOR MEDICAL ASSISTANCE
AND MINNESOTACARE.
new text end

new text begin Subdivision 1.new text end

new text begin Direction to the commissioner.new text end

new text begin (a) The commissioner shall develop an
implementation plan for a direct payment system to deliver services to eligible individuals
in order to achieve better health outcomes and reduce the cost of health care for the state.
Under this system, eligible individuals must receive services through the medical assistance
fee-for-service system, county-based purchasing plans, or county-owned health maintenance
organizations. The commissioner shall present an implementation plan for the direct payment
system to the chairs and ranking minority members of the legislative committees with
jurisdiction over health care finance and policy by January 15, 2026. The commissioner
may contract for technical assistance in developing the implementation plan and conducting
related studies and analyses.
new text end

new text begin (b) For the purposes of the direct payment system, the commissioner shall make the
following assumptions:
new text end

new text begin (1) health care providers are reimbursed directly for all medical assistance covered
services provided to eligible individuals, using the fee-for-service payment methods specified
in chapters 256, 256B, 256R, and 256S;
new text end

new text begin (2) payments to a qualified hospital provider are equivalent to the payments that would
have been received based on managed care direct payment arrangements. If necessary, a
qualified hospital provider may use a county-owned health maintenance organization to
receive direct payments as described in section 256B.1973; and
new text end

new text begin (3) county-based purchasing plans and county-owned health maintenance organizations
must be reimbursed at the capitation rate determined under sections 256B.69 and 256B.692.
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) "Eligible individuals" means qualified medical assistance enrollees, defined as persons
eligible for medical assistance as families and children and adults without children.
new text end

new text begin (c) "Qualified hospital provider" means a nonstate government teaching hospital with
high medical assistance utilization and a level 1 trauma center, and all of the hospital's
owned or affiliated health care professionals, ambulance services, sites, and clinics.
new text end

new text begin Subd. 3.new text end

new text begin Implementation plan.new text end

new text begin (a) The implementation plan must include:
new text end

new text begin (1) a timeline for the development and recommended implementation date of the direct
payment system. In recommending a timeline, the commissioner must consider:
new text end

new text begin (i) timelines required by the existing contracts with managed care plans and county-based
purchasing plans to sunset existing delivery models;
new text end

new text begin (ii) in counties that choose to operate a county-based purchasing plan under section
256B.692, timelines for any new procurements required for those counties to establish a
new county-based purchasing plan or participate in an existing county-based purchasing
plan;
new text end

new text begin (iii) in counties that choose to operate a county-owned health maintenance organization
under section 256B.69, timelines for any new procurements required for those counties to
establish a new county-owned health maintenance organization or to continue serving
enrollees through an existing county-owned health maintenance organization; and
new text end

new text begin (iv) a recommendation on whether the commissioner should contract with a third-party
administrator to administer the direct payment system and the timeline needed for procuring
an administrator;
new text end

new text begin (2) the procedures to be used to ensure continuity of care for enrollees who transition
from managed care to fee-for-service and any administrative resources needed to carry out
these procedures;
new text end

new text begin (3) recommended quality measures for health care service delivery;
new text end

new text begin (4) any changes to fee-for-service payment rates that the commissioner determines are
necessary to ensure provider access and high-quality care and to reduce health disparities;
new text end

new text begin (5) recommendations on ensuring effective care coordination under the direct payment
system, especially for enrollees who have complex medical conditions, who face
socioeconomic barriers to receiving care, or who are from underserved populations that
experience health disparities;
new text end

new text begin (6) recommendations on whether the direct payment system should provide supplemental
payments for care coordination, including:
new text end

new text begin (i) the provider types eligible for supplemental payments;
new text end

new text begin (ii) procedures to coordinate supplemental payments with existing supplemental or
cost-based payment methods or to replace these existing methods; and
new text end

new text begin (iii) procedures to align care coordination initiatives funded through supplemental
payments under this section with existing care coordination initiatives;
new text end

new text begin (7) recommendations on whether the direct payment system should include funding to
providers for outreach initiatives to patients who, because of mental illness, homelessness,
or other circumstances, are unlikely to obtain needed care and treatment;
new text end

new text begin (8) recommendations for a supplemental payment to qualified hospital providers to offset
any potential revenue losses resulting from the shift from managed care payments;
new text end

new text begin (9) recommendations on whether and how the direct payment system should be expanded
to deliver services and care coordination to medical assistance enrollees who are age 65 or
older, are blind, or have a disability and to persons enrolled in MinnesotaCare; and
new text end

new text begin (10) recommendations for statutory changes necessary to implement the direct payment
system.
new text end

new text begin (b) In developing the implementation plan, the commissioner shall:
new text end

new text begin (1) calculate the projected cost of a direct payment system relative to the cost of the
current system;
new text end

new text begin (2) assess gaps in care coordination under the current medical assistance and
MinnesotaCare programs;
new text end

new text begin (3) evaluate the effectiveness of approaches other states have taken to coordinate care
under a fee-for-service system, including the coordination of care provided to persons who
are blind or have disabilities;
new text end

new text begin (4) estimate the loss of revenue and cost savings from other payment enhancements
based on managed care plan directed payments and pass-throughs;
new text end

new text begin (5) estimate cost trends under a direct payment system for managed care payments to
county-based purchasing plans and county-owned health maintenance organizations;
new text end

new text begin (6) estimate the impact of a direct payment system on other revenue, including taxes,
surcharges, or other federally approved in lieu of services and on other arrangements allowed
under managed care;
new text end

new text begin (7) consider allowing eligible individuals to opt out of managed care as an alternative
approach;
new text end

new text begin (8) assess the feasibility of a medical assistance outpatient prescription drug benefit
carve-out under section 256B.69, subdivision 6d, and in consultation with the commissioners
of commerce and health, assess the feasibility of including MinnesotaCare enrollees and
private sector enrollees of health plan companies in the drug benefit carve-out. The
assessment of feasibility must address and include recommendations related to the process
and terms by which the commissioner would contract with health plan companies to
administer prescription drug benefits and develop and manage a drug formulary, and the
impact of the drug-benefit carve-out on health care providers, including small pharmacies;
new text end

new text begin (9) consult with the commissioners of health and commerce and the contractor or
contractors analyzing the Minnesota Health Plan under section 19 and other health reform
models on plan design and assumptions; and
new text end

new text begin (10) conduct other analyses necessary to develop the implementation plan.
new text end

Sec. 10.

