Minnesota Legislature
SF 2995
2nd Engrossment - 93rd Legislature (2023 - 2024) Posted on 04/20/2023 08:45am
3.38 3.39
3.40 3.41 3.42 3.43 3.44 3.45 3.46 3.47 3.48 4.1 4.2 4.3
4.4 4.5 4.6 4.7 4.8 4.9 4.10 4.11 4.12 4.13 4.14 4.15 4.16
4.17
4.18 4.19 4.20 4.21 4.22 4.23 4.24 4.25 4.26 4.27 4.28 4.29 4.30 4.31 4.32 5.1 5.2 5.3 5.4 5.5 5.6 5.7 5.8 5.9 5.10 5.11 5.12 5.13 5.14 5.15 5.16 5.17 5.18 5.19 5.20 5.21 5.22 5.23 5.24 5.25 5.26 5.27 5.28 5.29 5.30 5.31 5.32 5.33 6.1 6.2 6.3 6.4 6.5 6.6 6.7 6.8 6.9 6.10 6.11 6.12 6.13 6.14 6.15 6.16 6.17 6.18 6.19 6.20 6.21 6.22 6.23 6.24 6.25 6.26 6.27 6.28 6.29 6.30 6.31 6.32 6.33 7.1 7.2 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 7.11 7.12 7.13 7.14 7.15 7.16 7.17 7.18 7.19 7.20 7.21 7.22 7.23 7.24 7.25 7.26 7.27 7.28 7.29 7.30 7.31 7.32 7.33 7.34 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16 8.17 8.18 8.19 8.20 8.21 8.22 8.23 8.24 8.25 8.26 8.27 8.28
8.29 8.30 8.31 8.32 9.1 9.2 9.3 9.4 9.5 9.6 9.7 9.8 9.9 9.10 9.11 9.12 9.13 9.14 9.15 9.16 9.17 9.18 9.19 9.20 9.21 9.22 9.23 9.24 9.25 9.26 9.27 9.28 9.29 9.30 9.31 9.32 10.1 10.2 10.3 10.4 10.5 10.6 10.7 10.8 10.9 10.10 10.11 10.12 10.13 10.14 10.15 10.16 10.17 10.18 10.19 10.20 10.21 10.22 10.23 10.24 10.25 10.26 10.27 10.28 10.29 10.30 10.31 10.32 10.33 11.1 11.2 11.3 11.4 11.5 11.6 11.7 11.8 11.9 11.10
11.11 11.12 11.13 11.14
11.15 11.16 11.17 11.18 11.19 11.20 11.21 11.22 11.23 11.24 11.25 11.26
11.27
11.28 11.29 11.30 11.31 11.32 12.1 12.2 12.3 12.4
12.5
12.6 12.7 12.8 12.9 12.10 12.11 12.12 12.13 12.14 12.15 12.16
12.17
12.18 12.19 12.20 12.21 12.22 12.23 12.24 12.25 12.26 12.27 12.28 12.29 13.1 13.2 13.3 13.4 13.5 13.6 13.7 13.8 13.9 13.10 13.11 13.12 13.13 13.14 13.15 13.16 13.17 13.18 13.19 13.20 13.21 13.22 13.23 13.24 13.25 13.26 13.27 13.28 13.29 14.1 14.2 14.3 14.4 14.5 14.6 14.7 14.8 14.9 14.10 14.11
14.12 14.13 14.14
14.15 14.16 14.17 14.18 14.19 14.20 14.21 14.22 14.23 14.24 14.25 14.26 14.27 14.28 14.29 14.30 14.31 14.32 14.33 15.1 15.2 15.3 15.4 15.5 15.6 15.7 15.8 15.9 15.10 15.11 15.12 15.13 15.14 15.15 15.16 15.17 15.18 15.19 15.20 15.21 15.22 15.23 15.24 15.25 15.26 15.27 15.28 15.29 15.30 15.31 15.32 15.33 15.34 16.1 16.2 16.3 16.4 16.5 16.6 16.7 16.8 16.9 16.10 16.11 16.12 16.13 16.14 16.15 16.16 16.17
16.18 16.19
16.20 16.21 16.22 16.23 16.24 16.25 16.26 16.27 16.28 16.29 16.30 16.31 16.32 16.33 16.34 17.1 17.2 17.3 17.4 17.5 17.6 17.7 17.8 17.9 17.10 17.11 17.12 17.13 17.14 17.15 17.16
17.17
17.18 17.19 17.20 17.21 17.22 17.23 17.24 17.25 17.26 17.27 17.28 17.29 17.30 17.31 17.32 17.33 17.34 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 18.9 18.10 18.11 18.12 18.13 18.14 18.15 18.16 18.17 18.18 18.19 18.20 18.21 18.22 18.23 18.24 18.25 18.26 18.27 18.28 18.29 18.30 18.31 18.32 19.1 19.2 19.3 19.4 19.5 19.6 19.7
19.8 19.9 19.10 19.11 19.12 19.13 19.14 19.15 19.16 19.17 19.18 19.19 19.20 19.21 19.22 19.23 19.24 19.25 19.26 19.27 19.28 19.29 19.30 19.31 19.32 19.33 20.1 20.2 20.3 20.4 20.5 20.6 20.7 20.8 20.9 20.10 20.11 20.12 20.13 20.14 20.15 20.16 20.17 20.18 20.19 20.20 20.21 20.22 20.23 20.24
20.25 20.26 20.27 20.28 20.29 20.30 20.31 20.32
21.1 21.2 21.3
21.4 21.5 21.6 21.7 21.8 21.9 21.10 21.11 21.12 21.13 21.14 21.15 21.16 21.17 21.18 21.19 21.20 21.21 21.22 21.23 21.24 21.25 21.26 21.27 21.28 21.29 21.30 21.31 21.32 21.33 22.1 22.2 22.3 22.4 22.5 22.6 22.7 22.8 22.9 22.10 22.11 22.12 22.13 22.14 22.15 22.16 22.17 22.18 22.19 22.20 22.21 22.22 22.23 22.24 22.25 22.26 22.27 22.28 22.29 22.30 22.31 22.32 23.1 23.2 23.3 23.4 23.5 23.6 23.7 23.8 23.9 23.10 23.11 23.12 23.13 23.14 23.15 23.16 23.17 23.18 23.19 23.20 23.21 23.22 23.23 23.24 23.25 23.26 23.27 23.28 23.29 23.30 23.31 23.32 23.33 23.34 24.1 24.2 24.3 24.4 24.5 24.6 24.7 24.8 24.9 24.10 24.11 24.12 24.13 24.14 24.15 24.16 24.17 24.18 24.19 24.20 24.21 24.22 24.23 24.24 24.25 24.26 24.27 24.28 24.29 24.30 25.1 25.2 25.3 25.4 25.5 25.6 25.7 25.8 25.9 25.10 25.11 25.12 25.13 25.14 25.15 25.16 25.17 25.18 25.19 25.20 25.21 25.22 25.23 25.24 25.25 25.26 25.27 25.28 25.29 25.30 25.31 25.32 26.1 26.2 26.3 26.4 26.5 26.6 26.7 26.8 26.9 26.10 26.11 26.12 26.13 26.14 26.15 26.16 26.17 26.18 26.19 26.20 26.21 26.22 26.23 26.24 26.25 26.26 26.27 26.28 26.29 26.30 26.31 26.32 26.33 26.34 27.1 27.2 27.3 27.4 27.5 27.6 27.7 27.8 27.9 27.10 27.11 27.12 27.13 27.14 27.15 27.16 27.17 27.18 27.19 27.20 27.21
27.22 27.23 27.24
27.25 27.26 27.27 27.28 27.29 27.30 27.31 27.32 28.1 28.2 28.3 28.4 28.5 28.6 28.7 28.8 28.9 28.10 28.11 28.12 28.13 28.14 28.15 28.16 28.17 28.18 28.19 28.20 28.21 28.22 28.23 28.24 28.25 28.26 28.27 28.28 28.29 28.30 28.31 29.1 29.2 29.3 29.4 29.5 29.6 29.7 29.8 29.9 29.10 29.11 29.12 29.13 29.14 29.15 29.16 29.17 29.18 29.19 29.20 29.21 29.22 29.23 29.24
29.25 29.26 29.27
29.28 29.29 29.30 29.31 29.32 30.1 30.2 30.3 30.4 30.5 30.6 30.7 30.8 30.9 30.10 30.11 30.12 30.13 30.14
30.15 30.16 30.17
30.18 30.19 30.20 30.21 30.22
30.23 30.24 30.25
30.26 30.27 30.28 30.29
30.30
31.1 31.2 31.3 31.4 31.5 31.6 31.7 31.8 31.9 31.10 31.11 31.12 31.13 31.14
31.15
31.16 31.17 31.18 31.19 31.20 31.21 31.22 31.23 31.24 31.25 31.26 31.27 31.28 31.29
31.30 31.31 31.32
32.1 32.2 32.3 32.4 32.5 32.6 32.7 32.8 32.9 32.10 32.11 32.12 32.13 32.14 32.15 32.16 32.17 32.18 32.19 32.20 32.21 32.22 32.23 32.24 32.25 32.26 32.27 32.28 32.29 32.30
32.31
33.1 33.2 33.3 33.4 33.5 33.6 33.7 33.8 33.9 33.10 33.11 33.12 33.13 33.14 33.15 33.16 33.17 33.18 33.19 33.20 33.21 33.22 33.23 33.24 33.25 33.26 33.27 33.28 33.29 33.30 34.1 34.2 34.3 34.4 34.5 34.6 34.7 34.8 34.9 34.10 34.11 34.12 34.13 34.14 34.15 34.16 34.17 34.18 34.19 34.20 34.21 34.22 34.23 34.24 34.25 34.26 34.27 34.28 34.29 34.30 34.31 35.1 35.2 35.3 35.4 35.5 35.6 35.7 35.8 35.9 35.10 35.11 35.12 35.13 35.14 35.15 35.16 35.17 35.18 35.19
35.20
35.21 35.22 35.23 35.24 35.25 35.26 35.27 35.28 35.29 35.30 35.31 35.32 36.1 36.2 36.3 36.4 36.5 36.6 36.7 36.8 36.9 36.10 36.11 36.12 36.13 36.14 36.15 36.16 36.17 36.18 36.19 36.20 36.21 36.22 36.23 36.24 36.25 36.26 36.27 36.28 36.29 36.30 36.31 36.32 36.33 36.34 36.35 37.1 37.2 37.3 37.4 37.5 37.6 37.7 37.8 37.9 37.10 37.11 37.12 37.13 37.14 37.15 37.16 37.17 37.18 37.19 37.20 37.21 37.22 37.23 37.24 37.25 37.26 37.27 37.28 37.29 37.30 37.31 37.32 37.33 37.34 37.35 38.1 38.2 38.3 38.4 38.5 38.6 38.7 38.8 38.9 38.10 38.11 38.12 38.13 38.14 38.15 38.16 38.17 38.18 38.19 38.20 38.21 38.22 38.23
38.24
38.25 38.26 38.27 38.28 38.29 38.30 38.31 38.32 38.33 39.1 39.2 39.3 39.4 39.5 39.6 39.7 39.8 39.9 39.10 39.11 39.12 39.13 39.14 39.15 39.16 39.17 39.18 39.19 39.20 39.21 39.22 39.23 39.24 39.25 39.26 39.27 39.28 39.29 39.30 39.31 40.1 40.2 40.3 40.4 40.5 40.6 40.7 40.8 40.9 40.10 40.11 40.12 40.13 40.14 40.15 40.16 40.17 40.18 40.19 40.20 40.21 40.22 40.23 40.24 40.25
40.26
40.27 40.28 40.29 40.30 40.31 40.32 40.33 41.1 41.2 41.3 41.4 41.5 41.6 41.7 41.8 41.9 41.10 41.11 41.12 41.13 41.14 41.15 41.16 41.17 41.18 41.19 41.20 41.21 41.22 41.23 41.24 41.25 41.26 41.27 41.28 41.29 41.30 41.31 41.32 41.33 41.34 41.35 42.1 42.2 42.3 42.4 42.5 42.6 42.7 42.8 42.9 42.10 42.11 42.12 42.13 42.14 42.15 42.16 42.17 42.18 42.19 42.20 42.21 42.22 42.23 42.24 42.25 42.26 42.27 42.28 42.29 42.30 42.31 42.32 42.33 42.34 42.35 43.1 43.2 43.3 43.4 43.5 43.6 43.7 43.8 43.9 43.10 43.11 43.12 43.13 43.14 43.15 43.16 43.17 43.18 43.19 43.20 43.21 43.22 43.23 43.24 43.25 43.26 43.27 43.28 43.29 43.30 43.31 43.32 43.33 43.34 44.1 44.2 44.3 44.4 44.5 44.6 44.7 44.8 44.9 44.10 44.11 44.12 44.13 44.14 44.15 44.16 44.17 44.18 44.19 44.20 44.21 44.22 44.23 44.24 44.25 44.26 44.27 44.28 44.29 44.30 44.31 44.32 44.33 45.1 45.2
45.3
45.4 45.5 45.6 45.7 45.8 45.9 45.10 45.11 45.12 45.13 45.14 45.15 45.16 45.17 45.18 45.19 45.20 45.21 45.22 45.23 45.24 45.25 45.26 45.27 45.28 45.29 45.30 45.31 45.32 45.33 46.1 46.2 46.3 46.4 46.5 46.6 46.7 46.8 46.9 46.10 46.11 46.12 46.13
46.14 46.15 46.16 46.17 46.18 46.19
46.20 46.21 46.22 46.23 46.24 46.25 46.26 46.27 46.28 46.29 46.30 46.31 46.32 46.33
47.1
47.2 47.3 47.4 47.5 47.6 47.7 47.8 47.9 47.10 47.11 47.12 47.13 47.14 47.15
47.16
47.17 47.18 47.19 47.20 47.21 47.22 47.23 47.24 47.25 47.26 47.27 47.28 47.29 47.30 47.31 48.1 48.2 48.3 48.4 48.5 48.6 48.7 48.8 48.9 48.10 48.11 48.12 48.13 48.14 48.15 48.16 48.17 48.18 48.19 48.20 48.21 48.22 48.23 48.24 48.25 48.26 48.27 48.28 48.29 48.30 48.31 48.32 49.1 49.2
49.3
49.4 49.5 49.6 49.7 49.8 49.9 49.10 49.11 49.12 49.13 49.14 49.15 49.16 49.17 49.18 49.19 49.20 49.21 49.22 49.23 49.24 49.25 49.26 49.27 49.28 49.29 49.30
49.31
50.1 50.2 50.3 50.4 50.5 50.6 50.7 50.8 50.9
50.10
50.11 50.12 50.13 50.14 50.15 50.16 50.17 50.18 50.19 50.20 50.21 50.22 50.23 50.24 50.25 50.26 50.27 50.28 50.29 50.30 50.31 50.32 50.33 50.34 51.1 51.2 51.3 51.4 51.5 51.6 51.7 51.8 51.9 51.10 51.11 51.12 51.13 51.14 51.15 51.16 51.17 51.18 51.19 51.20 51.21 51.22 51.23 51.24 51.25 51.26 51.27 51.28 51.29 51.30 51.31 51.32 51.33 52.1 52.2
52.3 52.4 52.5 52.6
52.7 52.8 52.9 52.10 52.11 52.12 52.13 52.14
52.15
52.16 52.17 52.18 52.19 52.20 52.21 52.22 52.23 52.24 52.25 52.26 52.27 52.28 52.29 52.30 53.1 53.2 53.3 53.4 53.5 53.6 53.7 53.8 53.9 53.10 53.11 53.12 53.13 53.14 53.15 53.16 53.17 53.18 53.19 53.20 53.21 53.22 53.23 53.24 53.25 53.26 53.27 53.28 53.29 53.30 53.31 53.32 53.33 53.34 54.1 54.2 54.3 54.4 54.5 54.6 54.7 54.8 54.9 54.10 54.11 54.12 54.13 54.14 54.15 54.16 54.17 54.18 54.19 54.20 54.21 54.22 54.23 54.24 54.25 54.26 54.27 54.28 54.29 54.30 54.31 55.1 55.2 55.3 55.4 55.5 55.6 55.7 55.8 55.9 55.10 55.11 55.12 55.13 55.14 55.15 55.16 55.17 55.18 55.19 55.20 55.21 55.22 55.23 55.24 55.25 55.26 55.27 55.28 55.29 55.30 55.31 55.32 55.33 56.1 56.2 56.3 56.4 56.5 56.6 56.7 56.8 56.9 56.10 56.11 56.12 56.13 56.14 56.15 56.16 56.17 56.18 56.19 56.20 56.21 56.22 56.23 56.24 56.25 56.26 56.27 56.28 56.29 56.30 56.31 56.32 56.33 56.34 57.1 57.2 57.3 57.4 57.5 57.6 57.7 57.8 57.9 57.10 57.11 57.12 57.13 57.14 57.15 57.16 57.17 57.18 57.19 57.20 57.21 57.22 57.23 57.24 57.25 57.26 57.27 57.28 57.29 57.30 57.31 58.1 58.2 58.3 58.4 58.5 58.6 58.7 58.8 58.9 58.10 58.11 58.12 58.13 58.14 58.15 58.16 58.17 58.18 58.19 58.20 58.21 58.22 58.23 58.24 58.25 58.26 58.27 58.28 58.29 58.30 58.31 58.32 58.33 58.34 58.35 59.1 59.2 59.3 59.4 59.5 59.6 59.7 59.8 59.9 59.10 59.11 59.12 59.13 59.14 59.15 59.16 59.17 59.18 59.19 59.20 59.21 59.22 59.23 59.24 59.25 59.26 59.27 59.28 59.29 59.30 59.31 60.1 60.2 60.3 60.4 60.5 60.6 60.7 60.8 60.9 60.10 60.11 60.12 60.13 60.14 60.15 60.16 60.17 60.18 60.19 60.20 60.21 60.22 60.23 60.24
60.25 60.26 60.27
60.28 60.29 60.30 60.31 60.32 61.1 61.2 61.3 61.4 61.5 61.6 61.7 61.8 61.9 61.10 61.11 61.12 61.13 61.14 61.15 61.16 61.17 61.18 61.19 61.20 61.21 61.22 61.23 61.24 61.25 61.26 61.27 61.28 61.29 61.30 61.31 61.32 61.33 61.34 61.35 62.1 62.2 62.3 62.4 62.5 62.6 62.7 62.8 62.9 62.10 62.11 62.12 62.13 62.14 62.15
62.16 62.17 62.18 62.19 62.20 62.21 62.22 62.23 62.24 62.25 62.26 62.27 62.28 62.29 62.30 62.31
63.1 63.2 63.3 63.4 63.5 63.6 63.7 63.8 63.9 63.10 63.11 63.12 63.13 63.14 63.15 63.16 63.17
63.18 63.19 63.20
63.21 63.22 63.23 63.24 63.25 63.26 63.27 63.28 63.29 63.30 63.31 64.1 64.2 64.3 64.4
64.5 64.6 64.7 64.8 64.9 64.10 64.11 64.12 64.13 64.14 64.15 64.16 64.17 64.18 64.19
64.20 64.21
64.22 64.23 64.24 64.25 64.26 64.27 64.28 64.29 64.30 64.31 64.32 64.33 65.1 65.2 65.3 65.4 65.5 65.6 65.7 65.8 65.9 65.10 65.11
65.12 65.13 65.14 65.15 65.16 65.17 65.18 65.19 65.20 65.21 65.22 65.23 65.24 65.25 65.26 65.27 65.28 65.29 65.30 65.31 66.1 66.2 66.3 66.4 66.5 66.6 66.7 66.8 66.9 66.10 66.11 66.12 66.13 66.14 66.15 66.16 66.17 66.18 66.19 66.20 66.21 66.22 66.23 66.24 66.25 66.26 66.27 66.28 66.29 66.30 66.31 66.32 67.1 67.2 67.3
67.4 67.5
67.6 67.7 67.8 67.9 67.10 67.11 67.12 67.13 67.14 67.15 67.16 67.17 67.18 67.19 67.20 67.21 67.22 67.23 67.24 67.25 67.26 67.27 67.28 67.29 67.30 67.31 67.32 67.33 68.1 68.2 68.3 68.4 68.5 68.6 68.7 68.8 68.9 68.10 68.11 68.12 68.13 68.14 68.15 68.16 68.17 68.18 68.19 68.20 68.21 68.22 68.23 68.24 68.25 68.26 68.27 68.28 68.29 68.30 68.31 68.32 68.33 68.34 69.1 69.2
69.3 69.4 69.5 69.6 69.7 69.8 69.9 69.10
69.11 69.12
69.13 69.14 69.15 69.16 69.17 69.18 69.19 69.20 69.21 69.22 69.23 69.24 69.25 69.26 69.27
69.28 69.29
70.1 70.2 70.3 70.4 70.5 70.6
70.7 70.8
70.9 70.10 70.11 70.12 70.13 70.14 70.15
70.16 70.17
70.18 70.19 70.20 70.21 70.22 70.23 70.24 70.25 70.26 70.27 70.28 70.29 70.30 71.1 71.2 71.3 71.4 71.5 71.6 71.7 71.8 71.9 71.10 71.11 71.12 71.13 71.14 71.15 71.16 71.17 71.18 71.19 71.20 71.21 71.22 71.23 71.24 71.25 71.26 71.27 71.28 71.29
71.30 71.31 71.32 71.33 72.1 72.2 72.3 72.4 72.5 72.6 72.7 72.8 72.9
72.10 72.11
72.12 72.13 72.14 72.15 72.16 72.17 72.18 72.19 72.20 72.21 72.22 72.23 72.24 72.25 72.26 72.27 72.28 72.29 72.30 72.31 72.32 73.1 73.2 73.3 73.4 73.5 73.6 73.7 73.8 73.9 73.10 73.11 73.12 73.13 73.14 73.15 73.16 73.17 73.18 73.19 73.20 73.21 73.22 73.23 73.24 73.25 73.26 73.27 73.28 73.29 73.30 73.31 73.32 73.33
74.1 74.2 74.3 74.4 74.5 74.6 74.7 74.8 74.9 74.10 74.11 74.12 74.13 74.14 74.15 74.16 74.17 74.18 74.19 74.20 74.21 74.22 74.23 74.24 74.25 74.26
74.27
74.28 74.29 74.30 74.31 75.1 75.2 75.3 75.4 75.5 75.6 75.7 75.8 75.9 75.10 75.11 75.12 75.13 75.14 75.15 75.16 75.17 75.18 75.19 75.20 75.21 75.22 75.23 75.24 75.25 75.26 75.27 75.28 75.29 75.30 75.31 75.32 76.1 76.2