Minnesota Statutes 2022, section 256B.04, is amended by adding a subdivision
to read:

new text begin Subd. 26.new text end

new text begin Disenrollment under medical assistance and MinnesotaCare.new text end

new text begin (a) The
commissioner shall regularly update mailing addresses and other contact information for
medical assistance and MinnesotaCare enrollees in cases of returned mail and nonresponse
using information available through managed care and county-based purchasing plans, state
health and human services programs, and other sources.
new text end

new text begin (b) The commissioner shall not disenroll an individual from medical assistance or
MinnesotaCare in cases of returned mail until the commissioner makes at least two attempts
by phone, email, or other methods to contact the individual. The commissioner may disenroll
the individual after providing no less than 30 days for the individual to respond to the most
recent contact attempt.
new text end

Sec. 11.

Minnesota Statutes 2022, section 256B.056, subdivision 7, is amended to read:

Subd. 7.

Period of eligibility.

(a) Eligibility is available for the month of application
and for three months prior to application if the person was eligible in those prior months.
A redetermination of eligibility must occur every 12 months.

new text begin (b) Notwithstanding any other law to the contrary:
new text end

new text begin (1) a child under 19 years of age who is determined eligible for medical assistance must
remain eligible for a period of 12 months;
new text end

new text begin (2) a child 19 years of age and older but under 21 years of age who is determined eligible
for medical assistance must remain eligible for a period of 12 months; and
new text end

new text begin (3) a child under six years of age who is determined eligible for medical assistance must
remain eligible through the month in which the child reaches six years of age.
new text end

new text begin (c) A child's eligibility under paragraph (b) may be terminated earlier if:
new text end

new text begin (1) the child or the child's representative requests voluntary termination of eligibility;
new text end

new text begin (2) the child ceases to be a resident of this state;
new text end

new text begin (3) the child dies;
new text end

new text begin (4) the child attains the maximum age; or
new text end

new text begin (5) the agency determines eligibility was erroneously granted at the most recent eligibility
determination due to agency error or fraud, abuse, or perjury attributed to the child or the
child's representative.
new text end

deleted text begin (b)deleted text end new text begin (d)new text end For a person eligible for an insurance affordability program as defined in section
256B.02, subdivision 19, who reports a change that makes the person eligible for medical
assistance, eligibility is available for the month the change was reported and for three months
prior to the month the change was reported, if the person was eligible in those prior months.

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, except that paragraph (b), clause (1), is effective January 1, 2024, or
upon federal approval and the implementation of required administrative and systems
changes, whichever is later. The commissioner of human services shall notify the revisor
of statutes when federal approval is obtained and the required administrative and systems
changes are implemented.
new text end

Sec. 12.

Minnesota Statutes 2022, section 256B.0631, subdivision 1, is amended to read:

Subdivision 1.

Cost-sharing.

(a) Except as provided in subdivision 2, the medical
assistance benefit plan shall include the following cost-sharing for all recipients, effective
for services provided deleted text begin on or afterdeleted text end new text begin fromnew text end September 1, 2011new text begin , to December 31, 2023new text end :

(1) $3 per nonpreventive visit, except as provided in paragraph (b). For purposes of this
subdivision, a visit means an episode of service which is required because of a recipient's
symptoms, diagnosis, or established illness, and which is delivered in an ambulatory setting
by a physician or physician assistant, chiropractor, podiatrist, nurse midwife, advanced
practice nurse, audiologist, optician, or optometrist;

(2) $3.50 for nonemergency visits to a hospital-based emergency room, except that this
co-payment shall be increased to $20 upon federal approval;

(3) $3 per brand-name drug prescription, $1 per generic drug prescription, and $1 per
prescription for a brand-name multisource drug listed in preferred status on the preferred
drug list, subject to a $12 per month maximum for prescription drug co-payments. No
co-payments shall apply to antipsychotic drugs when used for the treatment of mental illness;

(4) a family deductible equal to $2.75 per month per family and adjusted annually by
the percentage increase in the medical care component of the CPI-U for the period of
September to September of the preceding calendar year, rounded to the next higher five-cent
increment; and

(5) total monthly cost-sharing must not exceed five percent of family income. For
purposes of this paragraph, family income is the total earned and unearned income of the
individual and the individual's spouse, if the spouse is enrolled in medical assistance and
also subject to the five percent limit on cost-sharing. This paragraph does not apply to
premiums charged to individuals described under section 256B.057, subdivision 9.

(b) Recipients of medical assistance are responsible for all co-payments and deductibles
in this subdivision.

(c) Notwithstanding paragraph (b), the commissioner, through the contracting process
under sections 256B.69 and 256B.692, may allow managed care plans and county-based
purchasing plans to waive the family deductible under paragraph (a), clause (4). The value
of the family deductible shall not be included in the capitation payment to managed care
plans and county-based purchasing plans. Managed care plans and county-based purchasing
plans shall certify annually to the commissioner the dollar value of the family deductible.

(d) Notwithstanding paragraph (b), the commissioner may waive the collection of the
family deductible described under paragraph (a), clause (4), from individuals and allow
long-term care and waivered service providers to assume responsibility for payment.

(e) Notwithstanding paragraph (b), the commissioner, through the contracting process
under section 256B.0756 shall allow the pilot program in Hennepin County to waive
co-payments. The value of the co-payments shall not be included in the capitation payment
amount to the integrated health care delivery networks under the pilot program.

Sec. 13.

Minnesota Statutes 2022, section 256B.0631, is amended by adding a subdivision
to read:

new text begin Subd. 1a.new text end

new text begin Prohibition on cost-sharing and deductibles.new text end

new text begin Effective January 1, 2024, the
medical assistance benefit plan must not include cost-sharing or deductibles for any medical
assistance recipient or benefit.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective January 1, 2024, and applies to all medical
assistance benefit plans offered, issued, or renewed on or after that date.
new text end

Sec. 14.

Minnesota Statutes 2022, section 256B.0631, subdivision 3, is amended to read:

Subd. 3.

Collection.

(a) The medical assistance reimbursement to the provider shall be
reduced by the amount of the co-payment or deductible, except that reimbursements shall
not be reduced:

(1) once a recipient has reached the $12 per month maximum for prescription drug
co-payments; or

(2) for a recipient who has met their monthly five percent cost-sharing limit.

(b) The provider collects the co-payment or deductible from the recipient. Providers
may not deny services to recipients who are unable to pay the co-payment or deductible.

deleted text begin (c) Medical assistance reimbursement to fee-for-service providers and payments to
managed care plans shall not be increased as a result of the removal of co-payments or
deductibles effective on or after January 1, 2009.
deleted text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 15.

Minnesota Statutes 2022, section 256L.04, subdivision 10, is amended to read:

Subd. 10.

Citizenship requirements.

(a) Eligibility for MinnesotaCare is deleted text begin limiteddeleted text end new text begin
availablenew text end to citizens or nationals of the United States deleted text begin anddeleted text end new text begin ;new text end lawfully present noncitizens as
defined in Code of Federal Regulations, title 8, section 103.12deleted text begin .deleted text end new text begin ; andnew text end undocumented
noncitizens deleted text begin are ineligible for MinnesotaCaredeleted text end . For purposes of this subdivision, an
undocumented noncitizen is an individual who resides in the United States without the
approval or acquiescence of the United States Citizenship and Immigration Services. Families
with children who are citizens or nationals of the United States must cooperate in obtaining
satisfactory documentary evidence of citizenship or nationality according to the requirements
of the federal Deficit Reduction Act of 2005, Public Law 109-171.

(b) Notwithstanding subdivisions 1 and 7, eligible persons include families and
individuals who are deleted text begin lawfully present anddeleted text end ineligible for medical assistance by reason of
immigration status and who have incomes equal to or less than 200 percent of federal poverty
guidelinesnew text begin , except that these persons may be eligible for emergency medical assistance
under section 256B.06, subdivision 4new text end .

new text begin EFFECTIVE DATE.new text end

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

Sec. 16.

Minnesota Statutes 2022, section 270B.14, is amended by adding a subdivision
to read:

new text begin Subd. 22.new text end

new text begin Disclosure to MNsure board.new text end

new text begin The commissioner may disclose a return or
return information to the MNsure board if a taxpayer makes the designation under section
290.433 on an income tax return filed with the commissioner. The commissioner must only
disclose data necessary to provide the taxpayer with information about the potential eligibility
for financial assistance and health insurance enrollment options under section 62V.13.
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. 17.

new text begin [290.433] EASY ENROLLMENT HEALTH INSURANCE OUTREACH
PROGRAM CHECKOFF.
new text end

new text begin Subdivision 1.new text end

new text begin Taxpayer designation.new text end

new text begin Any individual who files an income tax return
may designate on their original return a request that the commissioner provide their return
information to the MNsure board for purposes of providing the individual with information
about potential eligibility for financial assistance and health insurance enrollment options
under section 62V.13, to the extent necessary to administer the easy enrollment health
insurance outreach program.
new text end

new text begin Subd. 2.new text end

new text begin Form.new text end

new text begin The commissioner shall notify filers of their ability to make the
designation in subdivision 1 on their income tax return.
new text end

new text begin EFFECTIVE DATE.new text end

new text begin This section is effective for taxable years beginning after December
31, 2023.
new text end

Sec. 18. new text begin DIRECTION TO MNSURE BOARD AND COMMISSIONER.
new text end

new text begin The MNsure board and the commissioner of the Department of Revenue must develop
and implement systems, policies, and procedures that encourage, facilitate, and streamline
data sharing, projected eligibility assessments, and notice to taxpayers to achieve the purpose
of the easy enrollment health insurance outreach program under Minnesota Statutes, section
62V.13, for operation beginning with tax year 2024.
new text end

Sec. 19. new text begin ANALYSIS OF BENEFITS AND COSTS OF A UNIVERSAL HEALTH
CARE FINANCING SYSTEM.
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.
new text end

new text begin (b) "Total public and private health care spending" means:
new text end

new text begin (1) spending on all medical care, including but not limited to dental, vision and hearing,
mental health, substance use disorder treatment, prescription drugs, medical equipment and
supplies, long-term care, and home care, whether paid through premiums, co-payments and
deductibles, other out-of-pocket payments, or funding from the government, employers, or
other sources; and
new text end

new text begin (2) the costs of administering, delivering, and paying for medical care, including but not
limited to all expenses incurred by insurers, providers, employers, individuals, and the
government to select, negotiate, purchase, administer, and provide coverage for health care,
dental care, long-term care, prescription drugs, the medical expense portions of workers
compensation and automobile insurance, and the cost of administering and paying for all
health care products and services that are not covered by insurance.
new text end

new text begin (c) "All necessary care" means the full range of services listed in the proposed Minnesota
Health Plan legislation for a universal health care financing system specified in subdivision
5, including medical, dental, vision and hearing, mental health, substance use disorder
treatment, reproductive and sexual health, prescription drugs, medical equipment and
supplies, long-term care, home care, and the coordination of care.
new text end

new text begin Subd. 2.new text end

new text begin Initial assumptions.new text end

new text begin (a) When calculating administrative savings under the
universal health care financing proposal, the analysts shall recognize that simple, direct
payment of medical services avoids the need for provider networks, eliminates prior
authorization requirements, and eliminates administrative complexity of other payment
schemes, along with the need for creating risk adjustment mechanisms and measuring,
tracking, and paying entities according to risk-adjusted or nonrisk-adjusted payment schemes.
new text end

new text begin (b) The analysts shall assume that, while gross provider payments may be reduced to
reflect reduced administrative costs, net provider income would remain similar to the current
system. The analysts shall not assume that payment rate negotiations will track current
Medicaid, Medicare, or market payment rates or a combination of those rates, because
provider compensation, after adjusting for reduced administrative costs, would not be
universally raised or lowered but would be negotiated based on market needs, so provider
compensation might be raised in an underserved area such as mental health but lowered in
other areas.
new text end