76.3 76.4 76.5 76.6 76.7 76.8 76.9 76.10 76.11 76.12 76.13 76.14 76.15 76.16 76.17 76.18 76.19 76.20 76.21 76.22 76.23 76.24 76.25 76.26 76.27 76.28 76.29 76.30
77.1 77.2 77.3 77.4 77.5 77.6 77.7 77.8 77.9 77.10 77.11 77.12 77.13 77.14 77.15 77.16 77.17 77.18 77.19 77.20 77.21 77.22 77.23 77.24 77.25 77.26 77.27 77.28 77.29 77.30 78.1 78.2 78.3 78.4 78.5 78.6 78.7 78.8 78.9 78.10 78.11 78.12 78.13 78.14 78.15 78.16 78.17 78.18 78.19 78.20 78.21 78.22 78.23 78.24 78.25 78.26 78.27 78.28 78.29 78.30 78.31 79.1 79.2 79.3 79.4 79.5 79.6 79.7 79.8 79.9 79.10 79.11 79.12 79.13 79.14 79.15 79.16 79.17 79.18 79.19
79.20 79.21 79.22 79.23 79.24 79.25 79.26 79.27 79.28 79.29 79.30 79.31 79.32 80.1 80.2 80.3 80.4 80.5 80.6 80.7 80.8 80.9 80.10 80.11 80.12 80.13 80.14 80.15 80.16 80.17 80.18 80.19 80.20 80.21 80.22 80.23 80.24 80.25 80.26 80.27 80.28 80.29 80.30 80.31 80.32 81.1 81.2 81.3 81.4 81.5 81.6 81.7 81.8 81.9 81.10 81.11 81.12 81.13 81.14 81.15 81.16 81.17 81.18 81.19 81.20 81.21 81.22
81.23 81.24 81.25 81.26 81.27 81.28 81.29 81.30 81.31 81.32 82.1 82.2 82.3 82.4 82.5 82.6 82.7 82.8 82.9 82.10 82.11 82.12 82.13 82.14 82.15 82.16 82.17 82.18 82.19 82.20 82.21 82.22 82.23 82.24 82.25 82.26 82.27 82.28 82.29 82.30 83.1 83.2 83.3 83.4 83.5 83.6 83.7 83.8 83.9 83.10 83.11 83.12 83.13 83.14
83.15 83.16 83.17 83.18 83.19 83.20 83.21 83.22 83.23 83.24 83.25 83.26 83.27 83.28 83.29 83.30 83.31 84.1 84.2 84.3 84.4 84.5 84.6 84.7 84.8 84.9 84.10 84.11 84.12 84.13
84.14 84.15 84.16 84.17 84.18 84.19 84.20 84.21 84.22 84.23 84.24 84.25 84.26 84.27 84.28 84.29 84.30 85.1 85.2 85.3 85.4 85.5 85.6 85.7 85.8 85.9 85.10 85.11 85.12 85.13 85.14 85.15 85.16 85.17 85.18 85.19 85.20 85.21 85.22
85.23 85.24 85.25 85.26 85.27 85.28 85.29 85.30 85.31 85.32 85.33 86.1 86.2 86.3
86.4 86.5 86.6 86.7 86.8 86.9 86.10 86.11 86.12 86.13 86.14 86.15 86.16 86.17 86.18 86.19 86.20 86.21 86.22 86.23 86.24 86.25 86.26
86.27 86.28 86.29 86.30 87.1 87.2 87.3 87.4 87.5 87.6 87.7 87.8 87.9 87.10 87.11 87.12 87.13
87.14 87.15 87.16 87.17 87.18 87.19 87.20 87.21 87.22 87.23 87.24 87.25 87.26 87.27 87.28 87.29 87.30 88.1 88.2 88.3 88.4 88.5
88.6 88.7 88.8 88.9 88.10 88.11 88.12 88.13 88.14 88.15 88.16 88.17 88.18 88.19 88.20 88.21 88.22 88.23 88.24 88.25 88.26 88.27 88.28 88.29 89.1 89.2 89.3 89.4 89.5 89.6 89.7 89.8 89.9 89.10 89.11 89.12 89.13 89.14 89.15 89.16 89.17 89.18 89.19 89.20 89.21 89.22 89.23 89.24 89.25 89.26 89.27 89.28 89.29 89.30 89.31 90.1 90.2 90.3 90.4 90.5 90.6
90.7 90.8 90.9 90.10 90.11 90.12 90.13 90.14 90.15 90.16 90.17 90.18 90.19 90.20 90.21 90.22 90.23 90.24 90.25 90.26 90.27 90.28 90.29 91.1 91.2 91.3 91.4 91.5 91.6 91.7 91.8 91.9 91.10
91.11 91.12 91.13 91.14 91.15 91.16 91.17 91.18 91.19 91.20 91.21 91.22 91.23 91.24 91.25 91.26 91.27 91.28 91.29 91.30 92.1 92.2 92.3 92.4 92.5 92.6 92.7 92.8 92.9
92.10 92.11 92.12 92.13 92.14 92.15 92.16 92.17 92.18 92.19 92.20 92.21 92.22 92.23 92.24 92.25 92.26 92.27 92.28 92.29 92.30 93.1 93.2 93.3 93.4 93.5 93.6 93.7 93.8 93.9
93.10 93.11 93.12 93.13 93.14
93.15 93.16 93.17 93.18
93.19 93.20 93.21 93.22 93.23 93.24 93.25 93.26 93.27 93.28 93.29 94.1 94.2 94.3 94.4 94.5 94.6 94.7 94.8 94.9 94.10 94.11 94.12 94.13 94.14 94.15 94.16 94.17 94.18 94.19 94.20 94.21 94.22 94.23 94.24 94.25 94.26 94.27 94.28 94.29 94.30 95.1 95.2 95.3 95.4 95.5 95.6 95.7
95.8 95.9 95.10 95.11 95.12 95.13 95.14 95.15 95.16 95.17 95.18 95.19 95.20 95.21 95.22 95.23 95.24 95.25 95.26 95.27 95.28 95.29 95.30 95.31 96.1 96.2 96.3 96.4 96.5 96.6 96.7 96.8 96.9 96.10 96.11 96.12 96.13
96.14 96.15
96.16 96.17 96.18 96.19 96.20 96.21 96.22 96.23 96.24 96.25 96.26 96.27 96.28 96.29 96.30 97.1 97.2 97.3 97.4 97.5 97.6 97.7 97.8 97.9 97.10 97.11 97.12 97.13 97.14 97.15 97.16 97.17 97.18 97.19 97.20 97.21 97.22 97.23 97.24 97.25 97.26 97.27 97.28 97.29 97.30 97.31 97.32 98.1 98.2 98.3 98.4 98.5 98.6 98.7 98.8 98.9 98.10 98.11 98.12 98.13 98.14 98.15 98.16 98.17 98.18 98.19 98.20 98.21 98.22 98.23 98.24 98.25 98.26 98.27 98.28 98.29 98.30 98.31 98.32 98.33 99.1 99.2 99.3 99.4 99.5 99.6 99.7 99.8 99.9 99.10 99.11 99.12 99.13 99.14 99.15 99.16 99.17 99.18 99.19 99.20 99.21 99.22 99.23 99.24 99.25 99.26 99.27 99.28 99.29
99.30 99.31
100.1 100.2 100.3 100.4 100.5 100.6 100.7 100.8 100.9 100.10 100.11 100.12 100.13 100.14 100.15 100.16 100.17 100.18 100.19 100.20 100.21 100.22 100.23 100.24 100.25 100.26 100.27 100.28 100.29 100.30 100.31 100.32 100.33 101.1 101.2 101.3 101.4 101.5 101.6 101.7 101.8 101.9 101.10 101.11 101.12
101.13 101.14
101.15 101.16 101.17 101.18 101.19 101.20 101.21 101.22 101.23 101.24 101.25 101.26 101.27 101.28 101.29 102.1 102.2 102.3 102.4 102.5 102.6 102.7 102.8 102.9 102.10 102.11 102.12 102.13 102.14 102.15 102.16 102.17 102.18 102.19 102.20 102.21 102.22 102.23 102.24 102.25 102.26 102.27 102.28 102.29 102.30 102.31 102.32 102.33 103.1 103.2 103.3 103.4 103.5 103.6 103.7 103.8 103.9 103.10 103.11 103.12 103.13 103.14 103.15 103.16 103.17 103.18 103.19 103.20 103.21 103.22 103.23 103.24 103.25 103.26 103.27 103.28 103.29 103.30 103.31 104.1 104.2 104.3 104.4 104.5 104.6 104.7 104.8 104.9 104.10 104.11 104.12 104.13 104.14 104.15 104.16 104.17 104.18 104.19 104.20 104.21 104.22 104.23 104.24 104.25 104.26 104.27 104.28 104.29 104.30 104.31 104.32 104.33 105.1 105.2 105.3 105.4 105.5 105.6 105.7 105.8 105.9 105.10
105.11 105.12
105.13 105.14 105.15 105.16 105.17 105.18 105.19 105.20 105.21 105.22 105.23 105.24 105.25 105.26 105.27
105.28 105.29
106.1 106.2 106.3 106.4 106.5 106.6 106.7 106.8 106.9 106.10 106.11 106.12 106.13 106.14 106.15 106.16 106.17 106.18 106.19 106.20 106.21 106.22 106.23 106.24 106.25 106.26 106.27 106.28 106.29 106.30 106.31 106.32 107.1 107.2 107.3 107.4 107.5 107.6 107.7 107.8 107.9 107.10 107.11 107.12 107.13 107.14 107.15 107.16 107.17 107.18 107.19 107.20 107.21 107.22 107.23
107.24 107.25
107.26 107.27 107.28 107.29 107.30 107.31 107.32 108.1 108.2 108.3 108.4 108.5 108.6 108.7 108.8 108.9 108.10 108.11 108.12 108.13 108.14 108.15 108.16 108.17 108.18 108.19 108.20 108.21 108.22 108.23 108.24 108.25 108.26 108.27 108.28 108.29
108.30 108.31 108.32 108.33 109.1 109.2 109.3 109.4 109.5 109.6 109.7 109.8 109.9 109.10 109.11 109.12 109.13 109.14 109.15
109.16 109.17 109.18 109.19 109.20 109.21 109.22 109.23 109.24 109.25 109.26 109.27 109.28 109.29 109.30 109.31 109.32 110.1 110.2 110.3 110.4 110.5 110.6 110.7
110.8 110.9 110.10 110.11 110.12 110.13 110.14 110.15 110.16 110.17 110.18 110.19 110.20 110.21 110.22 110.23 110.24 110.25 110.26 110.27 110.28 110.29
110.30 110.31 110.32 111.1 111.2 111.3 111.4 111.5 111.6 111.7 111.8 111.9 111.10 111.11 111.12 111.13 111.14 111.15 111.16 111.17 111.18 111.19 111.20 111.21 111.22 111.23 111.24 111.25 111.26 111.27 111.28 111.29 111.30 111.31 112.1 112.2 112.3
112.4 112.5 112.6 112.7 112.8 112.9 112.10 112.11 112.12 112.13 112.14 112.15 112.16 112.17 112.18 112.19 112.20 112.21 112.22 112.23 112.24 112.25 112.26 112.27 112.28 112.29
113.1 113.2 113.3 113.4 113.5 113.6 113.7 113.8 113.9 113.10 113.11 113.12 113.13 113.14 113.15 113.16 113.17 113.18
113.19 113.20 113.21 113.22 113.23 113.24 113.25 113.26 113.27 113.28 113.29 113.30 113.31 113.32 113.33 114.1 114.2 114.3 114.4 114.5 114.6 114.7 114.8 114.9 114.10 114.11 114.12 114.13 114.14 114.15 114.16 114.17 114.18 114.19 114.20 114.21 114.22 114.23 114.24 114.25 114.26 114.27 114.28 114.29 114.30 114.31 114.32 114.33 114.34 115.1 115.2 115.3 115.4 115.5 115.6 115.7 115.8 115.9 115.10 115.11 115.12 115.13 115.14 115.15 115.16 115.17 115.18 115.19 115.20 115.21 115.22 115.23 115.24 115.25 115.26 115.27 115.28 115.29 115.30 115.31 115.32 115.33 116.1 116.2 116.3 116.4 116.5 116.6 116.7 116.8 116.9 116.10 116.11 116.12 116.13 116.14 116.15 116.16 116.17 116.18 116.19 116.20 116.21 116.22 116.23 116.24 116.25 116.26 116.27 116.28 116.29 116.30 116.31 116.32 116.33 116.34 117.1 117.2 117.3 117.4 117.5 117.6 117.7 117.8 117.9 117.10 117.11 117.12 117.13 117.14 117.15 117.16 117.17 117.18 117.19 117.20 117.21 117.22 117.23 117.24 117.25 117.26 117.27 117.28 117.29 117.30 117.31
118.1 118.2 118.3 118.4 118.5 118.6 118.7 118.8 118.9 118.10 118.11 118.12 118.13 118.14 118.15 118.16 118.17 118.18 118.19 118.20 118.21 118.22 118.23 118.24 118.25 118.26 118.27 118.28 118.29 118.30 118.31 119.1 119.2 119.3 119.4 119.5 119.6 119.7 119.8 119.9 119.10 119.11 119.12 119.13 119.14 119.15 119.16 119.17 119.18 119.19 119.20 119.21 119.22 119.23
119.24 119.25 119.26 119.27 119.28
120.1 120.2
120.3 120.4 120.5 120.6 120.7 120.8 120.9 120.10 120.11 120.12 120.13 120.14 120.15 120.16 120.17 120.18 120.19 120.20 120.21 120.22 120.23 120.24 120.25 120.26 120.27 120.28 120.29 120.30 121.1 121.2 121.3 121.4 121.5 121.6 121.7 121.8 121.9 121.10 121.11 121.12 121.13 121.14 121.15 121.16 121.17 121.18 121.19 121.20 121.21
121.22 121.23 121.24 121.25 121.26 121.27 121.28 121.29 121.30 121.31 122.1 122.2 122.3 122.4 122.5 122.6 122.7 122.8 122.9 122.10 122.11 122.12 122.13 122.14 122.15 122.16 122.17 122.18 122.19 122.20 122.21 122.22 122.23 122.24 122.25 122.26 122.27
122.28 122.29 122.30 122.31 122.32 122.33 123.1 123.2 123.3 123.4 123.5 123.6 123.7 123.8 123.9 123.10 123.11 123.12 123.13 123.14 123.15 123.16 123.17
123.18 123.19 123.20 123.21 123.22 123.23 123.24 123.25 123.26 123.27 123.28 123.29 123.30 123.31 123.32 123.33 124.1 124.2 124.3 124.4 124.5 124.6 124.7 124.8 124.9 124.10 124.11 124.12 124.13 124.14 124.15 124.16 124.17 124.18 124.19 124.20 124.21 124.22 124.23 124.24 124.25 124.26 124.27 124.28 124.29 124.30 124.31 124.32 124.33 124.34 124.35 125.1 125.2 125.3
125.4 125.5 125.6 125.7 125.8 125.9 125.10 125.11 125.12 125.13 125.14 125.15 125.16
125.17 125.18 125.19 125.20 125.21 125.22 125.23 125.24 125.25 125.26 125.27 125.28 125.29 125.30 125.31 126.1 126.2 126.3 126.4 126.5 126.6 126.7 126.8 126.9 126.10 126.11 126.12 126.13 126.14 126.15 126.16 126.17 126.18 126.19 126.20 126.21 126.22 126.23 126.24 126.25 126.26 126.27 126.28 126.29 126.30 126.31 126.32 126.33 126.34 127.1 127.2 127.3 127.4 127.5 127.6 127.7 127.8 127.9 127.10 127.11 127.12 127.13 127.14 127.15 127.16 127.17 127.18 127.19 127.20 127.21 127.22 127.23 127.24 127.25 127.26 127.27 127.28 127.29 127.30 127.31 128.1 128.2 128.3 128.4 128.5 128.6 128.7 128.8 128.9 128.10 128.11 128.12 128.13 128.14 128.15 128.16 128.17 128.18 128.19 128.20 128.21 128.22 128.23 128.24 128.25 128.26 128.27 128.28 128.29 128.30 128.31 128.32 128.33 128.34 129.1 129.2 129.3 129.4 129.5 129.6 129.7 129.8 129.9 129.10 129.11 129.12 129.13 129.14 129.15 129.16 129.17 129.18 129.19 129.20 129.21 129.22 129.23 129.24 129.25 129.26 129.27 129.28 129.29 129.30 129.31 129.32 130.1 130.2 130.3 130.4 130.5 130.6 130.7 130.8 130.9 130.10 130.11 130.12 130.13 130.14 130.15 130.16 130.17 130.18 130.19 130.20 130.21 130.22 130.23 130.24 130.25 130.26 130.27 130.28 130.29 130.30 130.31 130.32 131.1 131.2 131.3 131.4 131.5 131.6 131.7 131.8 131.9 131.10 131.11 131.12 131.13 131.14 131.15 131.16 131.17 131.18 131.19 131.20 131.21 131.22 131.23 131.24 131.25 131.26 131.27 131.28 131.29 131.30 131.31 131.32 131.33 131.34
132.1 132.2 132.3 132.4 132.5 132.6 132.7 132.8 132.9 132.10 132.11 132.12 132.13 132.14 132.15 132.16 132.17 132.18 132.19 132.20 132.21 132.22 132.23 132.24 132.25 132.26 132.27 132.28 132.29 132.30 132.31 133.1 133.2 133.3 133.4 133.5 133.6 133.7 133.8 133.9 133.10 133.11 133.12 133.13 133.14 133.15 133.16 133.17
133.18 133.19 133.20 133.21 133.22 133.23 133.24 133.25
133.26 133.27 133.28 133.29 133.30 133.31 134.1 134.2 134.3 134.4 134.5 134.6 134.7 134.8 134.9 134.10 134.11 134.12 134.13 134.14 134.15 134.16
134.17
134.18 134.19 134.20 134.21 134.22 134.23 134.24 134.25 134.26 134.27 134.28 134.29 134.30 134.31 134.32 134.33 135.1 135.2 135.3 135.4 135.5 135.6 135.7 135.8 135.9 135.10 135.11 135.12 135.13 135.14 135.15 135.16 135.17 135.18 135.19 135.20 135.21 135.22 135.23 135.24 135.25 135.26 135.27 135.28 135.29 135.30 135.31 136.1 136.2 136.3 136.4 136.5 136.6
136.7
136.8 136.9 136.10 136.11 136.12 136.13 136.14 136.15 136.16 136.17 136.18 136.19 136.20 136.21 136.22 136.23 136.24 136.25 136.26 136.27 136.28 136.29 136.30 136.31 136.32 137.1 137.2 137.3 137.4 137.5 137.6 137.7 137.8 137.9 137.10 137.11 137.12 137.13 137.14 137.15 137.16 137.17 137.18 137.19 137.20 137.21 137.22 137.23 137.24 137.25 137.26 137.27 137.28
137.29
137.30 137.31 137.32 137.33 138.1 138.2 138.3 138.4 138.5 138.6 138.7 138.8 138.9 138.10 138.11 138.12 138.13 138.14 138.15 138.16 138.17 138.18 138.19 138.20 138.21 138.22 138.23 138.24 138.25 138.26 138.27 138.28 138.29 138.30 138.31 139.1 139.2 139.3 139.4 139.5 139.6 139.7 139.8 139.9 139.10 139.11 139.12 139.13 139.14 139.15 139.16 139.17 139.18 139.19 139.20 139.21 139.22 139.23 139.24 139.25 139.26 139.27 139.28 139.29 139.30 139.31 139.32 140.1 140.2 140.3 140.4 140.5 140.6 140.7 140.8 140.9 140.10 140.11 140.12 140.13 140.14 140.15 140.16 140.17 140.18 140.19 140.20 140.21 140.22 140.23 140.24 140.25 140.26 140.27 140.28 140.29 140.30 140.31 141.1 141.2 141.3 141.4 141.5 141.6 141.7 141.8 141.9 141.10 141.11 141.12 141.13 141.14 141.15 141.16 141.17 141.18 141.19 141.20 141.21
141.22
141.23 141.24 141.25 141.26 141.27 141.28 141.29 141.30 141.31 142.1 142.2 142.3 142.4 142.5 142.6 142.7 142.8 142.9 142.10 142.11 142.12 142.13 142.14 142.15 142.16 142.17 142.18 142.19 142.20 142.21 142.22 142.23 142.24 142.25 142.26 142.27 142.28 142.29 142.30 142.31 142.32 142.33 143.1 143.2 143.3 143.4 143.5 143.6 143.7 143.8 143.9