new text begin Subd. 3.new text end

new text begin Contract for analysis of proposal.new text end

new text begin (a) The commissioner of health shall
contract with one or more independent entities to conduct an analysis of the benefits and
costs of a legislative proposal for a universal health care financing system and a similar
analysis of the current health care financing system to assist the state in comparing the
proposal to the current system. The contract must be designed to produce estimates for all
elements in subdivision 6.
new text end

new text begin (b) The commissioner shall issue a request for information. Based on responses to the
request for information, the commissioner shall issue a request for proposals that specifies
requirements for the design, analysis, and deliverables, and shall select one or more
contractors based on responses to the request for proposals. The commissioner shall consult
with the chief authors of this section in implementing this paragraph.
new text end

new text begin (c) The commissioner is exempt from the requirements of Minnesota Statutes, chapters
16A and 16C, when entering into a new contract or amending an existing contract to complete
the necessary analysis required under this section.
new text end

new text begin Subd. 4.new text end

new text begin Access to information.new text end

new text begin (a) The commissioner may request that a state agency
provide the commissioner and contractor with data as defined in Minnesota Statutes, sections
62J.04 and 295.52, in a usable format as requested by the commissioner at no cost to the
commissioner.
new text end

new text begin (b) The commissioner may request from a state agency unique or custom data sets. The
agency may charge the commissioner for providing these data sets at the same rate the
agency would charge any other public or private entity.
new text end

new text begin (c) Any data submitted to the commissioner shall retain their original classification under
the Minnesota Data Practices Act in Minnesota Statutes, chapter 13.
new text end

new text begin (d) The commissioner, under the authority of Minnesota Statutes, chapter 62J, may
collect data necessary for the performance of assigned duties and shall collect this data in
a form and manner that ensures the collection of high-quality, transparent data.
new text end

new text begin (e) The commissioner of human services shall make available to the vendor selected
under subdivision 3 any relevant findings from:
new text end

new text begin (1) any actuarial and economic analysis for a MinnesotaCare public option
implementation plan and waiver; and
new text end

new text begin (2) any analysis of a direct payment system.
new text end

new text begin Subd. 5.new text end

new text begin Proposal.new text end

new text begin The commissioner of health, in consultation with the commissioners
of human services and commerce, shall submit to the contractor for analysis the legislative
proposal known as the Minnesota Health Plan, proposed in the 93rd Minnesota Legislature
as Senate File No. 2740/House File No. 2798, that would establish a universal health care
financing system designed to:
new text end

new text begin (1) ensure all Minnesotans have health care coverage;
new text end

new text begin (2) cover all necessary care; and
new text end

new text begin (3) allow patients to choose their doctors, hospitals, and other providers.
new text end

new text begin Subd. 6.new text end

new text begin Proposal analysis.new text end

new text begin (a) The analysis must measure the performance of both the
proposed Minnesota Health Plan and the current public and private health care financing
system over a ten-year period to contrast the impact of these approaches on:
new text end

new text begin (1) coverage: the number of people who are uninsured versus the number of people who
are insured;
new text end

new text begin (2) benefit completeness: adequacy of coverage measured by the completeness of the
coverage and the number of people lacking coverage for key necessary care elements such
as dental services, long-term care, medical equipment or supplies, vision and hearing, and
other health services. The analysis must take into account the variety of benefit designs in
the commercial market and report the extent of coverage in each market segment;
new text end

new text begin (3) underinsurance: whether people with coverage can afford the care they need or
whether cost prevents them from accessing care. This includes affordability in terms of
premiums, deductibles, and out-of-pocket expenses;
new text end

new text begin (4) system capacity: the timeliness and appropriateness of the care received and whether
people turn to inappropriate care such as emergency rooms because of a lack of proper care
in accordance with clinical guidelines; and
new text end

new text begin (5) health care spending: total public and private health care spending in Minnesota
under the current system versus under the Minnesota Health Plan legislative proposal,
including all spending by individuals, businesses, and government. Where relevant, the
analysis must be broken out by key necessary care areas, such as medical, dental, and mental
health. The analysis of total health care spending must examine whether there are savings
or additional costs under the universal health care financing system established by the
legislative proposal compared to the existing system due to:
new text end

new text begin (i) changes in the cost of insurance, billing, underwriting, marketing, evaluation, and
other administrative functions for all entities involved in the health care system, including
savings from global budgeting for hospitals and institutional care, instead of billing for
individual services provided;
new text end

new text begin (ii) changes in prices for medical services and products, including pharmaceuticals, due
to price negotiations under the proposal;
new text end

new text begin (iii) the impact on utilization, health outcomes, and workplace absenteeism due to
prevention, early intervention, and health-promoting activities;
new text end

new text begin (iv) shortages or excess capacity of medical facilities, equipment, and personnel, including
caregivers and staff, under either the current system or the proposal, including the rate of
inappropriate emergency room usage. The analysis must break down capacity by geographic
differences such as rural versus metropolitan, and disparate access by population group;
new text end

new text begin (v) the impact on state, local, and federal government non-health-care expenditures.
This may include factors such as reduced crime and out-of-home placement costs due to
the availability of mental health or substance use disorder coverage and other factors
identified by additional analyses;
new text end

new text begin (vi) job losses or gains within the health care system, related to any changes in health
care delivery, health billing, and insurance administration;
new text end

new text begin (vii) job losses or gains elsewhere in the economy under the proposal due to any reduction
in insurance and administrative burdens on businesses;
new text end

new text begin (viii) impact on disparities in health care access and outcomes; and
new text end

new text begin (ix) care coordination and case management, including care management conducted by
health plan companies, to assess the costs of coordinating and navigating care for enrollees.
new text end

new text begin (b) The commissioner may provide interim reports and status updates, and shall issue a
final report by January 15, 2026, to the governor and the chairs and ranking minority
members of the legislative committees with jurisdiction over health care finance and policy.
The findings and recommendations of the report must address the feasibility and affordability
of the proposal and the projected impact of the proposal on the variables listed in paragraph
(a). The report must also include:
new text end

new text begin (1) clear documentation of the technical assumptions made to conduct the analysis;
new text end

new text begin (2) a comprehensive description of the methodological approach used;
new text end

new text begin (3) the sensitivity of results to variations in the assumptions; and
new text end