143.10
143.11 143.12 143.13 143.14 143.15 143.16 143.17 143.18 143.19 143.20 143.21 143.22 143.23 143.24 143.25 143.26 143.27 143.28 143.29 143.30 143.31 144.1 144.2 144.3 144.4 144.5 144.6 144.7 144.8 144.9 144.10 144.11 144.12 144.13 144.14 144.15 144.16 144.17 144.18 144.19 144.20
144.21
144.22 144.23 144.24 144.25 144.26 144.27 144.28 144.29 144.30 144.31 144.32 145.1 145.2 145.3 145.4 145.5 145.6 145.7 145.8 145.9 145.10 145.11 145.12 145.13 145.14 145.15 145.16 145.17
145.18
145.19 145.20 145.21 145.22 145.23 145.24 145.25 145.26 145.27 145.28 146.1 146.2 146.3 146.4 146.5 146.6 146.7 146.8 146.9 146.10 146.11 146.12 146.13 146.14 146.15 146.16 146.17 146.18 146.19 146.20 146.21 146.22
146.23 146.24 146.25 146.26 146.27 146.28 146.29 146.30 146.31 147.1 147.2 147.3 147.4 147.5 147.6 147.7 147.8 147.9 147.10 147.11
147.12
147.13 147.14 147.15 147.16 147.17 147.18 147.19 147.20 147.21 147.22 147.23 147.24 147.25 147.26 147.27
147.28 147.29 147.30 148.1 148.2 148.3 148.4 148.5
148.6 148.7 148.8 148.9 148.10 148.11 148.12 148.13 148.14 148.15 148.16 148.17 148.18 148.19
148.20
148.21 148.22 148.23 148.24 148.25 148.26 148.27 148.28 148.29 148.30 148.31 148.32
149.1 149.2 149.3 149.4 149.5 149.6 149.7 149.8 149.9 149.10 149.11 149.12 149.13 149.14 149.15 149.16 149.17 149.18
149.19 149.20 149.21 149.22 149.23 149.24
149.25 149.26 149.27 149.28 149.29 149.30 149.31 149.32 150.1 150.2 150.3 150.4 150.5 150.6 150.7 150.8 150.9
150.10 150.11 150.12 150.13 150.14 150.15 150.16
150.17 150.18
150.19 150.20 150.21 150.22
150.23
150.24 150.25 150.26 150.27
150.28
151.1 151.2 151.3 151.4 151.5 151.6 151.7 151.8 151.9 151.10 151.11 151.12 151.13 151.14 151.15 151.16 151.17 151.18 151.19 151.20 151.21 151.22 151.23 151.24 151.25 151.26 151.27 151.28 151.29 151.30 151.31 151.32 151.33 151.34 152.1 152.2 152.3 152.4 152.5 152.6 152.7 152.8 152.9 152.10 152.11 152.12 152.13 152.14 152.15
152.16
152.17 152.18 152.19 152.20 152.21 152.22 152.23 152.24 152.25 152.26 152.27 152.28 152.29 152.30 152.31 152.32 152.33
153.1
153.2 153.3 153.4 153.5 153.6 153.7 153.8 153.9 153.10 153.11 153.12 153.13
153.14
153.15 153.16 153.17 153.18 153.19 153.20 153.21 153.22 153.23 153.24
153.25
153.26 153.27 153.28 154.1 154.2 154.3 154.4 154.5 154.6 154.7 154.8 154.9 154.10 154.11 154.12 154.13 154.14 154.15 154.16 154.17 154.18 154.19 154.20 154.21 154.22 154.23 154.24
154.25
154.26 154.27 154.28 154.29 154.30 154.31 155.1 155.2 155.3 155.4 155.5 155.6 155.7 155.8 155.9 155.10 155.11 155.12 155.13 155.14 155.15 155.16 155.17 155.18 155.19 155.20 155.21
155.22
155.23 155.24 155.25 155.26 155.27 155.28 155.29 155.30 155.31 155.32 156.1 156.2 156.3 156.4 156.5 156.6 156.7 156.8 156.9 156.10 156.11 156.12 156.13 156.14 156.15 156.16 156.17 156.18 156.19 156.20 156.21 156.22 156.23 156.24 156.25 156.26 156.27 156.28 156.29 156.30 156.31 156.32 156.33 157.1 157.2 157.3 157.4 157.5 157.6 157.7 157.8 157.9 157.10 157.11 157.12 157.13 157.14 157.15 157.16 157.17 157.18 157.19 157.20 157.21 157.22 157.23 157.24 157.25 157.26 157.27
157.28
158.1 158.2 158.3 158.4 158.5 158.6 158.7 158.8 158.9 158.10 158.11 158.12 158.13
158.14 158.15 158.16 158.17 158.18 158.19 158.20 158.21 158.22 158.23 158.24 158.25 158.26 158.27 158.28 158.29 158.30 158.31 158.32 159.1 159.2 159.3
159.4 159.5 159.6 159.7 159.8 159.9 159.10 159.11 159.12 159.13 159.14 159.15 159.16 159.17 159.18 159.19 159.20 159.21
159.22 159.23 159.24 159.25 159.26 159.27 159.28 159.29 159.30 159.31 159.32 160.1 160.2 160.3 160.4 160.5 160.6 160.7
160.8 160.9 160.10 160.11 160.12 160.13 160.14 160.15 160.16 160.17 160.18 160.19 160.20 160.21 160.22 160.23 160.24 160.25 160.26 160.27 160.28 160.29 160.30 160.31 160.32 161.1 161.2
161.3 161.4 161.5 161.6 161.7 161.8 161.9 161.10 161.11 161.12 161.13 161.14 161.15
161.16 161.17 161.18 161.19 161.20 161.21 161.22 161.23 161.24 161.25 161.26 161.27 161.28 161.29 161.30 162.1 162.2 162.3 162.4 162.5 162.6 162.7 162.8 162.9 162.10 162.11 162.12 162.13
162.14 162.15 162.16 162.17 162.18 162.19 162.20 162.21 162.22 162.23 162.24 162.25 162.26 162.27 162.28 162.29 162.30 162.31 162.32 162.33 163.1 163.2 163.3 163.4 163.5 163.6 163.7 163.8 163.9 163.10 163.11 163.12 163.13
163.14 163.15 163.16 163.17 163.18 163.19 163.20 163.21 163.22 163.23 163.24 163.25 163.26 163.27 163.28 163.29 163.30 164.1 164.2 164.3 164.4 164.5 164.6 164.7 164.8 164.9 164.10 164.11 164.12 164.13 164.14 164.15 164.16 164.17 164.18 164.19 164.20 164.21 164.22 164.23 164.24 164.25 164.26 164.27 164.28 164.29 164.30 164.31 165.1 165.2 165.3 165.4 165.5 165.6 165.7 165.8 165.9 165.10 165.11 165.12 165.13 165.14
165.15 165.16 165.17 165.18 165.19 165.20 165.21 165.22 165.23 165.24 165.25 165.26 165.27 165.28 165.29 165.30 165.31 166.1 166.2 166.3 166.4 166.5 166.6 166.7 166.8 166.9 166.10 166.11 166.12 166.13 166.14 166.15 166.16 166.17 166.18 166.19 166.20 166.21
166.22 166.23 166.24 166.25 166.26 166.27 166.28 166.29 166.30 166.31 167.1 167.2 167.3 167.4 167.5 167.6 167.7 167.8 167.9 167.10 167.11 167.12 167.13 167.14 167.15 167.16 167.17 167.18 167.19 167.20
167.21 167.22 167.23 167.24 167.25 167.26 167.27 167.28 167.29 167.30 167.31 168.1 168.2 168.3 168.4 168.5 168.6 168.7 168.8 168.9 168.10 168.11 168.12 168.13 168.14 168.15 168.16 168.17 168.18 168.19 168.20 168.21 168.22 168.23 168.24 168.25 168.26
168.27 168.28 168.29 168.30 168.31
169.1 169.2 169.3 169.4 169.5 169.6 169.7 169.8 169.9 169.10 169.11 169.12 169.13 169.14 169.15 169.16 169.17 169.18 169.19 169.20 169.21 169.22 169.23 169.24 169.25 169.26 169.27 169.28 169.29 169.30 169.31 169.32 169.33 169.34 169.35 169.36 170.1 170.2 170.3 170.4 170.5 170.6 170.7 170.8 170.9 170.10 170.11 170.12 170.13 170.14 170.15 170.16 170.17 170.18 170.19 170.20 170.21 170.22 170.23 170.24 170.25 170.26 170.27 170.28 170.29 170.30 170.31 170.32 170.33 170.34 170.35 170.36 171.1 171.2 171.3 171.4 171.5 171.6 171.7 171.8 171.9 171.10 171.11 171.12 171.13 171.14 171.15 171.16 171.17 171.18 171.19 171.20 171.21 171.22
171.23 171.24 171.25 171.26 171.27 171.28 171.29 171.30 171.31 171.32 172.1 172.2 172.3 172.4 172.5 172.6 172.7 172.8 172.9 172.10 172.11
172.12 172.13 172.14 172.15 172.16 172.17 172.18 172.19 172.20
172.21
172.22 172.23 172.24 172.25 172.26 172.27 172.28 172.29 172.30 172.31 172.32 173.1 173.2
173.3
173.4 173.5 173.6 173.7 173.8 173.9 173.10 173.11 173.12 173.13 173.14 173.15 173.16 173.17 173.18 173.19 173.20 173.21 173.22 173.23 173.24 173.25 173.26 173.27 173.28 173.29 173.30 173.31 174.1 174.2 174.3 174.4
174.5
174.6 174.7 174.8 174.9 174.10 174.11 174.12 174.13 174.14 174.15 174.16 174.17 174.18 174.19 174.20 174.21 174.22 174.23 174.24 174.25 174.26 174.27 174.28 174.29 175.1 175.2 175.3 175.4 175.5 175.6 175.7 175.8 175.9 175.10 175.11 175.12 175.13 175.14 175.15 175.16 175.17
175.18
175.19 175.20 175.21 175.22 175.23 175.24 175.25 175.26 175.27 175.28 175.29 175.30 175.31 176.1 176.2 176.3 176.4 176.5
176.6
176.7 176.8 176.9 176.10 176.11 176.12 176.13 176.14 176.15 176.16
176.17
176.18 176.19 176.20 176.21 176.22 176.23 176.24 176.25 176.26 176.27 176.28 176.29 176.30 176.31 176.32
177.1 177.2 177.3 177.4 177.5 177.6 177.7
177.8 177.9 177.10 177.11 177.12 177.13 177.14 177.15 177.16 177.17 177.18 177.19 177.20 177.21 177.22 177.23 177.24 177.25 177.26 177.27 177.28 177.29 177.30 177.31 177.32
178.1 178.2 178.3 178.4 178.5 178.6 178.7 178.8 178.9 178.10 178.11 178.12 178.13 178.14 178.15 178.16 178.17 178.18 178.19
178.20 178.21 178.22 178.23 178.24 178.25 178.26 178.27 178.28 178.29 178.30 178.31 178.32 179.1 179.2 179.3 179.4 179.5 179.6 179.7 179.8 179.9 179.10 179.11 179.12 179.13 179.14 179.15 179.16 179.17 179.18 179.19 179.20 179.21 179.22 179.23
179.24
179.25 179.26 179.27 179.28 179.29 179.30 179.31 180.1 180.2 180.3 180.4 180.5 180.6 180.7 180.8 180.9 180.10 180.11 180.12 180.13 180.14 180.15
180.16 180.17 180.18 180.19 180.20 180.21 180.22 180.23 180.24 180.25 180.26 180.27 180.28 180.29 180.30 180.31 180.32 180.33 181.1 181.2 181.3 181.4 181.5 181.6 181.7 181.8 181.9 181.10 181.11 181.12 181.13 181.14 181.15 181.16 181.17 181.18 181.19 181.20 181.21 181.22 181.23 181.24 181.25 181.26 181.27 181.28 181.29 181.30 181.31 182.1 182.2 182.3 182.4 182.5 182.6 182.7 182.8 182.9 182.10 182.11 182.12 182.13 182.14 182.15 182.16 182.17 182.18 182.19 182.20 182.21 182.22 182.23 182.24 182.25 182.26 182.27 182.28 182.29 182.30 182.31 183.1 183.2 183.3 183.4 183.5 183.6 183.7 183.8 183.9 183.10 183.11 183.12 183.13 183.14 183.15 183.16 183.17 183.18 183.19 183.20 183.21 183.22 183.23 183.24 183.25 183.26 183.27 183.28 183.29 184.1 184.2 184.3 184.4 184.5 184.6 184.7 184.8 184.9 184.10 184.11 184.12 184.13 184.14 184.15 184.16 184.17 184.18 184.19 184.20 184.21 184.22 184.23 184.24 184.25 184.26 184.27 184.28 184.29 184.30 184.31 184.32 185.1 185.2 185.3 185.4 185.5 185.6 185.7 185.8 185.9 185.10 185.11 185.12 185.13 185.14 185.15 185.16 185.17 185.18 185.19 185.20 185.21 185.22 185.23 185.24 185.25 185.26 185.27 185.28 185.29 185.30 186.1 186.2 186.3 186.4 186.5 186.6 186.7 186.8 186.9 186.10 186.11 186.12 186.13 186.14 186.15 186.16 186.17 186.18 186.19 186.20 186.21 186.22 186.23 186.24 186.25 186.26 186.27 186.28 186.29 186.30 186.31 187.1 187.2 187.3 187.4 187.5 187.6 187.7 187.8 187.9 187.10 187.11 187.12 187.13 187.14 187.15 187.16 187.17 187.18 187.19 187.20 187.21 187.22 187.23 187.24 187.25 187.26 187.27
187.28 187.29 187.30 187.31
188.1 188.2 188.3 188.4 188.5 188.6 188.7 188.8 188.9 188.10 188.11 188.12 188.13 188.14 188.15 188.16 188.17 188.18 188.19 188.20 188.21 188.22 188.23 188.24 188.25 188.26 188.27 188.28 188.29 189.1 189.2 189.3 189.4 189.5 189.6 189.7 189.8 189.9 189.10 189.11 189.12 189.13 189.14 189.15 189.16 189.17 189.18 189.19 189.20 189.21 189.22 189.23 189.24 189.25 189.26 189.27 189.28 189.29 189.30 189.31 189.32 190.1 190.2 190.3 190.4 190.5 190.6 190.7 190.8 190.9 190.10 190.11 190.12 190.13 190.14 190.15 190.16 190.17 190.18 190.19 190.20 190.21 190.22 190.23 190.24 190.25 190.26 190.27 190.28 190.29 190.30 190.31 191.1 191.2
191.3 191.4
191.5 191.6 191.7 191.8 191.9 191.10 191.11 191.12 191.13 191.14 191.15 191.16 191.17 191.18 191.19 191.20 191.21 191.22 191.23 191.24 191.25 191.26 191.27 191.28 191.29 191.30 192.1 192.2 192.3 192.4 192.5 192.6 192.7 192.8 192.9 192.10 192.11 192.12 192.13 192.14 192.15 192.16 192.17 192.18 192.19 192.20 192.21 192.22 192.23 192.24 192.25 192.26 192.27 192.28
192.29 192.30 192.31
193.1 193.2 193.3 193.4 193.5 193.6 193.7 193.8 193.9 193.10 193.11 193.12
193.13 193.14
193.15 193.16 193.17 193.18 193.19 193.20 193.21 193.22 193.23 193.24 193.25 193.26 193.27 193.28 193.29 193.30
194.1 194.2 194.3 194.4 194.5 194.6 194.7 194.8 194.9 194.10 194.11 194.12 194.13 194.14 194.15 194.16 194.17 194.18 194.19 194.20 194.21 194.22
194.23 194.24 194.25 194.26 194.27 194.28 194.29 194.30 194.31 195.1 195.2 195.3 195.4 195.5 195.6 195.7 195.8 195.9
195.10 195.11 195.12 195.13 195.14
195.15 195.16 195.17 195.18 195.19 195.20 195.21 195.22 195.23 195.24 195.25 195.26 195.27 195.28 195.29 195.30 195.31 195.32 196.1 196.2 196.3 196.4 196.5 196.6 196.7 196.8 196.9 196.10 196.11 196.12 196.13 196.14 196.15 196.16 196.17 196.18 196.19 196.20 196.21 196.22 196.23 196.24 196.25 196.26 196.27 196.28 196.29 196.30 196.31 196.32 197.1 197.2 197.3 197.4 197.5 197.6 197.7 197.8
197.9 197.10 197.11 197.12 197.13 197.14 197.15 197.16 197.17 197.18 197.19 197.20 197.21 197.22 197.23 197.24 197.25 197.26 197.27 197.28 197.29 197.30 197.31 198.1
198.2 198.3 198.4 198.5 198.6 198.7 198.8 198.9 198.10 198.11 198.12 198.13 198.14 198.15 198.16 198.17 198.18 198.19 198.20 198.21 198.22 198.23 198.24 198.25 198.26 198.27 198.28 198.29 198.30 198.31 199.1 199.2 199.3 199.4 199.5 199.6 199.7 199.8 199.9 199.10 199.11 199.12 199.13 199.14
199.15 199.16 199.17 199.18 199.19 199.20 199.21 199.22 199.23 199.24 199.25 199.26 199.27 199.28 199.29 199.30 199.31 200.1 200.2 200.3 200.4 200.5 200.6 200.7 200.8 200.9 200.10 200.11 200.12 200.13 200.14 200.15 200.16 200.17 200.18 200.19 200.20 200.21 200.22 200.23 200.24 200.25 200.26 200.27 200.28 200.29 200.30 200.31 200.32 201.1 201.2 201.3 201.4 201.5 201.6 201.7 201.8 201.9 201.10 201.11 201.12 201.13 201.14 201.15 201.16 201.17 201.18 201.19 201.20 201.21 201.22 201.23 201.24 201.25 201.26 201.27 201.28 201.29 201.30 202.1 202.2 202.3 202.4 202.5 202.6 202.7 202.8 202.9 202.10 202.11 202.12 202.13 202.14 202.15 202.16 202.17 202.18 202.19 202.20 202.21 202.22 202.23 202.24 202.25 202.26 202.27 202.28 202.29 202.30 202.31 202.32 203.1 203.2 203.3 203.4 203.5 203.6 203.7 203.8 203.9 203.10 203.11 203.12 203.13 203.14 203.15 203.16 203.17 203.18 203.19
203.20 203.21 203.22 203.23 203.24 203.25
203.26 203.27 203.28 203.29 203.30 203.31 204.1 204.2 204.3 204.4 204.5 204.6 204.7 204.8 204.9 204.10 204.11 204.12 204.13 204.14 204.15 204.16 204.17 204.18 204.19 204.20 204.21 204.22 204.23 204.24 204.25 204.26 204.27 204.28 204.29 204.30 204.31 204.32 205.1 205.2 205.3 205.4 205.5 205.6 205.7 205.8 205.9 205.10 205.11 205.12 205.13 205.14 205.15 205.16 205.17 205.18 205.19 205.20 205.21 205.22 205.23 205.24 205.25 205.26 205.27 205.28 205.29 205.30 205.31 205.32 205.33 205.34 206.1 206.2 206.3 206.4 206.5 206.6 206.7 206.8 206.9 206.10 206.11 206.12 206.13 206.14 206.15 206.16 206.17 206.18 206.19 206.20 206.21 206.22 206.23 206.24 206.25 206.26 206.27 206.28 206.29 206.30 206.31 206.32 206.33 207.1 207.2