new text begin (4) the data sources and the robustness of the information used.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 20. new text begin ACTUARIAL AND ECONOMIC ANALYSES FOR PUBLIC OPTION
IMPLEMENTATION PLAN AND WAIVER.
new text end

new text begin Subdivision 1.new text end

new text begin Contracting requirement; consultation.new text end

new text begin (a) The commissioner of human
services must contract with one or more independent third-party actuarial firms, which may
include the actuarial firm that develops and certifies current MinnesotaCare rates, to perform
and certify actuarial and economic analyses of different public option models that meet the
requirements of this section.
new text end

new text begin (b) The commissioner of human services, in implementing this section, shall consult
with the commissioners of commerce and health and the Board of Directors of MNsure.
new text end

new text begin Subd. 2.new text end

new text begin Content of analyses; state-specific impacts.new text end

new text begin The actuarial and economic
analyses of public option models must include conclusions, data, and assumptions related
to:
new text end

new text begin (1) estimated 1332 waiver pass-through funding Minnesota will receive each year for
the first five years after the implementation of the public option;
new text end

new text begin (2) changes to existing federal funding and federal financing options from all sources
other than a 1332 waiver pass-through;
new text end

new text begin (3) impact on the state budget, including but not limited to any state subsidy of the public
option;
new text end

new text begin (4) impacts on enrollment, stratification of enrollee risk across plans, premiums,
cost-sharing, other enrollee costs, variety and volume of enrollee plan options, provider
network adequacy, provider reimbursement rates, and other material considerations in
medical assistance and MinnesotaCare, on an aggregated and disaggregated basis for
populations, including but not limited to populations defined by race, ethnicity, and
geography, as requested by the commissioner of human services;
new text end

new text begin (5) projected impacts on the individual health insurance market, including impacts on
enrollment, stratification of enrollee risk across plans, premiums, cost-sharing, other insured
costs, variety and volume of insured plan options, provider network adequacy, provider
reimbursement rates, and other material considerations, on an aggregated and disaggregated
basis for populations, including populations defined by race, ethnicity, and geography, as
requested by the commissioner of human services; and
new text end

new text begin (6) projected impact of changes to the risk rating of the current MinnesotaCare population,
the expected public option population, and the current individual health insurance market.
new text end

new text begin Subd. 3.new text end

new text begin Content of analyses; health and affordability.new text end

new text begin The actuarial and economic
analyses must include:
new text end

new text begin (1) the estimated affordability of premiums and cost-sharing for consumers and the
extent to which the model meets the affordability threshold in United States Code, title 26,
section 36B(b)(3)(A)(i), as indexed according to item (ii) of that section. For purposes of
this clause, "affordability" for consumers means:
new text end

new text begin (i) using a household budget approach that considers the total costs paid by consumers
for health care coverage, including the enrollee share of premiums and enrollee out-of-pocket
costs, including deductibles, co-payments, coinsurance, and other forms of cost-sharing;
new text end

new text begin (ii) minimizing premium affordability cliffs; and
new text end

new text begin (iii) considering affordability by age and geographic location; and
new text end

new text begin (2) the estimated impact on racial and ethnic disparities in rates of insurance and access
to health care services.
new text end

new text begin Subd. 4.new text end

new text begin Content of analyses; MinnesotaCare public option.new text end

new text begin The actuarial and
economic analyses must include conclusions, data, and assumptions sufficient for the
commissioners of commerce, human services, and health; the Board of Directors of MNsure;
and the legislature to evaluate different public option models, including a MinnesotaCare
public option under which MinnesotaCare continues to be administered as a basic health
program in accordance with Minnesota Statutes, section 256L.02, subdivision 5. The actuarial
and economic analyses must meet the requirements of this section.
new text end

new text begin Subd. 5.new text end

new text begin Content of analyses; 1332 waiver requirements.new text end

new text begin The actuarial and economic
analyses must include data and analyses sufficient for the commissioners of commerce,
human services, and health; the Board of Directors of MNsure; and the legislature to design
and evaluate different public option models, including but not limited to a MinnesotaCare
public option, that would receive approval under a 1332 waiver from the United States
Department of Health and Human Services and United States Department of Treasury,
including but not limited to data necessary for the actuarial firm or another independent
third-party firm to complete:
new text end

new text begin (1) actuarial analyses and actuarial certifications required to support an estimate by the
state that a proposed waiver will comply with the comprehensive coverage requirement,
the affordability requirement, and the scope of coverage requirement as described in Code
of Federal Regulations, title 45, section 155.1308; and
new text end

new text begin (2) economic analyses required to support an estimate by the state that a proposed waiver
will comply with the comprehensive coverage requirement, the affordability requirement,
the scope of coverage requirement, and the federal deficit requirement as described in Code
of Federal Regulations, title 45, section 155.1308.
new text end

new text begin Subd. 6.new text end

new text begin Content of analyses; commissioner discretion.new text end

new text begin The actuarial and economic
analyses must include all other data, information, or analyses related to a public option or
1332 waiver requested by the commissioner of human services, including potential
modifications to a MinnesotaCare public option or other public option models that may
improve one or more outcomes listed in subdivision 2 or 3.
new text end

new text begin Subd. 7.new text end

new text begin Contract exemption.new text end

new text begin The commissioner of human services is exempt from
the requirements of Minnesota Statutes, chapters 16A and 16C, when entering into a new
contract or amending an existing contract to complete the actuarial and economic analyses
required under this section.
new text end

new text begin Subd. 8.new text end

new text begin Consultation with governmental entities.new text end

new text begin The commissioners of human
services and commerce may consult with any federal or state governmental entity as
necessary to complete the actuarial and economic analyses under this section or provide a
final recommendation and implementation plan to the legislature under section 21.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 21. new text begin REPORT TO LEGISLATURE ON IMPLEMENTATION PLAN AND
WAIVER FOR PUBLIC OPTION.
new text end

new text begin By February 1, 2024, the commissioner of commerce, in consultation with the
commissioners of human services and health and the Board of Directors of MNsure, must
report the following to the chairs and ranking minority members of the legislative committees
with primary jurisdiction over health care finance and policy and health insurance:
new text end

new text begin (1) the results of the actuarial and economic analyses performed under section 20;
new text end

new text begin (2) the extent to which each public option model maximizes federal funding;
new text end

new text begin (3) additional information that the commissioner determines to be necessary to design
a public option, receive approval for a 1332 waiver from the United States Department of
Health and Human Services and United States Department of Treasury, and implement the
plan upon approval of a 1332 waiver application;
new text end

new text begin (4) the commissioner of commerce's final recommendation for a public option. The
recommendation must include a detailed description of:
new text end

new text begin (i) the health care benefit set to be provided to enrollees;
new text end

new text begin (ii) premiums and cost-sharing for enrollees across the income range, including any age
or geographic rating, after state or federal subsidies;
new text end

new text begin (iii) potential modifications to the public option that might improve one or more of the
outcomes listed in section 20, subdivision 2 or 3;
new text end

new text begin (iv) plan issuers, which may include a health plan company, governmental entity, or
other entity;
new text end

new text begin (v) plan administrators;
new text end

new text begin (vi) health care provider reimbursement rates and the availability of providers and health
care services;
new text end

new text begin (vii) adequacy of the expected provider network;
new text end

new text begin (viii) a determination of the public option's compliance with the requirements to receive
a 1332 waiver, including detailed descriptions of compliance with the requirements described
in Code of Federal Regulations, titles 45, section 155.1308, and 31, section 33.108; and
new text end

new text begin (ix) the information described in section 20, subdivision 2, as specifically determined
by using assumptions and parameters based on implementation of the final recommendation
as the public option health benefit plan; and
new text end

new text begin (5) the commissioner's final implementation plan. The implementation plan must include
a detailed description of:
new text end

new text begin (i) additional actuarial and economic analyses necessary to receive a 1332 waiver;
new text end

new text begin (ii) the 1332 waiver process and requirements;
new text end

new text begin (iii) a detailed draft timeline for the state's implementation of the proposed waiver as
described in Code of Federal Regulations, title 45, section 155.1308;
new text end

new text begin (iv) costs to the state to implement the plan, including a detailed ten-year budget plan
that is deficit neutral to the federal government as described in Code of Federal Regulations,
title 45, section 155.1308; and
new text end

new text begin (v) proposed legislation the commissioner anticipates will be necessary to implement
the public option by January 1, 2027.
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. 22. new text begin WAIVER SUBMITTAL.
new text end

new text begin (a) The commissioner of commerce is authorized to perform the steps necessary to
submit a 1332 waiver application, including but not limited to submitting the waiver
application and all other steps necessary to complete the waiver application process, based
on the final recommendation of the commissioner of commerce under section 21 if the
legislature does not enact a law by June 1, 2024, modifying the:
new text end

new text begin (1) recommendation under section 21; or
new text end

new text begin (2) commissioner of commerce's authority under this section.
new text end

new text begin (b) Upon receipt of a federal waiver and the enactment of any necessary legislation, the
commissioner of commerce shall implement a public option to be made available to
consumers beginning January 1, 2027.
new text end

new text begin (c) In implementing this section, the commissioner of commerce shall consult with the
commissioners of human services and health and the Board of Directors of MNsure.
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. 23. new text begin REPEALER.
new text end

new text begin Minnesota Statutes 2022, section 256B.0631, subdivisions 1, 2, and 3,new text end new text begin are repealed.
new text end

new text begin EFFECTIVE DATE.new text end

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

ARTICLE 17

HUMAN SERVICES POLICY

Section 1.

Minnesota Statutes 2022, section 62V.05, subdivision 4a, is amended to read:

Subd. 4a.

Background study required.

(a) The board must initiate background studies
under section 245C.031 of:

(1) each navigator;

(2) each in-person assister; and

(3) each certified application counselor.

(b) The board may initiate the background studies required by paragraph (a) using the
online NETStudy 2.0 system operated by the commissioner of human services.

(c) The board shall not permit any individual to provide any service or function listed
in paragraph (a) until deleted text begin the board has received notification from the commissioner of human
services indicating that the individualdeleted text end :

(1)new text begin the board has evaluated any notification received from the commissioner of human
services indicating the individual's potential disqualifications and has determined that the
individualnew text end is not disqualified under chapter 245C; or

(2)new text begin the board has determined that the individualnew text end is disqualifieddeleted text begin ,deleted text end but has deleted text begin receiveddeleted text end new text begin grantednew text end
a set aside deleted text begin from the boarddeleted text end of that disqualification according to sections 245C.22 and 245C.23.

(d) The board or its delegate shall review a reconsideration request of an individual in
paragraph (a), including granting a set aside, according to the procedures and criteria in
chapter 245C. The board shall notify the individual and the Department of Human Services
of the board's decision.

Sec. 2.

Minnesota Statutes 2022, section 122A.18, subdivision 8, is amended to read:

Subd. 8.

Background studies.

(a) The Professional Educator Licensing and Standards
Board and the Board of School Administrators must initiate criminal history background
studies of all first-time applicants for educator new text begin and administrator new text end licenses under their
jurisdiction. Applicants must include with their licensure applications:

(1) an executed criminal history consent form, including fingerprints; and

(2) payment to conduct the background study. The Professional Educator Licensing and
Standards Board must deposit payments received under this subdivision in an account in
the special revenue fund. Amounts in the account are annually appropriated to the
Professional Educator Licensing and Standards Board to pay for the costs of background
studies on applicants for licensure.

(b) The background study for all first-time deleted text begin teachingdeleted text end applicants fornew text begin educatornew text end licenses
must include a review of information from the Bureau of Criminal Apprehension, including
criminal history data as defined in section 13.87, and must also include a review of the
national criminal records repository. The superintendent of the Bureau of Criminal
Apprehension is authorized to exchange fingerprints with the Federal Bureau of Investigation
for purposes of the criminal history check.

(c) The Professional Educator Licensing and Standards Board may initiate criminal
history background studies through the commissioner of human services according to section
245C.031 to obtain background study data required under this chapter.

Sec. 3.

Minnesota Statutes 2022, section 245.4661, subdivision 9, is amended to read:

Subd. 9.

Services and programs.

(a) The following three distinct grant programs are
funded under this section:

(1) mental health crisis services;

(2) housing with supports for adults with serious mental illness; and

(3) projects for assistance in transitioning from homelessness (PATH program).