207.3 207.4 207.5 207.6 207.7 207.8 207.9 207.10 207.11 207.12 207.13 207.14 207.15 207.16 207.17 207.18 207.19 207.20 207.21 207.22 207.23 207.24 207.25 207.26 207.27 207.28 207.29 207.30 207.31 208.1 208.2 208.3 208.4 208.5 208.6 208.7 208.8 208.9 208.10 208.11 208.12 208.13 208.14 208.15 208.16 208.17 208.18 208.19 208.20 208.21 208.22 208.23 208.24 208.25 208.26 208.27 208.28 208.29 208.30 209.1 209.2 209.3 209.4 209.5 209.6 209.7 209.8 209.9
209.10 209.11 209.12 209.13 209.14 209.15 209.16 209.17 209.18 209.19 209.20 209.21 209.22 209.23 209.24 209.25 209.26 209.27 209.28 209.29 209.30 209.31 209.32 209.33 209.34
210.1 210.2 210.3 210.4 210.5 210.6 210.7 210.8 210.9 210.10 210.11 210.12 210.13 210.14 210.15 210.16 210.17 210.18 210.19 210.20 210.21 210.22 210.23 210.24 210.25 210.26 210.27 210.28 210.29
210.30 210.31
211.1 211.2 211.3 211.4 211.5 211.6 211.7 211.8 211.9 211.10 211.11 211.12 211.13 211.14 211.15 211.16 211.17 211.18 211.19 211.20 211.21 211.22 211.23 211.24
211.25 211.26 211.27 211.28 211.29 211.30 211.31 212.1 212.2 212.3 212.4 212.5 212.6 212.7 212.8 212.9 212.10
212.11 212.12 212.13 212.14 212.15 212.16 212.17 212.18 212.19 212.20 212.21 212.22 212.23 212.24 212.25 212.26 212.27 212.28 212.29 212.30 212.31 212.32 212.33 213.1 213.2 213.3 213.4 213.5 213.6 213.7 213.8 213.9 213.10 213.11 213.12 213.13 213.14 213.15 213.16 213.17 213.18 213.19 213.20 213.21 213.22 213.23 213.24 213.25 213.26 213.27
213.28 213.29 213.30 213.31 214.1 214.2 214.3 214.4 214.5 214.6 214.7 214.8 214.9 214.10 214.11 214.12 214.13 214.14 214.15 214.16 214.17 214.18 214.19 214.20 214.21 214.22 214.23 214.24 214.25 214.26 214.27 214.28 214.29 214.30
215.1 215.2 215.3 215.4 215.5 215.6 215.7 215.8 215.9 215.10 215.11 215.12 215.13 215.14 215.15 215.16 215.17 215.18 215.19 215.20 215.21 215.22 215.23 215.24 215.25 215.26 215.27 215.28 215.29 215.30 216.1 216.2 216.3 216.4 216.5 216.6 216.7
216.8 216.9 216.10 216.11 216.12 216.13 216.14 216.15 216.16 216.17 216.18 216.19 216.20 216.21 216.22 216.23 216.24 216.25 216.26 216.27 216.28 216.29 216.30 217.1 217.2 217.3 217.4 217.5 217.6 217.7 217.8 217.9 217.10 217.11 217.12 217.13 217.14
217.15 217.16 217.17 217.18 217.19 217.20 217.21 217.22 217.23 217.24 217.25 217.26 217.27 217.28 217.29 217.30 217.31 217.32 218.1 218.2 218.3 218.4 218.5 218.6 218.7 218.8 218.9 218.10
218.11 218.12 218.13 218.14 218.15 218.16 218.17 218.18 218.19 218.20 218.21 218.22 218.23 218.24 218.25 218.26 218.27 218.28 218.29 218.30 218.31 218.32 218.33 219.1 219.2 219.3 219.4 219.5 219.6 219.7
219.8 219.9 219.10 219.11 219.12 219.13 219.14 219.15 219.16 219.17 219.18 219.19 219.20 219.21
219.22 219.23 219.24 219.25 219.26 219.27 219.28 219.29 219.30 219.31 220.1 220.2
220.3 220.4 220.5 220.6 220.7
220.8 220.9 220.10 220.11 220.12 220.13 220.14 220.15 220.16 220.17 220.18 220.19 220.20 220.21 220.22 220.23
220.24 220.25 220.26 220.27 220.28 220.29 220.30 220.31 220.32 221.1 221.2 221.3 221.4 221.5 221.6 221.7 221.8 221.9
221.10
221.11 221.12 221.13 221.14 221.15 221.16 221.17 221.18 221.19 221.20 221.21 221.22
221.23
221.24 221.25 221.26 221.27 221.28 221.29 221.30 221.31 222.1 222.2 222.3 222.4 222.5
222.6
222.7 222.8 222.9 222.10 222.11 222.12 222.13 222.14 222.15 222.16 222.17 222.18 222.19 222.20
222.21
222.22 222.23 222.24 222.25 222.26 222.27 222.28 222.29 222.30 222.31 223.1 223.2 223.3 223.4 223.5 223.6 223.7 223.8
223.9
223.10 223.11 223.12 223.13 223.14 223.15 223.16 223.17 223.18 223.19 223.20 223.21
223.22 223.23 223.24 223.25 223.26 223.27
223.28 223.29 223.30 223.31
224.1 224.2 224.3 224.4 224.5 224.6
224.7 224.8 224.9 224.10 224.11 224.12 224.13 224.14 224.15 224.16 224.17 224.18
224.19 224.20 224.21 224.22 224.23 224.24 224.25
224.26 224.27 224.28 224.29
225.1 225.2 225.3 225.4 225.5 225.6 225.7 225.8 225.9 225.10 225.11 225.12 225.13 225.14 225.15 225.16 225.17 225.18 225.19
225.20 225.21 225.22 225.23 225.24 225.25 225.26 225.27 225.28 225.29 225.30 225.31 225.32 226.1 226.2 226.3 226.4 226.5 226.6 226.7 226.8
226.9
226.10 226.11 226.12 226.13 226.14
226.15 226.16 226.17 226.18 226.19 226.20 226.21 226.22 226.23 226.24 226.25 226.26 226.27 226.28 226.29 226.30 227.1 227.2 227.3 227.4 227.5 227.6 227.7 227.8 227.9 227.10 227.11 227.12 227.13 227.14 227.15 227.16 227.17 227.18 227.19 227.20 227.21 227.22 227.23
227.24 227.25 227.26 227.27 227.28 227.29 227.30 227.31 228.1 228.2 228.3 228.4 228.5 228.6 228.7 228.8 228.9 228.10 228.11 228.12 228.13 228.14 228.15 228.16 228.17 228.18 228.19 228.20 228.21 228.22 228.23 228.24 228.25
228.26 228.27 228.28 228.29 228.30 228.31 228.32 229.1 229.2 229.3 229.4 229.5 229.6 229.7 229.8 229.9 229.10 229.11 229.12 229.13 229.14 229.15 229.16 229.17 229.18 229.19 229.20 229.21 229.22 229.23 229.24 229.25 229.26 229.27
229.28 229.29 229.30 229.31 230.1 230.2 230.3 230.4
230.5
230.6 230.7 230.8 230.9 230.10 230.11 230.12 230.13 230.14 230.15 230.16 230.17 230.18 230.19 230.20 230.21 230.22 230.23 230.24 230.25 230.26 230.27 230.28 230.29 230.30 231.1 231.2 231.3 231.4 231.5 231.6 231.7 231.8 231.9 231.10 231.11 231.12 231.13 231.14
231.15 231.16 231.17 231.18 231.19 231.20 231.21 231.22 231.23 231.24 231.25 231.26 231.27 231.28 231.29 231.30 231.31 231.32 231.33 232.1 232.2 232.3 232.4 232.5 232.6 232.7 232.8 232.9 232.10 232.11 232.12 232.13 232.14 232.15 232.16 232.17
232.18 232.19 232.20 232.21 232.22 232.23 232.24 232.25 232.26 232.27 232.28 232.29 232.30 233.1 233.2 233.3 233.4 233.5 233.6 233.7 233.8 233.9 233.10 233.11 233.12 233.13 233.14 233.15 233.16 233.17 233.18 233.19 233.20 233.21 233.22
233.23 233.24 233.25 233.26 233.27
233.28
233.29 233.30 233.31 234.1 234.2 234.3 234.4 234.5 234.6 234.7
234.8
234.9 234.10 234.11 234.12 234.13 234.14 234.15 234.16 234.17 234.18 234.19 234.20 234.21 234.22 234.23 234.24 234.25 234.26 234.27 234.28 234.29 234.30 235.1 235.2 235.3 235.4 235.5 235.6 235.7 235.8 235.9 235.10 235.11 235.12 235.13 235.14 235.15 235.16 235.17 235.18 235.19 235.20 235.21 235.22 235.23 235.24 235.25 235.26 235.27 235.28 235.29 235.30 235.31 235.32 236.1 236.2 236.3 236.4 236.5 236.6 236.7 236.8
236.9 236.10
236.11 236.12 236.13 236.14
236.15
236.16 236.17
236.18 236.19 236.20 236.21 236.22 236.23 236.24 236.25 236.26 236.27 236.28 236.29 236.30 237.1 237.2 237.3 237.4 237.5 237.6 237.7 237.8 237.9 237.10 237.11 237.12 237.13 237.14 237.15 237.16 237.17
237.18 237.19 237.20 237.21 237.22 237.23 237.24 237.25 237.26 237.27 237.28 237.29 237.30 237.31 237.32 238.1 238.2 238.3 238.4 238.5 238.6 238.7 238.8 238.9 238.10 238.11 238.12 238.13 238.14 238.15 238.16 238.17 238.18 238.19 238.20 238.21 238.22 238.23 238.24 238.25 238.26 238.27 238.28 238.29 238.30 238.31 238.32 239.1 239.2
239.3 239.4 239.5 239.6 239.7 239.8 239.9 239.10 239.11 239.12 239.13 239.14 239.15 239.16 239.17 239.18 239.19 239.20 239.21 239.22 239.23 239.24 239.25 239.26 239.27 239.28 239.29 239.30 239.31 239.32 239.33 239.34 240.1 240.2 240.3 240.4 240.5 240.6 240.7 240.8 240.9 240.10 240.11 240.12 240.13 240.14 240.15 240.16 240.17 240.18 240.19 240.20 240.21 240.22 240.23 240.24 240.25 240.26 240.27 240.28 240.29 240.30 240.31 240.32 240.33 240.34 241.1 241.2 241.3 241.4 241.5 241.6
241.7 241.8 241.9 241.10 241.11 241.12 241.13 241.14 241.15 241.16 241.17 241.18 241.19 241.20 241.21 241.22 241.23 241.24 241.25 241.26 241.27 241.28
241.29 241.30 241.31 242.1 242.2 242.3 242.4 242.5
242.6 242.7 242.8 242.9 242.10 242.11 242.12 242.13 242.14 242.15 242.16 242.17 242.18 242.19 242.20 242.21 242.22 242.23 242.24 242.25 242.26 242.27 242.28 242.29 242.30 242.31 242.32 242.33 243.1 243.2 243.3 243.4 243.5 243.6 243.7
243.8 243.9 243.10 243.11 243.12 243.13 243.14 243.15 243.16 243.17 243.18 243.19 243.20 243.21 243.22 243.23
243.24 243.25 243.26 243.27 243.28 243.29 243.30 243.31 243.32
244.1 244.2 244.3 244.4 244.5 244.6 244.7 244.8 244.9 244.10 244.11 244.12 244.13 244.14 244.15 244.16 244.17 244.18 244.19 244.20 244.21 244.22 244.23 244.24 244.25 244.26 244.27 244.28 244.29 244.30 244.31 245.1 245.2 245.3 245.4
245.5 245.6 245.7 245.8 245.9 245.10 245.11 245.12 245.13 245.14 245.15 245.16 245.17 245.18 245.19 245.20
245.21 245.22 245.23 245.24 245.25 245.26 245.27 245.28 245.29 245.30 245.31 246.1 246.2 246.3 246.4 246.5
246.6 246.7 246.8 246.9 246.10 246.11 246.12 246.13 246.14 246.15 246.16 246.17 246.18 246.19 246.20 246.21 246.22 246.23 246.24 246.25 246.26 246.27 246.28 246.29 246.30 246.31 246.32 247.1 247.2 247.3 247.4 247.5 247.6 247.7 247.8 247.9 247.10 247.11 247.12 247.13 247.14 247.15 247.16 247.17 247.18
247.19 247.20 247.21 247.22 247.23 247.24 247.25 247.26 247.27 247.28 247.29 247.30 247.31 247.32 248.1 248.2 248.3 248.4 248.5
248.6 248.7 248.8 248.9 248.10 248.11 248.12 248.13 248.14
248.15 248.16 248.17 248.18 248.19 248.20 248.21 248.22 248.23 248.24 248.25 248.26 248.27 248.28 248.29 248.30 248.31 249.1 249.2 249.3 249.4 249.5 249.6 249.7 249.8 249.9 249.10 249.11 249.12 249.13 249.14 249.15 249.16 249.17 249.18 249.19 249.20 249.21 249.22 249.23 249.24 249.25 249.26 249.27 249.28 249.29 249.30 249.31 249.32 250.1 250.2 250.3 250.4 250.5 250.6 250.7 250.8 250.9 250.10 250.11 250.12 250.13 250.14 250.15 250.16 250.17 250.18 250.19 250.20 250.21 250.22 250.23 250.24 250.25 250.26 250.27
250.28 250.29 250.30 250.31 250.32 250.33 251.1 251.2 251.3 251.4 251.5 251.6 251.7 251.8 251.9 251.10 251.11 251.12 251.13 251.14 251.15 251.16 251.17 251.18 251.19 251.20 251.21 251.22 251.23 251.24 251.25 251.26 251.27 251.28 251.29 251.30 251.31 251.32 251.33 251.34 252.1 252.2 252.3 252.4 252.5 252.6 252.7 252.8 252.9 252.10 252.11 252.12 252.13 252.14 252.15 252.16 252.17 252.18 252.19 252.20 252.21 252.22 252.23 252.24 252.25 252.26 252.27 252.28 252.29 252.30 253.1 253.2 253.3 253.4 253.5 253.6 253.7 253.8 253.9 253.10 253.11 253.12 253.13 253.14 253.15 253.16 253.17 253.18 253.19 253.20 253.21 253.22 253.23 253.24 253.25 253.26 253.27 253.28 253.29 253.30 253.31 253.32 253.33 253.34 254.1 254.2 254.3 254.4 254.5 254.6 254.7 254.8 254.9 254.10 254.11 254.12 254.13 254.14 254.15 254.16 254.17 254.18 254.19 254.20 254.21 254.22 254.23 254.24
254.25 254.26 254.27 254.28 254.29 254.30 254.31 254.32 255.1 255.2 255.3 255.4 255.5 255.6 255.7 255.8 255.9 255.10 255.11 255.12 255.13 255.14 255.15 255.16 255.17 255.18 255.19 255.20 255.21 255.22 255.23 255.24 255.25 255.26 255.27 255.28 255.29 255.30 255.31 255.32 255.33 255.34 255.35 256.1 256.2 256.3 256.4 256.5 256.6 256.7 256.8 256.9 256.10 256.11 256.12 256.13 256.14 256.15 256.16
256.17 256.18 256.19 256.20 256.21 256.22 256.23 256.24 256.25 256.26 256.27 256.28 256.29 256.30 256.31
257.1 257.2 257.3
257.4 257.5
257.6 257.7 257.8
257.9 257.10 257.11 257.12 257.13 257.14 257.15 257.16 257.17 257.18 257.19
257.20 257.21 257.22 257.23 257.24 257.25 257.26 257.27 257.28 257.29 257.30 257.31 258.1 258.2 258.3 258.4
258.5 258.6 258.7 258.8
258.9 258.10
258.11 258.12 258.13 258.14 258.15 258.16 258.17 258.18 258.19 258.20 258.21 258.22 258.23 258.24 258.25 258.26 258.27
259.1 259.2 259.3 259.4 259.5 259.6 259.7 259.8 259.9 259.10 259.11 259.12 259.13 259.14 259.15 259.16 259.17 259.18 259.19 259.20 259.21 259.22 259.23 259.24 259.25 259.26 259.27 259.28 259.29 259.30 259.31 259.32 260.1 260.2 260.3 260.4 260.5 260.6 260.7 260.8 260.9 260.10 260.11 260.12 260.13 260.14 260.15 260.16 260.17 260.18 260.19 260.20 260.21 260.22 260.23 260.24 260.25
260.26 260.27 260.28 260.29 260.30 260.31 260.32 261.1 261.2 261.3 261.4 261.5 261.6 261.7 261.8 261.9 261.10 261.11 261.12 261.13 261.14 261.15 261.16 261.17
261.18 261.19 261.20 261.21
261.22 261.23 261.24 261.25
261.26 261.27 261.28 261.29 261.30 261.31 262.1 262.2 262.3 262.4 262.5 262.6 262.7 262.8 262.9 262.10 262.11 262.12 262.13 262.14 262.15 262.16 262.17 262.18 262.19
262.20 262.21
262.22 262.23 262.24 262.25 262.26 262.27 263.1 263.2 263.3 263.4 263.5 263.6 263.7 263.8 263.9 263.10 263.11 263.12 263.13 263.14 263.15 263.16 263.17
263.18 263.19 263.20 263.21 263.22 263.23
263.24 263.25 263.26 263.27 264.1 264.2 264.3 264.4 264.5 264.6 264.7 264.8 264.9 264.10 264.11 264.12 264.13
264.14 264.15 264.16 264.17 264.18 264.19 264.20 264.21 264.22 264.23 264.24 264.25 264.26 264.27 264.28 264.29 265.1 265.2 265.3 265.4 265.5 265.6 265.7 265.8 265.9 265.10 265.11 265.12 265.13 265.14 265.15 265.16 265.17 265.18 265.19 265.20 265.21 265.22 265.23 265.24 265.25 265.26 265.27 265.28 265.29 265.30 265.31 266.1 266.2 266.3 266.4 266.5 266.6 266.7 266.8 266.9 266.10 266.11 266.12 266.13 266.14 266.15 266.16 266.17 266.18 266.19 266.20 266.21 266.22 266.23 266.24 266.25 266.26 266.27 266.28 266.29 266.30 266.31 266.32 267.1 267.2 267.3 267.4 267.5 267.6 267.7 267.8 267.9 267.10 267.11 267.12 267.13 267.14 267.15 267.16 267.17 267.18 267.19 267.20 267.21 267.22 267.23 267.24 267.25 267.26 267.27 267.28 267.29 267.30 267.31 267.32 267.33 268.1 268.2 268.3 268.4 268.5 268.6 268.7 268.8 268.9 268.10 268.11 268.12 268.13 268.14 268.15 268.16 268.17 268.18 268.19 268.20 268.21 268.22 268.23 268.24 268.25 268.26 268.27 268.28 268.29 268.30 268.31 268.32 269.1 269.2 269.3 269.4 269.5 269.6 269.7 269.8 269.9 269.10 269.11 269.12 269.13 269.14 269.15 269.16 269.17 269.18 269.19 269.20 269.21 269.22 269.23 269.24 269.25 269.26 269.27 269.28 269.29 269.30 269.31 269.32 269.33 270.1 270.2 270.3 270.4 270.5 270.6 270.7 270.8 270.9 270.10 270.11 270.12 270.13 270.14 270.15 270.16 270.17 270.18 270.19 270.20 270.21 270.22 270.23 270.24 270.25 270.26 270.27 270.28 270.29 270.30 270.31 270.32 270.33 271.1 271.2 271.3 271.4 271.5 271.6 271.7 271.8 271.9 271.10 271.11 271.12 271.13 271.14 271.15 271.16 271.17 271.18 271.19 271.20 271.21 271.22 271.23 271.24 271.25 271.26 271.27 271.28 271.29 271.30 271.31 271.32 271.33 271.34 272.1 272.2 272.3 272.4 272.5 272.6 272.7 272.8 272.9 272.10 272.11 272.12 272.13 272.14 272.15 272.16 272.17 272.18 272.19 272.20 272.21 272.22 272.23 272.24 272.25 272.26 272.27 272.28 272.29 272.30 272.31 273.1 273.2 273.3 273.4 273.5 273.6 273.7 273.8 273.9 273.10 273.11 273.12 273.13 273.14 273.15 273.16 273.17 273.18 273.19 273.20 273.21 273.22 273.23 273.24 273.25 273.26 273.27 273.28
273.29 273.30 273.31 273.32 273.33 274.1 274.2 274.3 274.4 274.5 274.6 274.7 274.8 274.9 274.10 274.11 274.12 274.13 274.14 274.15 274.16 274.17 274.18 274.19 274.20 274.21 274.22 274.23 274.24 274.25 274.26 274.27 274.28 274.29 274.30 274.31 274.32 274.33 275.1 275.2 275.3 275.4 275.5 275.6 275.7 275.8
275.9 275.10 275.11 275.12 275.13 275.14 275.15 275.16 275.17 275.18 275.19 275.20 275.21 275.22 275.23 275.24 275.25 275.26 275.27 275.28 275.29 275.30 275.31 276.1 276.2 276.3 276.4 276.5 276.6 276.7 276.8 276.9
276.10 276.11 276.12 276.13 276.14 276.15 276.16 276.17 276.18 276.19 276.20 276.21 276.22 276.23 276.24 276.25 276.26 276.27 276.28 276.29 276.30 277.1 277.2 277.3 277.4 277.5 277.6 277.7 277.8 277.9 277.10 277.11 277.12 277.13 277.14 277.15 277.16 277.17 277.18 277.19 277.20 277.21 277.22 277.23 277.24 277.25 277.26 277.27 277.28 277.29 277.30
278.1 278.2 278.3 278.4 278.5 278.6 278.7 278.8 278.9 278.10 278.11 278.12 278.13 278.14 278.15 278.16 278.17 278.18 278.19 278.20 278.21 278.22 278.23 278.24 278.25 278.26 278.27 278.28 278.29 278.30 278.31
279.1 279.2 279.3 279.4 279.5 279.6 279.7 279.8 279.9 279.10 279.11 279.12 279.13 279.14 279.15 279.16 279.17 279.18 279.19 279.20 279.21 279.22 279.23 279.24 279.25 279.26 279.27 279.28 279.29 279.30 279.31 280.1 280.2 280.3 280.4 280.5 280.6 280.7 280.8 280.9 280.10 280.11 280.12 280.13 280.14 280.15 280.16 280.17 280.18 280.19 280.20 280.21 280.22 280.23 280.24 280.25 280.26 280.27 280.28 280.29 280.30 280.31 280.32 280.33 281.1 281.2 281.3 281.4 281.5 281.6 281.7 281.8 281.9 281.10 281.11 281.12 281.13 281.14 281.15 281.16 281.17 281.18 281.19 281.20 281.21 281.22 281.23 281.24 281.25 281.26 281.27 281.28 281.29 281.30 281.31 282.1 282.2 282.3 282.4 282.5 282.6 282.7 282.8 282.9 282.10 282.11 282.12 282.13 282.14 282.15 282.16 282.17 282.18 282.19 282.20 282.21 282.22 282.23 282.24 282.25 282.26 282.27 282.28 282.29 282.30 282.31 282.32 282.33 283.1 283.2 283.3 283.4 283.5 283.6 283.7 283.8 283.9 283.10 283.11 283.12 283.13 283.14 283.15 283.16 283.17 283.18 283.19 283.20 283.21 283.22 283.23 283.24 283.25 283.26 283.27 283.28 283.29 283.30 283.31 283.32 283.33 284.1 284.2 284.3 284.4 284.5 284.6 284.7 284.8 284.9 284.10 284.11 284.12 284.13
284.14 284.15 284.16 284.17 284.18 284.19 284.20 284.21 284.22 284.23 284.24
284.25 284.26 284.27 284.28 284.29 284.30 284.31 284.32 285.1 285.2
285.3
285.4 285.5
285.6 285.7 285.8 285.9 285.10 285.11 285.12 285.13 285.14 285.15 285.16 285.17 285.18 285.19 285.20 285.21 285.22 285.23 285.24 285.25 285.26 285.27 285.28 285.29 285.30 285.31 285.32 286.1 286.2 286.3 286.4 286.5 286.6 286.7 286.8 286.9 286.10 286.11 286.12 286.13 286.14 286.15 286.16 286.17 286.18 286.19 286.20 286.21 286.22 286.23 286.24 286.25 286.26 286.27 286.28 286.29 286.30 286.31 286.32 286.33 286.34 287.1 287.2 287.3 287.4 287.5 287.6 287.7 287.8 287.9 287.10 287.11 287.12 287.13 287.14 287.15 287.16 287.17 287.18 287.19 287.20 287.21 287.22 287.23 287.24 287.25 287.26 287.27 287.28 287.29 287.30 287.31 287.32 287.33 287.34 288.1 288.2 288.3 288.4 288.5 288.6 288.7 288.8 288.9 288.10 288.11 288.12 288.13 288.14 288.15 288.16 288.17 288.18 288.19 288.20 288.21 288.22 288.23 288.24 288.25 288.26 288.27 288.28 288.29 288.30 288.31 288.32
289.1 289.2 289.3 289.4
289.5 289.6 289.7 289.8
289.9 289.10 289.11 289.12 289.13 289.14 289.15 289.16 289.17 289.18 289.19 289.20 289.21 289.22 289.23 289.24 289.25 289.26 289.27
289.28 289.29 289.30 290.1 290.2 290.3 290.4 290.5 290.6 290.7 290.8 290.9 290.10 290.11 290.12 290.13 290.14 290.15 290.16 290.17 290.18 290.19 290.20 290.21 290.22 290.23 290.24 290.25 290.26 290.27 290.28 290.29 290.30 290.31 291.1 291.2 291.3 291.4 291.5 291.6 291.7 291.8 291.9 291.10 291.11 291.12 291.13 291.14 291.15
291.16 291.17 291.18 291.19 291.20 291.21 291.22 291.23 291.24 291.25
291.26 291.27 291.28 292.1 292.2 292.3 292.4 292.5 292.6 292.7 292.8 292.9 292.10 292.11 292.12 292.13 292.14 292.15 292.16
292.17 292.18 292.19 292.20 292.21 292.22 292.23 292.24 292.25 292.26 292.27 292.28 292.29 292.30 292.31 292.32 293.1 293.2 293.3 293.4 293.5 293.6 293.7 293.8 293.9 293.10 293.11 293.12 293.13 293.14 293.15 293.16 293.17 293.18 293.19 293.20 293.21 293.22 293.23 293.24 293.25 293.26 293.27 293.28 293.29 293.30
294.1 294.2 294.3 294.4 294.5 294.6 294.7 294.8 294.9 294.10 294.11 294.12 294.13 294.14 294.15 294.16 294.17 294.18 294.19 294.20 294.21 294.22 294.23 294.24 294.25 294.26 294.27 294.28 294.29 294.30 294.31 294.32 294.33 295.1 295.2 295.3 295.4 295.5 295.6 295.7 295.8 295.9 295.10 295.11 295.12 295.13 295.14 295.15 295.16 295.17 295.18 295.19 295.20 295.21 295.22 295.23 295.24 295.25 295.26 295.27 295.28 295.29 295.30 295.31 295.32 296.1 296.2 296.3 296.4 296.5 296.6 296.7 296.8 296.9 296.10 296.11 296.12 296.13 296.14 296.15 296.16 296.17 296.18 296.19 296.20 296.21 296.22 296.23 296.24 296.25 296.26 296.27 296.28 296.29
296.30
297.1 297.2 297.3 297.4 297.5 297.6 297.7 297.8 297.9 297.10 297.11 297.12 297.13 297.14 297.15 297.16 297.17 297.18 297.19 297.20 297.21 297.22 297.23 297.24 297.25 297.26 297.27 297.28 297.29 298.1 298.2 298.3
298.4 298.5 298.6 298.7 298.8 298.9 298.10 298.11 298.12 298.13 298.14 298.15 298.16 298.17 298.18 298.19 298.20 298.21 298.22 298.23 298.24 298.25 298.26 298.27 298.28 298.29 298.30 298.31 298.32 299.1 299.2 299.3 299.4 299.5 299.6 299.7 299.8 299.9 299.10 299.11 299.12 299.13 299.14 299.15 299.16
299.17 299.18 299.19 299.20 299.21 299.22 299.23 299.24 299.25 299.26 299.27 299.28 299.29 299.30 300.1 300.2 300.3 300.4 300.5 300.6 300.7 300.8 300.9 300.10 300.11 300.12 300.13 300.14
300.15 300.16
300.17 300.18 300.19 300.20 300.21 300.22 300.23 300.24 300.25 300.26 300.27 300.28 300.29 300.30 300.31 301.1 301.2 301.3 301.4 301.5 301.6 301.7 301.8 301.9 301.10 301.11 301.12 301.13 301.14 301.15 301.16 301.17 301.18 301.19 301.20 301.21 301.22 301.23 301.24 301.25 301.26 301.27 301.28 301.29 301.30 301.31 301.32 301.33 301.34 302.1 302.2 302.3 302.4 302.5 302.6 302.7 302.8 302.9 302.10 302.11 302.12
302.13 302.14 302.15 302.16 302.17 302.18
302.19 302.20 302.21 302.22 302.23 302.24 302.25 302.26
302.27 302.28 302.29 302.30 302.31 303.1 303.2
303.3 303.4 303.5 303.6 303.7 303.8 303.9 303.10
303.11 303.12 303.13 303.14 303.15 303.16 303.17
303.18 303.19 303.20 303.21 303.22 303.23
303.24 303.25 303.26 303.27 303.28 303.29 303.30
304.1 304.2 304.3 304.4 304.5 304.6 304.7 304.8 304.9
304.10 304.11 304.12 304.13 304.14 304.15 304.16 304.17
304.18 304.19 304.20 304.21 304.22 304.23 304.24 304.25
304.26 304.27 304.28 304.29 304.30
305.1 305.2 305.3 305.4 305.5 305.6 305.7
305.8 305.9 305.10 305.11 305.12 305.13
305.14 305.15 305.16 305.17 305.18
305.19 305.20 305.21 305.22 305.23 305.24 305.25 305.26 305.27 305.28 305.29 305.30 305.31 306.1 306.2 306.3 306.4 306.5
306.6 306.7 306.8 306.9 306.10 306.11
306.12 306.13 306.14 306.15 306.16 306.17 306.18
306.19 306.20 306.21 306.22 306.23 306.24
306.25 306.26 306.27 306.28 306.29
307.1 307.2 307.3 307.4 307.5 307.6 307.7 307.8 307.9 307.10 307.11 307.12 307.13 307.14 307.15 307.16 307.17 307.18 307.19 307.20 307.21 307.22 307.23 307.24 307.25 307.26 307.27 307.28 307.29 307.30 307.31 307.32 307.33 307.34 308.1 308.2 308.3 308.4 308.5 308.6 308.7 308.8 308.9 308.10 308.11 308.12 308.13 308.14 308.15 308.16 308.17 308.18 308.19 308.20 308.21 308.22
308.23 308.24
308.25 308.26 308.27 308.28 308.29 308.30 308.31 308.32 308.33 309.1 309.2 309.3 309.4 309.5 309.6 309.7 309.8 309.9 309.10 309.11 309.12 309.13 309.14 309.15 309.16 309.17 309.18 309.19 309.20 309.21
309.22 309.23
309.24 309.25 309.26 309.27 309.28 309.29 309.30 309.31 310.1 310.2 310.3 310.4 310.5 310.6 310.7 310.8 310.9 310.10 310.11 310.12 310.13 310.14 310.15 310.16 310.17 310.18 310.19 310.20 310.21 310.22 310.23 310.24 310.25 310.26 310.27 310.28 310.29 310.30 310.31 310.32
311.1 311.2 311.3 311.4 311.5 311.6 311.7 311.8 311.9 311.10 311.11 311.12 311.13 311.14 311.15 311.16 311.17 311.18 311.19 311.20 311.21 311.22 311.23 311.24 311.25 311.26 311.27 311.28 311.29 311.30 311.31 311.32 312.1 312.2 312.3 312.4 312.5 312.6 312.7 312.8 312.9 312.10 312.11 312.12 312.13 312.14 312.15 312.16
312.17 312.18 312.19 312.20 312.21 312.22 312.23
312.24
312.25 312.26 312.27 312.28 312.29 312.30 312.31 313.1 313.2 313.3 313.4 313.5 313.6 313.7 313.8 313.9 313.10
313.11 313.12 313.13 313.14 313.15 313.16 313.17 313.18 313.19 313.20 313.21 313.22 313.23 313.24 313.25 313.26 313.27 313.28 313.29 313.30 313.31 313.32 313.33 313.34 314.1 314.2 314.3 314.4 314.5 314.6 314.7 314.8 314.9 314.10 314.11 314.12 314.13 314.14 314.15 314.16 314.17 314.18 314.19 314.20 314.21 314.22 314.23 314.24 314.25
314.26 314.27 314.28 314.29 314.30 314.31 314.32 314.33 315.1 315.2 315.3 315.4 315.5 315.6 315.7 315.8 315.9 315.10 315.11 315.12 315.13 315.14 315.15 315.16 315.17 315.18 315.19 315.20 315.21 315.22 315.23 315.24 315.25 315.26 315.27 315.28 315.29 316.1 316.2 316.3 316.4 316.5 316.6 316.7 316.8 316.9 316.10 316.11 316.12 316.13 316.14 316.15 316.16
316.17 316.18 316.19 316.20 316.21 316.22 316.23 316.24 316.25 316.26 316.27 316.28 316.29 316.30 316.31 316.32 317.1 317.2 317.3 317.4 317.5 317.6 317.7 317.8 317.9 317.10 317.11
317.12 317.13 317.14 317.15 317.16 317.17 317.18 317.19 317.20 317.21 317.22 317.23 317.24 317.25 317.26 317.27 317.28 317.29 317.30 317.31 317.32 317.33 318.1 318.2 318.3 318.4 318.5 318.6 318.7 318.8 318.9 318.10 318.11 318.12 318.13 318.14
318.15
318.16 318.17 318.18 318.19 318.20 318.21 318.22 318.23 318.24 318.25 318.26 318.27 318.28 318.29 318.30 318.31 318.32 318.33 319.1 319.2 319.3 319.4 319.5 319.6 319.7 319.8 319.9 319.10 319.11 319.12 319.13 319.14 319.15 319.16 319.17 319.18 319.19 319.20 319.21 319.22 319.23
319.24 319.25 319.26 319.27 319.28 319.29 319.30 319.31 319.32 319.33 320.1 320.2 320.3 320.4 320.5
320.6 320.7 320.8 320.9 320.10 320.11 320.12 320.13 320.14 320.15 320.16 320.17 320.18 320.19 320.20 320.21
320.22 320.23 320.24 320.25 320.26 320.27 320.28 320.29 320.30 321.1 321.2 321.3 321.4 321.5 321.6 321.7 321.8 321.9 321.10 321.11 321.12 321.13 321.14 321.15 321.16 321.17 321.18 321.19 321.20 321.21 321.22 321.23 321.24 321.25 321.26 321.27 321.28 321.29 321.30 321.31 321.32 321.33 322.1 322.2 322.3 322.4 322.5 322.6 322.7 322.8 322.9 322.10 322.11 322.12 322.13 322.14 322.15 322.16 322.17 322.18 322.19 322.20 322.21 322.22 322.23 322.24 322.25 322.26 322.27 322.28 322.29 322.30 322.31 322.32 322.33 323.1 323.2 323.3 323.4 323.5 323.6 323.7 323.8 323.9 323.10 323.11 323.12 323.13 323.14 323.15 323.16 323.17 323.18 323.19 323.20 323.21 323.22 323.23 323.24 323.25 323.26 323.27 323.28 323.29 323.30 323.31 323.32 323.33 323.34 324.1 324.2 324.3 324.4 324.5 324.6 324.7 324.8 324.9 324.10 324.11 324.12 324.13 324.14 324.15 324.16 324.17 324.18 324.19 324.20 324.21 324.22 324.23 324.24 324.25 324.26 324.27 324.28 324.29 325.1 325.2 325.3 325.4 325.5 325.6 325.7 325.8 325.9 325.10 325.11 325.12 325.13 325.14 325.15 325.16 325.17 325.18 325.19 325.20 325.21 325.22 325.23 325.24 325.25 325.26 325.27 325.28
325.29 325.30 325.31 325.32
326.1 326.2
326.3 326.4
326.5 326.6 326.7 326.8 326.9 326.10 326.11 326.12 326.13 326.14 326.15 326.16 326.17 326.18 326.19 326.20 326.21 326.22 326.23 326.24 326.25 326.26 326.27 326.28 326.29 326.30 327.1 327.2
327.3 327.4 327.5 327.6 327.7 327.8 327.9 327.10 327.11 327.12 327.13 327.14 327.15 327.16 327.17 327.18 327.19 327.20 327.21 327.22 327.23 327.24 327.25 327.26 327.27 327.28 327.29 327.30 327.31 328.1 328.2 328.3 328.4 328.5 328.6 328.7 328.8 328.9 328.10 328.11 328.12 328.13 328.14 328.15 328.16 328.17 328.18 328.19 328.20 328.21 328.22 328.23 328.24 328.25 328.26 328.27 328.28 328.29 328.30 328.31 328.32 328.33 329.1 329.2 329.3 329.4 329.5 329.6 329.7 329.8 329.9 329.10 329.11 329.12 329.13 329.14 329.15 329.16 329.17 329.18 329.19 329.20 329.21 329.22 329.23 329.24 329.25 329.26 329.27 329.28 329.29 329.30 329.31 330.1 330.2 330.3 330.4 330.5 330.6 330.7 330.8 330.9 330.10 330.11 330.12 330.13 330.14 330.15 330.16 330.17 330.18 330.19 330.20 330.21 330.22 330.23 330.24 330.25
330.26 330.27 330.28 330.29 330.30
330.31 330.32 330.33
331.1 331.2 331.3 331.4 331.5 331.6 331.7 331.8 331.9 331.10 331.11 331.12 331.13 331.14 331.15 331.16 331.17 331.18 331.19 331.20 331.21 331.22 331.23 331.24 331.25 331.26 331.27 331.28 331.29 331.30 331.31 332.1 332.2 332.3 332.4 332.5 332.6 332.7 332.8 332.9 332.10 332.11 332.12 332.13 332.14 332.15 332.16 332.17 332.18 332.19 332.20 332.21 332.22 332.23 332.24 332.25 332.26 332.27 332.28 332.29 332.30 332.31 333.1 333.2 333.3 333.4 333.5 333.6
333.7 333.8 333.9