(b) In addition, the following are eligible for grant funds:

(1) community education and prevention;

(2) client outreach;

(3) early identification and intervention;

(4) adult outpatient diagnostic assessment and psychological testing;

(5) peer support services;

(6) community support program services (CSP);

(7) adult residential crisis stabilization;

(8) supported employment;

(9) assertive community treatment (ACT);

(10) housing subsidies;

(11) basic living, social skills, and community intervention;

(12) emergency response services;

(13) adult outpatient psychotherapy;

(14) adult outpatient medication management;

(15) adult mobile crisis services;

(16) adult day treatment;

(17) partial hospitalization;

(18) adult residential treatment;

(19) adult mental health targeted case management;new text begin and
new text end

deleted text begin (20) intensive community rehabilitative services (ICRS); and
deleted text end

deleted text begin (21)deleted text end new text begin (20)new text end transportation.

Sec. 4.

Minnesota Statutes 2022, section 245.469, subdivision 3, is amended to read:

Subd. 3.

Mental health crisis services.

The commissioner of human services shall
increase access to mental health crisis services for children and adults. In order to increase
access, the commissioner must:

(1) develop a central phone number where calls can be routed to the appropriate crisis
services;

(2) provide telephone consultation 24 hours a day to mobile crisis teams who are serving
people with traumatic brain injury or intellectual disabilities who are experiencing a mental
health crisis;

(3) expand crisis services across the state, including rural areas of the state and examining
access per population;

(4) establish and implement state standardsnew text begin and requirementsnew text end for crisis servicesnew text begin as outlined
in section 256B.0624new text end ; and

(5) provide grants to adult mental health initiatives, counties, tribes, or community mental
health providers to establish new mental health crisis residential service capacity.

Priority will be given to regions that do not have a mental health crisis residential services
program, do not have an inpatient psychiatric unit within the region, do not have an inpatient
psychiatric unit within 90 miles, or have a demonstrated need based on the number of crisis
residential or intensive residential treatment beds available to meet the needs of the residents
in the region. At least 50 percent of the funds must be distributed to programs in rural
Minnesota. Grant funds may be used for start-up costs, including but not limited to
renovations, furnishings, and staff training. Grant applications shall provide details on how
the intended service will address identified needs and shall demonstrate collaboration with
crisis teams, other mental health providers, hospitals, and police.

new text begin EFFECTIVE DATE.new text end

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

Sec. 5.

new text begin [245.4906] MENTAL HEALTH CERTIFIED PEER SPECIALIST GRANT
PROGRAM.
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 must establish a
mental health certified peer specialist grant program to provide funding for the training of
mental health certified peer specialists who provide services to support individuals with
lived experience of mental illness under section 256B.0615.
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 licensed entity or provider who
employs a mental health certified peer specialist qualified under section 245I.04, subdivision
10, and who provides services to individuals receiving assertive community treatment or
intensive residential treatment services under section 256B.0622, adult rehabilitative mental
health services under section 256B.0623, or crisis response services under section 256B.0624.
new text end

new text begin Subd. 3.new text end

new text begin Allowable grant activities.new text end

new text begin Grantees must use grant funding to provide training
for mental health certified peer specialists as specified in section 256B.0615, subdivision
5.
new text end

new text begin Subd. 4.new text end

new text begin Outcomes.new text end

new text begin (a) Grantees must provide an annual report to the commissioner
for the purposes of evaluating the effectiveness of the grant program. The report must
include:
new text end

new text begin (1) the number of mental health certified peer specialists who received training using
the grant funds under this section; and
new text end

new text begin (2) the extent to which individuals receiving peer services experienced progress on
achieving treatment goals and experienced a reduction in hospital admissions.
new text end

new text begin (b) The commissioner must submit the results of the evaluation to the chairs and ranking
minority members of the legislative committees with jurisdiction over mental health.
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. 6.

new text begin [245.4907] MENTAL HEALTH CERTIFIED FAMILY PEER SPECIALIST
GRANT PROGRAM.
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 must establish a
mental health certified peer family specialist grant program to provide funding for training
for mental health certified peer family specialists who provide services to support individuals
with lived experience of mental illness under section 256B.0616.
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 licensed entity or provider who
employs a mental health certified peer family specialist qualified under section 245I.04,
subdivision 12, and who provides services to families who have a child:
new text end

new text begin (1) with an emotional disturbance or severe emotional disturbance under chapter 245;
new text end

new text begin (2) receiving inpatient hospitalization under section 256B.0625, subdivision 1;
new text end

new text begin (3) admitted to a residential treatment facility under section 245.4882;
new text end

new text begin (4) receiving children's intensive behavioral health services under section 256B.0946;
new text end

new text begin (5) receiving day treatment or children's therapeutic services and supports under section
256B.0943; or
new text end

new text begin (6) receiving crisis response services under section 256B.0624.
new text end

new text begin Subd. 3.new text end

new text begin Allowable grant activities.new text end

new text begin Grantees must use grant funding to provide training
for mental health certified family peer specialists as specified in section 256B.0616,
subdivision 5.
new text end

new text begin Subd. 4.new text end

new text begin Outcomes.new text end

new text begin (a) Grantees must provide an annual report to the commissioner
for the purposes of evaluating the effectiveness of the grant program. The report must
include:
new text end

new text begin (1) the number of mental health certified peer specialists who received training using
the grant funds under this section; and
new text end

new text begin (2) the extent to which individuals receiving family peer services experienced progress
on achieving treatment goals and experienced a reduction in hospital admissions.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 7.