333.10 333.11 333.12 333.13 333.14 333.15 333.16 333.17 333.18 333.19 333.20 333.21 333.22 333.23 333.24 333.25 333.26 333.27 333.28 333.29 333.30 333.31 334.1 334.2 334.3 334.4 334.5 334.6 334.7 334.8 334.9 334.10 334.11 334.12 334.13 334.14 334.15 334.16 334.17 334.18 334.19 334.20 334.21 334.22 334.23 334.24 334.25 334.26 334.27 334.28 334.29 334.30 334.31 334.32 335.1 335.2 335.3 335.4 335.5 335.6 335.7 335.8 335.9 335.10 335.11 335.12 335.13 335.14 335.15 335.16 335.17 335.18 335.19 335.20 335.21 335.22 335.23 335.24 335.25 335.26 335.27 335.28
335.29 335.30 335.31
336.1 336.2 336.3 336.4 336.5 336.6 336.7 336.8
336.9 336.10 336.11
336.12 336.13 336.14 336.15 336.16 336.17 336.18 336.19 336.20 336.21 336.22 336.23 336.24 336.25 336.26 336.27 336.28 336.29 336.30 337.1 337.2 337.3 337.4 337.5 337.6 337.7 337.8 337.9 337.10 337.11 337.12 337.13 337.14 337.15 337.16 337.17 337.18 337.19 337.20 337.21 337.22 337.23 337.24 337.25 337.26 337.27 337.28 337.29 337.30 337.31 337.32 338.1 338.2 338.3 338.4 338.5 338.6 338.7 338.8 338.9 338.10 338.11 338.12 338.13 338.14 338.15 338.16 338.17 338.18 338.19 338.20 338.21 338.22 338.23 338.24 338.25 338.26 338.27 338.28 338.29 338.30 338.31 338.32 339.1 339.2 339.3 339.4 339.5 339.6 339.7 339.8 339.9 339.10 339.11 339.12 339.13 339.14 339.15 339.16 339.17 339.18 339.19 339.20 339.21 339.22 339.23 339.24 339.25 339.26 339.27 339.28 339.29 340.1 340.2 340.3 340.4 340.5 340.6 340.7 340.8 340.9 340.10 340.11 340.12 340.13 340.14 340.15 340.16 340.17 340.18 340.19 340.20 340.21 340.22 340.23 340.24 340.25 340.26
340.27 340.28 340.29 340.30 340.31 340.32 341.1 341.2 341.3 341.4 341.5 341.6 341.7 341.8 341.9 341.10 341.11 341.12 341.13 341.14 341.15 341.16 341.17 341.18 341.19
341.20 341.21 341.22
341.23 341.24 341.25 341.26 341.27 341.28 341.29 341.30 341.31 342.1 342.2 342.3 342.4 342.5 342.6 342.7 342.8 342.9 342.10 342.11 342.12 342.13 342.14 342.15 342.16 342.17 342.18 342.19 342.20 342.21 342.22 342.23 342.24 342.25 342.26 342.27 342.28 342.29 342.30 342.31 342.32 343.1 343.2 343.3 343.4 343.5 343.6 343.7 343.8 343.9 343.10 343.11 343.12 343.13 343.14 343.15 343.16 343.17 343.18 343.19 343.20 343.21 343.22 343.23 343.24 343.25 343.26 343.27 343.28 343.29 343.30 343.31
344.1 344.2 344.3
344.4 344.5 344.6 344.7 344.8 344.9
344.10 344.11 344.12 344.13 344.14 344.15 344.16 344.17 344.18 344.19 344.20 344.21 344.22 344.23 344.24 344.25 344.26 344.27 344.28 344.29 344.30 344.31 344.32 345.1 345.2 345.3 345.4 345.5 345.6 345.7 345.8 345.9 345.10 345.11 345.12 345.13 345.14 345.15 345.16 345.17 345.18 345.19 345.20 345.21 345.22 345.23 345.24 345.25 345.26 345.27 345.28 345.29 345.30 345.31 345.32 345.33 345.34 346.1 346.2 346.3 346.4 346.5 346.6 346.7 346.8 346.9 346.10 346.11 346.12 346.13 346.14 346.15 346.16 346.17 346.18 346.19 346.20 346.21 346.22 346.23 346.24 346.25 346.26 346.27 346.28 346.29 346.30 346.31 346.32 347.1 347.2 347.3 347.4 347.5 347.6 347.7 347.8 347.9 347.10 347.11 347.12 347.13 347.14 347.15 347.16 347.17 347.18 347.19 347.20 347.21 347.22 347.23
347.24
347.25 347.26 347.27 347.28 347.29 347.30 347.31 348.1 348.2 348.3 348.4 348.5 348.6 348.7 348.8 348.9 348.10 348.11 348.12 348.13 348.14 348.15 348.16
348.17
348.18 348.19 348.20 348.21 348.22 348.23 348.24 348.25 348.26 348.27 348.28 349.1 349.2 349.3 349.4 349.5 349.6 349.7 349.8 349.9 349.10 349.11 349.12 349.13 349.14 349.15 349.16 349.17 349.18 349.19 349.20 349.21 349.22 349.23 349.24 349.25 349.26 349.27 349.28 349.29 349.30 349.31
349.32
350.1 350.2 350.3 350.4 350.5 350.6 350.7 350.8 350.9 350.10 350.11 350.12 350.13 350.14 350.15 350.16 350.17 350.18
350.19
350.20 350.21 350.22 350.23 350.24 350.25 350.26 350.27 350.28 350.29 350.30 350.31 350.32 351.1 351.2 351.3 351.4 351.5 351.6
351.7
351.8 351.9 351.10 351.11 351.12 351.13 351.14 351.15 351.16 351.17 351.18 351.19 351.20 351.21 351.22 351.23 351.24 351.25 351.26 351.27 351.28 351.29 351.30 352.1 352.2 352.3
352.4
352.5 352.6 352.7 352.8 352.9 352.10 352.11 352.12 352.13 352.14 352.15 352.16 352.17 352.18 352.19 352.20 352.21 352.22 352.23 352.24 352.25 352.26 352.27 352.28 352.29 352.30 352.31 352.32 352.33
352.34
353.1 353.2 353.3 353.4 353.5 353.6 353.7 353.8 353.9 353.10 353.11 353.12 353.13 353.14 353.15 353.16 353.17 353.18 353.19 353.20 353.21 353.22 353.23 353.24 353.25 353.26 353.27 353.28 353.29 353.30 353.31 353.32 353.33 354.1 354.2 354.3 354.4 354.5 354.6 354.7 354.8 354.9 354.10 354.11 354.12 354.13 354.14 354.15 354.16 354.17 354.18 354.19 354.20 354.21 354.22 354.23 354.24 354.25 354.26 354.27 354.28 354.29 354.30 354.31 354.32 354.33 355.1 355.2 355.3 355.4 355.5 355.6 355.7 355.8 355.9 355.10 355.11 355.12 355.13 355.14 355.15 355.16 355.17 355.18 355.19 355.20 355.21 355.22 355.23 355.24 355.25 355.26 355.27 355.28 355.29 355.30 355.31 355.32
355.33
356.1 356.2 356.3 356.4 356.5
356.6
356.7 356.8 356.9 356.10 356.11 356.12 356.13 356.14 356.15 356.16 356.17 356.18
356.19 356.20 356.21 356.22 356.23 356.24 356.25 356.26 356.27 356.28 356.29 356.30 356.31 356.32 357.1 357.2
357.3 357.4 357.5 357.6 357.7 357.8 357.9 357.10 357.11 357.12 357.13 357.14 357.15 357.16 357.17 357.18 357.19 357.20 357.21 357.22 357.23 357.24 357.25 357.26 357.27 357.28 357.29 357.30 357.31 357.32 357.33 357.34 358.1 358.2 358.3 358.4 358.5 358.6 358.7
358.8 358.9 358.10 358.11 358.12 358.13 358.14 358.15 358.16 358.17 358.18 358.19 358.20 358.21 358.22 358.23 358.24 358.25 358.26 358.27 358.28 358.29 358.30 358.31 359.1 359.2 359.3
359.4 359.5 359.6 359.7 359.8 359.9 359.10 359.11 359.12 359.13 359.14 359.15 359.16 359.17 359.18 359.19 359.20 359.21 359.22 359.23 359.24 359.25 359.26 359.27 359.28 359.29 359.30 360.1 360.2 360.3 360.4 360.5 360.6 360.7
360.8 360.9 360.10 360.11
360.12 360.13 360.14 360.15 360.16 360.17 360.18 360.19 360.20 360.21 360.22
360.23 360.24 360.25 360.26 360.27
360.28
361.1 361.2 361.3 361.4 361.5
361.6 361.7 361.8 361.9 361.10 361.11 361.12
361.13
361.14 361.15 361.16 361.17 361.18 361.19 361.20 361.21 361.22 361.23 361.24 361.25 361.26 361.27
361.28
362.1 362.2 362.3 362.4 362.5 362.6 362.7 362.8 362.9
362.10
362.11 362.12 362.13 362.14 362.15 362.16 362.17 362.18 362.19 362.20 362.21 362.22 362.23 362.24 362.25 362.26 362.27 362.28
362.29
363.1 363.2 363.3 363.4 363.5 363.6 363.7 363.8 363.9 363.10 363.11 363.12 363.13 363.14 363.15 363.16
363.17
363.18 363.19 363.20 363.21 363.22 363.23 363.24 363.25 363.26 363.27 363.28 363.29 363.30 363.31
363.32
364.1 364.2 364.3 364.4 364.5 364.6 364.7 364.8 364.9 364.10 364.11 364.12 364.13 364.14 364.15 364.16
364.17 364.18 364.19 364.20 364.21 364.22 364.23 364.24 364.25 364.26 364.27 364.28 364.29 364.30 364.31 365.1 365.2 365.3 365.4 365.5 365.6 365.7 365.8 365.9 365.10 365.11 365.12 365.13 365.14 365.15 365.16 365.17
365.18
365.19 365.20 365.21 365.22 365.23 365.24 365.25 365.26 365.27 365.28 365.29 365.30 365.31 365.32 365.33 366.1 366.2 366.3 366.4 366.5 366.6 366.7 366.8 366.9 366.10 366.11 366.12 366.13 366.14
366.15
366.16 366.17 366.18 366.19 366.20 366.21 366.22 366.23 366.24 366.25 366.26 366.27 366.28 366.29 366.30 366.31 366.32 367.1 367.2 367.3 367.4 367.5 367.6 367.7 367.8 367.9 367.10 367.11 367.12 367.13 367.14 367.15
367.16
367.17 367.18 367.19 367.20 367.21 367.22 367.23 367.24 367.25 367.26 367.27 367.28 367.29 367.30 367.31 367.32 367.33 367.34 368.1 368.2 368.3 368.4 368.5
368.6
368.7 368.8 368.9 368.10 368.11 368.12 368.13 368.14 368.15 368.16 368.17 368.18 368.19 368.20 368.21 368.22 368.23 368.24 368.25
368.26
368.27 368.28 368.29 368.30 368.31 369.1 369.2 369.3 369.4 369.5 369.6 369.7 369.8 369.9 369.10 369.11 369.12 369.13 369.14 369.15 369.16 369.17 369.18 369.19 369.20 369.21 369.22 369.23 369.24 369.25 369.26 369.27 369.28 369.29 369.30 369.31 369.32 369.33 369.34 370.1 370.2 370.3 370.4 370.5 370.6 370.7 370.8 370.9 370.10
370.11 370.12 370.13 370.14 370.15 370.16 370.17 370.18 370.19 370.20 370.21 370.22 370.23 370.24 370.25 370.26 370.27 370.28
371.1 371.2
371.3 371.4 371.5 371.6 371.7 371.8 371.9 371.10 371.11 371.12 371.13 371.14 371.15 371.16 371.17 371.18 371.19 371.20 371.21 371.22 371.23 371.24 371.25 371.26 371.27
371.28 371.29 371.30 371.31 371.32 372.1 372.2 372.3 372.4 372.5 372.6 372.7 372.8 372.9 372.10 372.11 372.12 372.13 372.14 372.15 372.16 372.17 372.18 372.19 372.20 372.21 372.22 372.23 372.24 372.25 372.26 372.27 372.28 372.29 372.30 373.1 373.2 373.3 373.4 373.5 373.6 373.7 373.8 373.9 373.10 373.11 373.12 373.13 373.14 373.15 373.16 373.17
373.18
373.19 373.20 373.21 373.22 373.23 373.24 373.25 373.26 373.27 373.28 373.29 373.30 373.31 373.32 374.1 374.2 374.3 374.4 374.5 374.6 374.7 374.8 374.9 374.10 374.11 374.12 374.13 374.14 374.15 374.16 374.17 374.18 374.19 374.20 374.21 374.22 374.23 374.24 374.25 374.26 374.27 374.28 374.29 374.30 374.31 374.32 374.33 375.1 375.2 375.3 375.4 375.5 375.6 375.7 375.8 375.9 375.10 375.11 375.12 375.13 375.14 375.15 375.16 375.17 375.18 375.19 375.20 375.21 375.22 375.23 375.24 375.25 375.26 375.27 375.28 375.29
375.30 375.31 375.32 376.1 376.2 376.3 376.4 376.5 376.6 376.7 376.8 376.9 376.10 376.11 376.12 376.13 376.14 376.15 376.16 376.17 376.18 376.19 376.20 376.21 376.22 376.23 376.24 376.25 376.26 376.27 376.28 376.29 376.30 376.31 376.32 377.1 377.2 377.3 377.4
377.5
377.6 377.7 377.8 377.9 377.10 377.11 377.12 377.13 377.14 377.15 377.16 377.17 377.18 377.19 377.20 377.21 377.22 377.23 377.24 377.25 377.26 377.27 377.28 377.29 377.30 377.31 377.32 377.33 378.1 378.2 378.3 378.4 378.5 378.6 378.7 378.8 378.9 378.10 378.11 378.12 378.13 378.14 378.15 378.16 378.17 378.18 378.19 378.20 378.21 378.22 378.23 378.24 378.25 378.26 378.27 378.28 378.29 378.30 378.31 378.32 379.1 379.2 379.3 379.4 379.5 379.6 379.7 379.8 379.9 379.10 379.11 379.12 379.13 379.14 379.15 379.16 379.17 379.18 379.19 379.20 379.21 379.22 379.23 379.24 379.25 379.26 379.27 379.28 379.29 379.30 379.31 379.32 380.1 380.2 380.3 380.4 380.5 380.6 380.7 380.8 380.9 380.10 380.11 380.12 380.13 380.14 380.15 380.16 380.17 380.18 380.19 380.20 380.21 380.22 380.23 380.24 380.25
380.26 380.27
380.28 380.29 380.30 380.31 380.32 380.33 380.34 381.1 381.2 381.3 381.4 381.5 381.6 381.7 381.8 381.9 381.10 381.11 381.12 381.13 381.14 381.15 381.16 381.17 381.18 381.19
381.20 381.21
381.22 381.23 381.24 381.25 381.26 381.27 381.28 381.29 381.30 381.31 381.32 381.33 381.34 382.1 382.2 382.3 382.4 382.5 382.6 382.7
382.8 382.9
382.10 382.11 382.12 382.13 382.14 382.15 382.16 382.17 382.18 382.19
382.20
382.21 382.22 382.23 382.24 382.25 382.26 382.27 382.28 382.29 382.30 382.31 383.1 383.2 383.3 383.4 383.5 383.6 383.7 383.8 383.9 383.10
383.11
383.12 383.13 383.14 383.15 383.16 383.17 383.18 383.19 383.20 383.21 383.22 383.23 383.24
383.25 383.26 383.27 383.28 383.29 383.30 384.1 384.2 384.3
384.4
384.5 384.6 384.7 384.8 384.9 384.10 384.11 384.12 384.13 384.14 384.15 384.16 384.17
384.18
384.19 384.20 384.21 384.22
384.23 384.24 384.25
384.26 384.27
384.28 384.29 384.30 384.31 385.1 385.2 385.3 385.4 385.5 385.6 385.7 385.8 385.9 385.10 385.11 385.12 385.13 385.14 385.15 385.16 385.17 385.18 385.19
385.20
385.21 385.22 385.23 385.24 385.25 385.26 385.27 385.28 385.29 385.30 385.31 385.32 386.1 386.2 386.3 386.4 386.5 386.6 386.7 386.8 386.9 386.10 386.11 386.12 386.13 386.14 386.15 386.16 386.17 386.18 386.19 386.20 386.21 386.22 386.23 386.24
386.25
386.26 386.27 386.28 386.29 386.30 386.31 386.32 386.33 386.34 387.1 387.2 387.3 387.4 387.5 387.6 387.7 387.8 387.9 387.10 387.11 387.12 387.13 387.14
387.15
387.16 387.17 387.18 387.19
387.20
387.21 387.22 387.23 387.24 387.25 387.26 387.27 387.28 387.29 387.30 387.31 388.1 388.2 388.3 388.4 388.5 388.6 388.7 388.8 388.9 388.10 388.11 388.12
388.13 388.14 388.15 388.16 388.17 388.18 388.19 388.20 388.21 388.22 388.23 388.24 388.25 388.26 388.27 388.28 388.29 388.30 388.31 388.32 389.1 389.2 389.3 389.4 389.5 389.6 389.7 389.8 389.9 389.10 389.11 389.12 389.13 389.14 389.15 389.16 389.17 389.18 389.19 389.20 389.21 389.22 389.23 389.24 389.25 389.26 389.27 389.28 389.29 389.30 389.31 389.32 390.1 390.2 390.3 390.4 390.5 390.6 390.7 390.8 390.9 390.10 390.11 390.12 390.13 390.14
390.15
390.16 390.17 390.18 390.19 390.20 390.21 390.22
390.23
390.24 390.25 390.26 390.27 390.28 390.29 390.30 390.31
391.1 391.2 391.3 391.4 391.5 391.6 391.7 391.8 391.9 391.10 391.11 391.12 391.13 391.14 391.15 391.16 391.17 391.18 391.19 391.20 391.21 391.22 391.23 391.24 391.25 391.26 391.27 391.28 391.29 391.30 391.31 391.32 392.1
392.2 392.3 392.4 392.5
392.6 392.7 392.8 392.9 392.10 392.11 392.12 392.13 392.14 392.15 392.16 392.17 392.18 392.19 392.20 392.21 392.22 392.23 392.24 392.25 392.26 392.27 392.28 392.29 392.30 393.1 393.2 393.3 393.4 393.5 393.6 393.7 393.8 393.9 393.10 393.11 393.12 393.13 393.14 393.15 393.16 393.17 393.18 393.19 393.20 393.21 393.22 393.23
393.24 393.25 393.26 393.27 393.28 393.29 393.30 394.1 394.2
394.3 394.4 394.5 394.6 394.7 394.8 394.9 394.10 394.11
394.12 394.13 394.14 394.15 394.16 394.17 394.18 394.19 394.20 394.21 394.22 394.23 394.24 394.25 394.26 394.27 394.28 394.29 394.30 394.31 395.1 395.2
395.3 395.4 395.5 395.6 395.7 395.8 395.9 395.10 395.11 395.12
395.13 395.14 395.15 395.16 395.17 395.18 395.19 395.20 395.21 395.22 395.23 395.24 395.25 395.26 395.27 395.28 395.29 395.30 395.31 395.32 395.33 396.1 396.2 396.3 396.4 396.5 396.6 396.7 396.8 396.9 396.10 396.11
396.12