new text begin [245.991] PROJECTS FOR ASSISTANCE IN TRANSITION FROM
HOMELESSNESS PROGRAM.
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 must establish
projects for assistance in transition from homelessness program to prevent or end
homelessness for people with serious mental illness or co-occurring substance use disorder
and ensure the commissioner achieves the goals of the housing mission statement in section
245.461, subdivision 4.
new text end

new text begin Subd. 2.new text end

new text begin Eligible applicants.new text end

new text begin An applicant for a grant under this section must be a
nonprofit organization, county, or other entity who provides services to help individuals
transition from homelessness.
new text end

new text begin Subd. 3.new text end

new text begin Allowable grant activities.new text end

new text begin Grantees must provide homeless outreach and case
management services. Projects may provide clinical assessment, habilitation and rehabilitation
services, community mental health services, substance use disorder treatment, housing
transition and sustaining services, or direct assistance funding. Services must be provided
to individuals with a serious mental illness, or with a co-occurring substance use disorder,
and who are homeless or at imminent risk of homelessness. Individuals receiving homeless
outreach services may be presumed eligible until a serious mental illness can be verified.
new text end

new text begin Subd. 4.new text end

new text begin Outcomes.new text end

new text begin (a) Grantees must submit an annual report to the commissioner for
the purposes of evaluating the effectiveness of the grant program. The report must include:
new text end

new text begin (1) the number of individuals to whom the grantee provided homeless outreach services;
new text end

new text begin (2) the number of individuals the grantee enrolled in case management services;
new text end

new text begin (3) the number of individuals that were able to access mental health and substance use
disorder treatment services; and
new text end

new text begin (4) the number of individuals that were able to transition from homelessness to housing.
new text end

new text begin Subd. 5.new text end

new text begin Federal aid or grants.new text end

new text begin The commissioner of human services must comply with
all conditions and requirements necessary to receive federal aid or grants with respect to
homeless services or programs as specified in section 245.70.
new text end

new text begin EFFECTIVE DATE.new text end

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

Sec. 8.

new text begin [245.992] HOUSING WITH SUPPORT FOR ADULTS WITH SERIOUS
MENTAL ILLNESS PROGRAM.
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 must establish a
housing with support for adults with serious mental illness program to prevent or end
homelessness for people with serious mental illness, to increase the availability of housing
with support, and to ensure the commissioner may achieve the goals of the housing mission
statement in section 245.461, subdivision 4.
new text end

new text begin Subd. 2.new text end

new text begin Eligible applicants.new text end

new text begin Program activities must be provided to people with a
serious mental illness, or with a co-occurring substance use disorder, who meet homeless
criteria determined by the commissioner.
new text end

new text begin Subd. 3.new text end

new text begin Allowable grant activities.new text end

new text begin Grantees must provide a range of activities and
supportive services that ensure individuals obtain and retain permanent supportive housing.
Program activities may include case management, site-based housing services, housing
transition and sustaining services, outreach services, community support services, or direct
assistance funding.
new text end

new text begin Subd. 4.new text end

new text begin Outcomes.new text end

new text begin (a) Grantees must submit an annual report to the commissioner for
the purposes of evaluating the effectiveness of the grant program. The report must include:
new text end

new text begin (1) whether the grantee's housing and activities utilized evidence-based practices;
new text end

new text begin (2) the number of individuals that were able to transition from homelessness to housing;
new text end

new text begin (3) the number of individuals that were able to retain housing; and
new text end

new text begin (4) whether the individuals were satisfied with their housing.
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. 9.

Minnesota Statutes 2022, section 245A.02, subdivision 5a, is amended to read:

Subd. 5a.

Controlling individual.

(a) "Controlling individual" means an owner of a
program or service provider licensed under this chapter and the following individuals, if
applicable:

(1) each officer of the organization, including the chief executive officer and chief
financial officer;

(2) the individual designated as the authorized agent under section 245A.04, subdivision
1, paragraph (b);

(3) the individual designated as the compliance officer under section 256B.04, subdivision
21, paragraph (g);

(4) each managerial official whose responsibilities include the direction of the
management or policies of a program; deleted text begin and
deleted text end

(5) the individual designated as the primary provider of care for a special family child
care program under section 245A.14, subdivision 4, paragraph (i)deleted text begin .deleted text end new text begin ; and
new text end

new text begin (6) the president and treasurer of the board of directors of a nonprofit corporation.
new text end

(b) Controlling individual does not include:

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

(2) an individual who is a state or federal official, or state or federal employee, or a
member or employee of the governing body of a political subdivision of the state or federal
government that operates one or more programs, unless the individual is also an officer,
owner, or managerial official of the program, receives remuneration from the program, or
owns any of the beneficial interests not excluded in this subdivision;

(3) an individual who owns less than five percent of the outstanding common shares of
a corporation:

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

(ii) whose transactions are exempt under section 80A.46, clause (2);

(4) an individual who is a member of an organization exempt from taxation under section
290.05, unless the individual is also an officer, owner, or managerial official of the program
or owns any of the beneficial interests not excluded in this subdivision. This clause does
not exclude from the definition of controlling individual an organization that is exempt from
taxation; or

(5) an employee stock ownership plan trust, or a participant or board member of an
employee stock ownership plan, unless the participant or board member is a controlling
individual according to paragraph (a).

(c) For purposes of this subdivision, "managerial official" means an individual who has
the decision-making authority related to the operation of the program, and the responsibility
for the ongoing management of or direction of the policies, services, or employees of the
program. A site director who has no ownership interest in the program is not considered to
be a managerial official for purposes of this definition.

Sec. 10.

Minnesota Statutes 2022, section 245A.02, subdivision 10b, is amended to read:

Subd. 10b.

Owner.

"Owner" means an individual or organization that has a direct or
indirect ownership interest of five percent or more in a program licensed under this chapter.
For purposes of this subdivision, "direct ownership interest" means the possession of equity
in capital, stock, or profits of an organization, and "indirect ownership interest" means a
direct ownership interest in an entity that has a direct or indirect ownership interest in a
licensed program. For purposes of this chapter, "owner of deleted text begin a nonprofit corporation" means
the president and treasurer of the board of directors or, for an entity owned bydeleted text end an employee
stock ownership plandeleted text begin ,deleted text end new text begin "new text end means the president and treasurer of the entity. A government entitynew text begin
or nonprofit corporationnew text end that is issued a license under this chapter shall be designated the
owner.

Sec. 11.

Minnesota Statutes 2022, section 245A.04, subdivision 1, is amended to read:

Subdivision 1.

Application for licensure.

(e) The commissioner may limit communication during the application process to the
authorized agent or the controlling individuals identified on the license application and for
whom a background study was initiated under chapter 245C. The commissioner may require
the applicant, except for child foster care, to demonstrate competence in the applicable
licensing requirements by successfully completing a written examination. The commissioner
may develop a prescribed written examination format.