396.13 396.14 396.15 396.16
396.17
396.18 396.19 396.20 396.21 396.22 396.23 396.24 396.25 396.26 396.27 396.28
396.29
397.1 397.2 397.3 397.4 397.5 397.6 397.7 397.8
397.9
397.10 397.11 397.12 397.13 397.14 397.15 397.16 397.17 397.18 397.19 397.20 397.21 397.22 397.23 397.24 397.25
397.26
397.27 397.28 397.29 397.30
397.31
398.1 398.2 398.3 398.4 398.5 398.6
398.7
398.8 398.9 398.10 398.11 398.12 398.13 398.14 398.15 398.16 398.17 398.18 398.19 398.20 398.21 398.22 398.23 398.24 398.25 398.26 398.27 398.28 398.29 398.30 399.1 399.2
399.3 399.4 399.5
399.6 399.7 399.8 399.9 399.10 399.11 399.12 399.13 399.14 399.15 399.16 399.17 399.18 399.19 399.20 399.21 399.22 399.23 399.24 399.25
399.26
399.27 399.28 399.29 399.30 399.31 400.1 400.2 400.3 400.4 400.5 400.6 400.7 400.8 400.9 400.10 400.11 400.12 400.13 400.14 400.15 400.16 400.17 400.18 400.19 400.20 400.21 400.22
400.23
400.24 400.25 400.26 400.27 400.28 400.29 400.30 400.31 401.1 401.2 401.3 401.4 401.5 401.6 401.7 401.8 401.9 401.10 401.11 401.12 401.13 401.14 401.15 401.16 401.17 401.18 401.19 401.20 401.21 401.22 401.23 401.24 401.25 401.26 401.27 401.28 401.29 401.30 401.31 401.32 401.33 401.34 402.1 402.2 402.3 402.4 402.5 402.6 402.7 402.8 402.9 402.10 402.11 402.12 402.13 402.14 402.15 402.16 402.17 402.18 402.19 402.20 402.21 402.22 402.23 402.24 402.25 402.26
402.27
402.28 402.29 402.30 402.31 402.32 403.1 403.2 403.3 403.4 403.5 403.6 403.7 403.8 403.9 403.10 403.11 403.12 403.13
403.14 403.15
403.16 403.17 403.18 403.19 403.20 403.21
403.22
403.23 403.24 403.25 403.26 403.27 403.28 403.29 404.1 404.2 404.3 404.4 404.5 404.6 404.7 404.8 404.9 404.10 404.11 404.12 404.13 404.14
404.15
404.16 404.17 404.18 404.19 404.20 404.21
404.22
404.23 404.24 404.25 404.26 404.27 404.28 404.29 404.30 404.31 405.1 405.2 405.3 405.4 405.5 405.6 405.7 405.8 405.9 405.10 405.11 405.12
405.13
405.14 405.15 405.16 405.17 405.18 405.19 405.20 405.21 405.22 405.23 405.24 405.25 405.26 405.27 405.28 405.29
405.30
406.1 406.2 406.3 406.4 406.5 406.6 406.7 406.8 406.9 406.10 406.11 406.12 406.13 406.14 406.15 406.16 406.17 406.18 406.19 406.20 406.21 406.22 406.23 406.24 406.25 406.26 406.27 406.28 406.29 406.30 406.31 407.1 407.2 407.3 407.4 407.5 407.6 407.7 407.8 407.9 407.10 407.11 407.12 407.13 407.14 407.15 407.16 407.17 407.18 407.19 407.20 407.21 407.22 407.23 407.24 407.25 407.26 407.27
407.28
407.29 407.30 407.31 407.32 407.33 408.1 408.2 408.3 408.4 408.5 408.6 408.7 408.8 408.9 408.10 408.11 408.12 408.13 408.14 408.15 408.16 408.17 408.18 408.19 408.20 408.21 408.22 408.23 408.24 408.25
408.26
408.27 408.28 408.29 408.30 408.31 408.32 408.33 409.1 409.2 409.3 409.4 409.5 409.6 409.7 409.8 409.9 409.10 409.11 409.12 409.13 409.14 409.15 409.16 409.17 409.18 409.19 409.20 409.21 409.22 409.23 409.24 409.25 409.26 409.27 409.28 409.29
409.30
410.1 410.2 410.3 410.4 410.5 410.6 410.7 410.8 410.9 410.10 410.11 410.12 410.13 410.14 410.15 410.16 410.17 410.18 410.19 410.20 410.21 410.22 410.23 410.24 410.25 410.26 410.27 410.28 410.29 410.30 410.31 410.32 410.33 410.34 411.1 411.2 411.3 411.4 411.5 411.6 411.7 411.8 411.9 411.10 411.11 411.12 411.13 411.14 411.15 411.16 411.17 411.18 411.19 411.20 411.21 411.22 411.23 411.24 411.25 411.26 411.27 411.28 411.29 411.30 411.31 411.32 411.33 411.34 412.1 412.2 412.3 412.4 412.5 412.6 412.7 412.8 412.9 412.10 412.11 412.12 412.13 412.14 412.15 412.16 412.17 412.18 412.19 412.20 412.21 412.22 412.23 412.24 412.25 412.26 412.27 412.28 412.29 412.30 412.31 412.32 413.1 413.2 413.3 413.4 413.5
413.6
413.7 413.8 413.9 413.10 413.11 413.12 413.13 413.14 413.15 413.16 413.17 413.18 413.19 413.20 413.21 413.22 413.23 413.24 413.25
413.26
413.27 413.28 413.29 413.30 413.31 413.32 414.1 414.2 414.3 414.4 414.5 414.6 414.7 414.8 414.9 414.10 414.11 414.12 414.13 414.14 414.15 414.16 414.17 414.18 414.19 414.20 414.21 414.22 414.23 414.24 414.25 414.26 414.27 414.28 414.29
414.30
415.1 415.2 415.3 415.4 415.5 415.6 415.7 415.8
415.9
415.10 415.11 415.12 415.13 415.14 415.15 415.16
415.17 415.18 415.19 415.20
415.21
415.22 415.23 415.24 415.25 415.26 415.27 415.28 415.29 415.30
416.1 416.2 416.3 416.4 416.5
416.6 416.7 416.8 416.9 416.10 416.11 416.12
416.13 416.14 416.15 416.16 416.17 416.18 416.19 416.20 416.21 416.22 416.23 416.24 416.25 416.26 416.27 416.28 416.29 417.1 417.2 417.3 417.4 417.5
417.6
417.7 417.8 417.9 417.10 417.11 417.12
417.13
417.14 417.15 417.16 417.17 417.18 417.19 417.20 417.21 417.22 417.23 417.24 417.25 417.26 417.27 417.28 418.1 418.2 418.3 418.4 418.5 418.6 418.7 418.8 418.9 418.10 418.11 418.12 418.13 418.14 418.15 418.16 418.17 418.18 418.19 418.20 418.21 418.22 418.23 418.24 418.25 418.26
418.27 418.28 418.29 418.30
419.1 419.2 419.3 419.4 419.5
419.6 419.7 419.8 419.9 419.10
419.11
419.12 419.13 419.14 419.15 419.16
419.17
419.18 419.19 419.20 419.21 419.22 419.23 419.24 419.25 419.26 419.27
419.28
420.1 420.2 420.3 420.4 420.5 420.6 420.7 420.8 420.9 420.10 420.11 420.12 420.13 420.14 420.15 420.16 420.17 420.18 420.19 420.20 420.21 420.22 420.23 420.24 420.25 420.26 420.27 420.28 420.29 420.30 420.31 420.32 421.1 421.2 421.3 421.4 421.5 421.6 421.7 421.8 421.9 421.10 421.11 421.12 421.13 421.14 421.15 421.16 421.17 421.18 421.19 421.20 421.21 421.22 421.23
421.24 421.25
421.26 421.27 421.28 421.29 422.1 422.2 422.3 422.4
422.5
422.6 422.7 422.8 422.9 422.10 422.11 422.12 422.13 422.14 422.15 422.16 422.17 422.18 422.19 422.20 422.21 422.22
422.23
422.24 422.25 422.26 422.27 422.28 422.29 423.1 423.2 423.3 423.4 423.5 423.6
423.7
423.8 423.9 423.10 423.11 423.12 423.13 423.14 423.15 423.16 423.17 423.18 423.19 423.20 423.21 423.22
423.23
423.24 423.25 423.26 423.27 423.28 423.29 424.1 424.2 424.3 424.4
424.5
424.6 424.7 424.8 424.9 424.10 424.11 424.12 424.13 424.14 424.15 424.16 424.17 424.18 424.19 424.20 424.21 424.22 424.23 424.24 424.25 424.26 424.27 424.28 424.29 424.30 424.31
424.32
425.1 425.2 425.3 425.4 425.5 425.6 425.7 425.8 425.9 425.10 425.11 425.12 425.13 425.14 425.15 425.16 425.17 425.18 425.19 425.20 425.21 425.22 425.23 425.24 425.25 425.26 425.27 425.28 425.29 425.30 425.31 425.32 426.1 426.2
426.3
426.4 426.5 426.6 426.7 426.8 426.9 426.10 426.11 426.12 426.13 426.14 426.15 426.16 426.17 426.18 426.19 426.20 426.21
426.22
426.23 426.24 426.25 426.26 426.27 426.28 426.29 426.30 427.1 427.2 427.3 427.4 427.5 427.6
427.7
427.8 427.9 427.10 427.11 427.12 427.13 427.14 427.15 427.16 427.17 427.18 427.19 427.20 427.21 427.22 427.23 427.24 427.25 427.26 427.27 427.28 427.29 427.30 427.31 428.1 428.2
428.3 428.4 428.5 428.6 428.7 428.8
428.9 428.10 428.11
428.12 428.13
428.14 428.15 428.16 428.17 428.18 428.19
428.20 428.21 428.22 428.23 428.24 428.25 428.26 428.27 428.28 428.29 428.30 429.1 429.2 429.3 429.4 429.5 429.6 429.7 429.8 429.9 429.10 429.11 429.12 429.13 429.14 429.15 429.16 429.17
429.18
429.19 429.20 429.21 429.22 429.23 429.24 429.25 429.26 429.27 429.28 429.29 429.30 429.31 430.1 430.2 430.3 430.4 430.5 430.6 430.7 430.8 430.9 430.10 430.11 430.12 430.13 430.14 430.15 430.16 430.17 430.18
430.19 430.20 430.21 430.22 430.23 430.24 430.25 430.26 430.27 430.28 430.29 430.30 431.1 431.2 431.3 431.4 431.5 431.6 431.7 431.8 431.9 431.10 431.11 431.12 431.13 431.14 431.15 431.16 431.17
431.18
431.19 431.20 431.21 431.22 431.23 431.24 431.25 431.26 431.27 431.28 431.29 431.30 431.31 431.32 432.1 432.2 432.3 432.4 432.5 432.6 432.7 432.8 432.9 432.10 432.11 432.12 432.13 432.14 432.15 432.16 432.17 432.18 432.19 432.20 432.21
432.22 432.23 432.24 432.25 432.26 432.27 432.28 432.29 432.30 432.31 432.32 432.33 432.34 433.1 433.2 433.3 433.4 433.5 433.6 433.7 433.8 433.9 433.10 433.11 433.12 433.13 433.14 433.15 433.16 433.17 433.18 433.19 433.20 433.21 433.22 433.23 433.24 433.25 433.26 433.27 433.28 433.29 434.1 434.2 434.3 434.4 434.5 434.6 434.7 434.8 434.9 434.10 434.11 434.12 434.13 434.14 434.15 434.16 434.17 434.18 434.19 434.20 434.21 434.22 434.23 434.24 434.25 434.26 434.27 434.28 434.29
435.1 435.2 435.3 435.4 435.5 435.6 435.7 435.8 435.9 435.10 435.11 435.12 435.13 435.14 435.15 435.16 435.17 435.18 435.19 435.20 435.21 435.22 435.23 435.24 435.25 435.26 435.27 435.28 435.29 436.1 436.2 436.3 436.4 436.5 436.6 436.7
436.8 436.9 436.10 436.11 436.12 436.13 436.14 436.15 436.16 436.17 436.18 436.19 436.20 436.21
436.22
436.23 436.24 436.25 436.26 436.27 436.28 436.29 436.30 437.1 437.2 437.3 437.4 437.5 437.6 437.7 437.8 437.9 437.10 437.11 437.12 437.13 437.14 437.15 437.16 437.17 437.18 437.19 437.20 437.21 437.22 437.23 437.24 437.25 437.26 437.27 437.28 437.29 437.30 437.31 438.1 438.2 438.3 438.4 438.5 438.6 438.7 438.8 438.9 438.10 438.11 438.12 438.13 438.14 438.15 438.16
438.17 438.18 438.19 438.20 438.21 438.22
438.23 438.24 438.25
439.1 439.2
439.3 439.4 439.5 439.6 439.7 439.8 439.9 439.10
439.11
439.12 439.13 439.14 439.15 439.16 439.17 439.18 439.19 439.20 439.21 439.22 439.23 439.24 439.25 439.26 439.27 439.28 439.29 439.30 439.31 439.32 439.33 440.1 440.2 440.3 440.4 440.5 440.6 440.7 440.8 440.9 440.10 440.11 440.12 440.13 440.14 440.15 440.16
440.17
440.18 440.19 440.20 440.21 440.22 440.23 440.24 440.25 440.26 440.27 440.28 440.29 440.30
440.31
441.1 441.2 441.3 441.4 441.5 441.6 441.7 441.8 441.9 441.10
441.11
441.12 441.13 441.14 441.15 441.16 441.17 441.18 441.19 441.20 441.21 441.22 441.23 441.24 441.25 441.26 441.27 441.28 441.29 441.30 442.1 442.2 442.3 442.4 442.5 442.6 442.7 442.8 442.9
442.10
442.11 442.12 442.13 442.14 442.15 442.16 442.17 442.18 442.19 442.20 442.21 442.22 442.23 442.24 442.25 442.26 442.27 442.28 442.29 442.30 443.1 443.2 443.3 443.4 443.5 443.6 443.7 443.8 443.9
443.10
443.11 443.12 443.13 443.14 443.15 443.16 443.17 443.18 443.19
443.20
443.21 443.22 443.23 443.24 443.25 443.26 443.27 443.28 443.29
443.30
444.1 444.2 444.3 444.4 444.5 444.6 444.7 444.8 444.9 444.10 444.11 444.12 444.13 444.14 444.15 444.16 444.17 444.18 444.19 444.20 444.21 444.22 444.23 444.24 444.25 444.26 444.27
444.28
444.29 444.30 444.31 444.32 444.33 445.1 445.2 445.3 445.4 445.5 445.6 445.7 445.8 445.9 445.10 445.11 445.12 445.13 445.14 445.15 445.16 445.17 445.18 445.19 445.20
445.21
445.22 445.23 445.24 445.25 445.26 445.27 445.28 445.29 446.1 446.2 446.3 446.4 446.5 446.6 446.7 446.8 446.9 446.10 446.11 446.12 446.13 446.14 446.15 446.16 446.17 446.18 446.19 446.20 446.21 446.22 446.23 446.24 446.25 446.26 446.27 446.28 446.29 446.30 446.31 447.1 447.2 447.3 447.4 447.5 447.6 447.7 447.8 447.9 447.10 447.11 447.12 447.13 447.14 447.15 447.16
447.17 447.18 447.19 447.20 447.21 447.22 447.23 447.24 447.25 447.26 447.27 447.28 447.29 447.30 447.31 447.32 447.33 448.1 448.2 448.3 448.4 448.5 448.6 448.7 448.8 448.9 448.10 448.11 448.12 448.13 448.14 448.15 448.16 448.17 448.18 448.19 448.20 448.21
448.22 448.23 448.24 448.25 448.26 448.27
448.28
449.1 449.2 449.3 449.4 449.5 449.6 449.7 449.8 449.9 449.10 449.11 449.12 449.13 449.14 449.15 449.16 449.17 449.18 449.19 449.20 449.21
449.22
449.23 449.24 449.25 449.26 449.27 449.28 449.29 449.30 449.31 449.32 450.1 450.2 450.3 450.4 450.5 450.6 450.7 450.8 450.9 450.10 450.11 450.12 450.13 450.14 450.15 450.16 450.17 450.18 450.19 450.20 450.21 450.22 450.23 450.24 450.25 450.26 450.27 450.28 450.29
450.30
451.1 451.2 451.3 451.4 451.5 451.6 451.7 451.8 451.9 451.10 451.11 451.12 451.13 451.14 451.15 451.16 451.17 451.18 451.19 451.20 451.21 451.22 451.23 451.24 451.25 451.26 451.27 451.28 451.29 451.30 451.31
451.32
452.1 452.2 452.3 452.4 452.5 452.6 452.7 452.8 452.9 452.10 452.11 452.12 452.13 452.14 452.15 452.16
452.17
452.18 452.19 452.20 452.21 452.22 452.23 452.24 452.25 452.26 452.27 452.28 452.29 452.30 452.31 453.1 453.2 453.3 453.4 453.5 453.6 453.7 453.8 453.9 453.10 453.11 453.12 453.13 453.14 453.15 453.16 453.17 453.18 453.19 453.20 453.21 453.22 453.23 453.24 453.25 453.26 453.27 453.28 453.29 453.30 454.1 454.2 454.3 454.4 454.5 454.6 454.7 454.8 454.9 454.10 454.11 454.12 454.13 454.14 454.15 454.16 454.17 454.18 454.19 454.20 454.21 454.22 454.23 454.24 454.25 454.26 454.27 454.28 454.29 454.30 455.1 455.2 455.3 455.4 455.5 455.6 455.7 455.8 455.9 455.10 455.11 455.12 455.13 455.14 455.15 455.16 455.17 455.18 455.19 455.20 455.21 455.22 455.23 455.24 455.25 455.26 455.27 455.28 455.29 455.30 455.31 455.32 456.1 456.2 456.3 456.4 456.5 456.6 456.7 456.8
456.9 456.10 456.11 456.12 456.13 456.14 456.15 456.16 456.17 456.18 456.19 456.20 456.21 456.22 456.23 456.24 456.25 456.26 456.27 456.28 456.29 456.30 456.31 456.32 457.1 457.2
457.3
457.4 457.5 457.6 457.7 457.8 457.9
457.10
457.11 457.12 457.13 457.14 457.15 457.16 457.17 457.18 457.19 457.20 457.21 457.22 457.23 457.24 457.25 457.26 457.27 457.28 457.29 457.30 457.31 458.1 458.2 458.3 458.4 458.5 458.6 458.7 458.8 458.9 458.10 458.11 458.12
458.13
458.14 458.15 458.16 458.17 458.18 458.19 458.20 458.21 458.22 458.23 458.24 458.25 458.26 458.27 458.28 458.29 458.30 459.1 459.2 459.3 459.4 459.5 459.6 459.7 459.8 459.9 459.10 459.11 459.12 459.13 459.14 459.15 459.16
459.17 459.18 459.19 459.20 459.21 459.22 459.23 459.24 459.25 459.26 459.27 459.28 459.29 459.30
460.1 460.2 460.3 460.4 460.5 460.6 460.7 460.8 460.9 460.10 460.11 460.12 460.13 460.14 460.15 460.16 460.17 460.18 460.19 460.20 460.21 460.22 460.23 460.24 460.25 460.26 460.27 460.28 460.29 460.30 460.31 461.1 461.2 461.3 461.4
461.5 461.6 461.7 461.8 461.9 461.10 461.11 461.12 461.13 461.14 461.15
461.16 461.17 461.18 461.19 461.20 461.21 461.22 461.23 461.24 461.25
461.26 461.27 461.28 461.29 461.30
461.31
462.1 462.2 462.3 462.4 462.5 462.6 462.7 462.8 462.9 462.10 462.11 462.12 462.13 462.14 462.15 462.16 462.17
462.18 462.19 462.20 462.21 462.22 462.23 462.24 462.25 462.26 462.27 462.28 462.29 462.30 462.31 463.1 463.2 463.3 463.4 463.5 463.6 463.7 463.8 463.9 463.10 463.11 463.12 463.13 463.14 463.15 463.16 463.17 463.18 463.19 463.20 463.21 463.22 463.23 463.24 463.25 463.26 463.27 463.28 463.29 463.30 463.31 463.32 463.33 464.1 464.2 464.3 464.4 464.5 464.6 464.7 464.8 464.9 464.10 464.11 464.12 464.13 464.14 464.15 464.16 464.17 464.18 464.19 464.20 464.21 464.22 464.23 464.24 464.25 464.26 464.27 464.28 464.29 464.30 465.1 465.2 465.3 465.4 465.5 465.6 465.7 465.8 465.9 465.10 465.11 465.12 465.13 465.14 465.15 465.16 465.17 465.18 465.19 465.20 465.21 465.22 465.23 465.24 465.25 465.26 465.27 465.28 465.29 465.30 466.1 466.2 466.3 466.4 466.5 466.6 466.7 466.8 466.9
466.10
466.11 466.12 466.13 466.14 466.15 466.16 466.17 466.18 466.19 466.20 466.21 466.22 466.23 466.24 466.25
466.26 466.27 466.28 466.29 466.30 466.31 467.1 467.2 467.3 467.4
467.5
467.6 467.7
467.8
467.9 467.10
467.11 467.12 467.13 467.14 467.15 467.16 467.17
467.18
467.19 467.20 467.21 467.22 467.23 467.24 467.25 467.26 467.27 467.28 467.29 467.30 467.31
468.1
468.2 468.3 468.4 468.5 468.6 468.7 468.8 468.9 468.10 468.11 468.12 468.13 468.14 468.15 468.16 468.17 468.18 468.19
468.20
468.21 468.22 468.23 468.24 468.25 468.26 468.27 468.28 468.29 468.30 468.31 468.32 469.1 469.2 469.3 469.4 469.5
469.6
469.7 469.8 469.9 469.10 469.11 469.12 469.13 469.14 469.15 469.16 469.17 469.18 469.19 469.20 469.21 469.22 469.23 469.24 469.25 469.26 469.27 469.28 469.29 469.30 469.31 469.32 470.1 470.2 470.3 470.4 470.5
470.6
470.7 470.8 470.9 470.10 470.11 470.12 470.13 470.14 470.15 470.16 470.17
470.18
470.19 470.20 470.21 470.22 470.23 470.24 470.25 470.26
470.27
470.28 470.29 470.30 471.1 471.2 471.3 471.4 471.5 471.6 471.7 471.8 471.9 471.10 471.11 471.12 471.13 471.14 471.15 471.16 471.17 471.18 471.19 471.20 471.21 471.22 471.23 471.24 471.25 471.26 471.27 471.28 471.29 471.30 471.31 471.32 471.33
472.1
472.2 472.3 472.4 472.5 472.6 472.7 472.8 472.9 472.10 472.11 472.12 472.13 472.14 472.15 472.16 472.17 472.18 472.19
472.20
472.21 472.22 472.23 472.24 472.25 472.26 472.27 472.28 472.29 472.30 472.31 472.32 473.1 473.2 473.3 473.4 473.5 473.6 473.7 473.8 473.9 473.10 473.11 473.12 473.13 473.14 473.15 473.16 473.17 473.18 473.19 473.20 473.21 473.22 473.23 473.24 473.25 473.26 473.27 473.28 473.29 473.30 473.31 474.1 474.2 474.3 474.4 474.5 474.6 474.7 474.8 474.9 474.10 474.11 474.12 474.13 474.14 474.15 474.16 474.17 474.18 474.19
474.20
474.21 474.22 474.23 474.24 474.25 474.26 474.27 474.28 474.29 474.30 474.31
474.32
475.1 475.2 475.3 475.4 475.5 475.6 475.7 475.8
475.9
475.10 475.11 475.12 475.13 475.14 475.15 475.16 475.17 475.18 475.19 475.20 475.21 475.22 475.23 475.24 475.25 475.26 475.27 475.28 475.29
475.30
476.1 476.2 476.3 476.4 476.5 476.6 476.7 476.8 476.9 476.10
476.11
476.12 476.13 476.14 476.15 476.16 476.17 476.18 476.19 476.20 476.21 476.22 476.23 476.24 476.25 476.26 476.27 476.28 476.29 476.30 477.1 477.2 477.3 477.4 477.5 477.6 477.7
477.8 477.9 477.10 477.11 477.12 477.13 477.14 477.15 477.16 477.17 477.18 477.19 477.20 477.21 477.22 477.23 477.24 477.25 477.26 477.27 477.28 477.29 477.30 477.31 478.1 478.2 478.3 478.4 478.5 478.6 478.7 478.8 478.9 478.10 478.11 478.12 478.13 478.14 478.15 478.16 478.17 478.18 478.19 478.20 478.21 478.22 478.23 478.24 478.25 478.26 478.27 478.28 478.29 478.30 478.31
479.1 479.2 479.3 479.4 479.5 479.6 479.7 479.8 479.9 479.10 479.11 479.12 479.13 479.14 479.15 479.16 479.17 479.18 479.19 479.20 479.21 479.22 479.23 479.24 479.25 479.26 479.27 479.28 479.29 479.30 479.31 480.1 480.2 480.3 480.4 480.5 480.6 480.7 480.8 480.9 480.10 480.11 480.12 480.13 480.14 480.15 480.16 480.17 480.18 480.19 480.20 480.21 480.22 480.23 480.24 480.25 480.26 480.27 480.28 480.29 480.30 480.31 480.32 480.33 481.1 481.2 481.3 481.4 481.5 481.6 481.7 481.8 481.9 481.10 481.11 481.12 481.13 481.14 481.15 481.16 481.17 481.18 481.19 481.20 481.21 481.22 481.23 481.24 481.25 481.26 481.27 481.28 481.29 481.30 481.31 481.32 481.33 482.1 482.2 482.3 482.4 482.5 482.6 482.7 482.8 482.9 482.10 482.11 482.12 482.13 482.14 482.15 482.16 482.17 482.18 482.19 482.20 482.21 482.22 482.23 482.24 482.25 482.26 482.27 482.28 482.29 482.30 482.31
483.1 483.2 483.3 483.4 483.5 483.6 483.7 483.8 483.9 483.10 483.11 483.12 483.13 483.14 483.15 483.16 483.17 483.18 483.19 483.20 483.21 483.22 483.23 483.24 483.25 483.26 483.27 483.28 483.29 483.30 483.31 484.1 484.2 484.3 484.4 484.5 484.6 484.7 484.8 484.9 484.10
484.11
484.12 484.13 484.14 484.15 484.16 484.17 484.18 484.19 484.20 484.21 484.22 484.23 484.24 484.25 484.26 484.27 484.28 484.29 484.30 484.31 484.32 485.1 485.2 485.3 485.4
485.5 485.6 485.7 485.8 485.9 485.10 485.11 485.12 485.13 485.14 485.15 485.16 485.17 485.18 485.19 485.20 485.21 485.22 485.23 485.24 485.25 485.26 485.27 485.28 485.29 485.30 485.31 486.1 486.2 486.3 486.4 486.5 486.6 486.7 486.8 486.9 486.10 486.11 486.12 486.13 486.14
486.15
486.16 486.17 486.18 486.19 486.20 486.21 486.22 486.23 486.24 486.25 486.26 486.27 486.28 486.29 486.30 486.31 486.32 486.33 487.1 487.2 487.3 487.4 487.5 487.6 487.7 487.8 487.9 487.10
487.11
487.12 487.13 487.14 487.15 487.16 487.17 487.18 487.19 487.20 487.21 487.22 487.23 487.24 487.25 487.26 487.27 487.28 487.29 487.30 488.1 488.2 488.3 488.4 488.5 488.6 488.7 488.8 488.9
488.10 488.11 488.12 488.13 488.14 488.15 488.16 488.17 488.18 488.19 488.20
488.21 488.22 488.23 488.24 488.25 488.26 488.27 488.28 488.29 488.30 488.31 489.1 489.2 489.3 489.4 489.5 489.6 489.7 489.8 489.9 489.10 489.11 489.12 489.13 489.14 489.15 489.16 489.17 489.18 489.19 489.20 489.21 489.22 489.23 489.24 489.25 489.26 489.27 489.28 489.29 489.30 489.31 489.32 490.1 490.2 490.3 490.4 490.5 490.6 490.7 490.8
490.9 490.10
490.11 490.12 490.13 490.14 490.15 490.16 490.17 490.18 490.19 490.20 490.21 490.22 490.23 490.24 490.25 490.26 490.27
490.28 490.29 490.30 490.31 491.1 491.2 491.3 491.4 491.5 491.6 491.7 491.8
491.9 491.10 491.11 491.12 491.13 491.14 491.15 491.16 491.17 491.18 491.19 491.20 491.21 491.22 491.23 491.24 491.25 491.26 491.27 491.28 491.29 491.30 491.31 491.32 491.33 492.1 492.2 492.3 492.4 492.5 492.6 492.7 492.8 492.9 492.10 492.11 492.12 492.13 492.14 492.15 492.16 492.17 492.18 492.19 492.20 492.21 492.22 492.23 492.24 492.25 492.26 492.27 492.28 492.29 492.30 492.31 493.1 493.2 493.3 493.4 493.5 493.6 493.7 493.8 493.9 493.10 493.11 493.12 493.13 493.14 493.15 493.16 493.17 493.18 493.19 493.20 493.21 493.22 493.23 493.24 493.25 493.26 493.27 493.28 493.29 493.30 493.31 493.32 493.33 494.1 494.2 494.3 494.4 494.5 494.6 494.7 494.8 494.9 494.10 494.11 494.12 494.13 494.14 494.15 494.16 494.17 494.18 494.19 494.20 494.21 494.22 494.23 494.24 494.25 494.26 494.27 494.28 494.29 494.30 494.31 494.32 494.33 494.34 495.1 495.2 495.3 495.4 495.5
495.6 495.7 495.8 495.9 495.10 495.11 495.12 495.13 495.14 495.15 495.16 495.17 495.18 495.19 495.20 495.21 495.22 495.23 495.24 495.25 495.26 495.27 495.28 495.29 495.30 495.31 496.1 496.2 496.3 496.4 496.5
496.6 496.7 496.8 496.9 496.10 496.11 496.12 496.13
496.14 496.15 496.16 496.17 496.18 496.19 496.20 496.21 496.22 496.23 496.24 496.25 496.26 496.27 496.28 496.29 496.30 496.31 496.32 496.33 497.1 497.2 497.3 497.4 497.5 497.6 497.7 497.8 497.9 497.10 497.11 497.12 497.13 497.14 497.15 497.16 497.17 497.18 497.19 497.20 497.21 497.22 497.23 497.24 497.25 497.26 497.27 497.28 497.29 497.30 497.31 497.32 497.33 497.34 497.35 498.1 498.2 498.3
498.4 498.5 498.6 498.7 498.8 498.9 498.10 498.11 498.12 498.13 498.14 498.15 498.16 498.17 498.18 498.19 498.20 498.21 498.22 498.23 498.24 498.25 498.26 498.27 498.28 498.29 498.30 498.31 498.32 498.33 499.1 499.2 499.3 499.4 499.5 499.6 499.7 499.8 499.9 499.10 499.11 499.12 499.13 499.14 499.15 499.16 499.17 499.18 499.19 499.20 499.21 499.22 499.23 499.24 499.25 499.26 499.27 499.28 499.29 499.30 499.31
500.1 500.2 500.3 500.4 500.5 500.6 500.7 500.8 500.9 500.10 500.11 500.12 500.13 500.14 500.15 500.16 500.17 500.18 500.19 500.20 500.21 500.22 500.23 500.24 500.25 500.26 500.27 500.28
500.29 500.30 500.31 501.1 501.2 501.3 501.4 501.5 501.6 501.7 501.8 501.9
501.10 501.11 501.12 501.13 501.14 501.15 501.16 501.17 501.18 501.19 501.20 501.21 501.22 501.23 501.24 501.25 501.26 501.27 501.28 501.29 501.30 501.31 502.1 502.2 502.3 502.4 502.5 502.6
502.7
502.8 502.9 502.10 502.11 502.12 502.13 502.14 502.15 502.16 502.17 502.18 502.19 502.20 502.21
502.22 502.23 502.24 502.25 502.26 502.27 502.28
502.29
503.1 503.2 503.3 503.4 503.5 503.6 503.7 503.8 503.9 503.10 503.11
503.12
503.13 503.14 503.15 503.16 503.17 503.18 503.19 503.20 503.21 503.22 503.23 503.24 503.25 503.26 503.27 503.28 503.29 503.30 504.1 504.2 504.3 504.4 504.5 504.6
504.7 504.8 504.9 504.10 504.11 504.12 504.13 504.14
504.15
504.16 504.17 504.18 504.19 504.20 504.21 504.22 504.23 504.24 504.25
504.26
504.27 504.28 504.29 504.30 504.31 505.1 505.2 505.3 505.4 505.5 505.6 505.7 505.8 505.9 505.10 505.11 505.12 505.13 505.14 505.15 505.16 505.17 505.18 505.19 505.20 505.21 505.22
505.23
505.24 505.25 505.26 505.27 505.28 505.29 505.30
505.31
506.1 506.2 506.3 506.4 506.5 506.6 506.7 506.8 506.9 506.10 506.11 506.12 506.13 506.14 506.15 506.16 506.17 506.18 506.19 506.20 506.21 506.22 506.23 506.24 506.25 506.26 506.27 506.28 506.29 506.30 506.31 506.32
506.33
507.1 507.2 507.3 507.4 507.5 507.6 507.7 507.8
507.9
507.10 507.11 507.12 507.13 507.14 507.15 507.16
507.17
507.18 507.19 507.20 507.21 507.22
507.23
507.24 507.25 507.26 507.27 507.28 507.29 507.30 507.31 508.1 508.2 508.3 508.4 508.5 508.6 508.7 508.8 508.9 508.10 508.11 508.12 508.13 508.14 508.15 508.16 508.17 508.18 508.19 508.20 508.21
508.22
508.23 508.24 508.25 508.26 508.27 508.28 508.29 508.30 508.31 508.32 508.33 509.1 509.2 509.3 509.4 509.5 509.6 509.7 509.8 509.9 509.10 509.11 509.12 509.13 509.14
509.15
509.16 509.17 509.18 509.19 509.20 509.21 509.22 509.23 509.24 509.25 509.26 509.27 509.28 509.29 509.30 509.31
509.32
510.1 510.2 510.3 510.4 510.5
510.6
510.7 510.8 510.9 510.10 510.11 510.12 510.13 510.14 510.15 510.16 510.17 510.18 510.19 510.20 510.21 510.22 510.23 510.24 510.25 510.26 510.27 510.28 510.29 510.30 510.31 511.1 511.2 511.3 511.4 511.5 511.6 511.7 511.8 511.9 511.10 511.11 511.12 511.13 511.14 511.15 511.16 511.17 511.18 511.19 511.20 511.21 511.22 511.23 511.24 511.25 511.26 511.27 511.28 511.29 511.30 511.31 511.32 511.33 512.1 512.2 512.3 512.4 512.5 512.6
512.7
512.8 512.9 512.10 512.11 512.12 512.13 512.14 512.15 512.16 512.17 512.18 512.19 512.20 512.21 512.22 512.23 512.24 512.25 512.26 512.27 512.28 512.29 512.30 512.31 513.1 513.2 513.3 513.4 513.5 513.6 513.7 513.8 513.9 513.10 513.11 513.12 513.13 513.14 513.15 513.16 513.17 513.18 513.19 513.20 513.21 513.22 513.23 513.24 513.25 513.26 513.27 513.28 513.29 513.30 513.31 513.32 513.33 514.1 514.2 514.3 514.4 514.5 514.6 514.7 514.8 514.9 514.10 514.11 514.12 514.13 514.14 514.15 514.16 514.17 514.18 514.19 514.20 514.21 514.22 514.23 514.24 514.25 514.26 514.27 514.28 514.29 514.30 514.31 514.32 515.1 515.2 515.3 515.4 515.5 515.6 515.7 515.8 515.9 515.10 515.11 515.12 515.13 515.14 515.15 515.16 515.17 515.18 515.19 515.20 515.21 515.22 515.23 515.24 515.25 515.26 515.27 515.28 515.29 515.30 515.31 515.32 515.33 516.1 516.2 516.3 516.4 516.5 516.6 516.7 516.8 516.9 516.10 516.11 516.12 516.13 516.14 516.15 516.16 516.17 516.18 516.19 516.20 516.21 516.22 516.23 516.24 516.25 516.26 516.27 516.28 516.29 516.30 516.31 517.1 517.2 517.3 517.4 517.5 517.6 517.7 517.8 517.9 517.10 517.11 517.12 517.13 517.14 517.15 517.16 517.17 517.18 517.19 517.20 517.21 517.22 517.23 517.24 517.25 517.26 517.27 517.28 517.29 517.30 517.31 517.32 517.33 517.34 518.1 518.2 518.3 518.4 518.5 518.6 518.7 518.8 518.9 518.10 518.11 518.12 518.13 518.14 518.15 518.16 518.17 518.18 518.19 518.20 518.21 518.22 518.23 518.24 518.25 518.26 518.27 518.28 518.29 518.30 518.31 518.32 518.33 518.34 519.1 519.2 519.3 519.4 519.5 519.6 519.7 519.8 519.9 519.10 519.11 519.12 519.13 519.14 519.15 519.16 519.17 519.18 519.19 519.20 519.21 519.22 519.23 519.24 519.25 519.26 519.27 519.28 519.29 519.30 519.31 519.32 519.33 520.1 520.2 520.3 520.4 520.5 520.6 520.7 520.8 520.9 520.10 520.11 520.12 520.13 520.14 520.15 520.16 520.17 520.18 520.19 520.20 520.21 520.22 520.23 520.24 520.25 520.26 520.27 520.28 520.29 520.30 520.31 520.32 521.1 521.2 521.3 521.4 521.5 521.6 521.7 521.8 521.9 521.10 521.11 521.12 521.13 521.14 521.15 521.16 521.17 521.18 521.19 521.20 521.21 521.22 521.23 521.24 521.25 521.26 521.27 521.28 521.29 521.30 521.31 521.32 522.1 522.2 522.3 522.4 522.5 522.6 522.7 522.8 522.9 522.10 522.11 522.12 522.13 522.14 522.15 522.16 522.17 522.18 522.19 522.20 522.21 522.22 522.23 522.24 522.25 522.26 522.27 522.28 522.29 522.30 522.31 523.1 523.2 523.3 523.4 523.5 523.6 523.7 523.8 523.9 523.10 523.11 523.12 523.13 523.14 523.15 523.16 523.17 523.18 523.19 523.20 523.21 523.22 523.23 523.24 523.25 523.26 523.27 523.28 523.29 523.30 523.31 523.32 523.33 524.1 524.2 524.3 524.4 524.5 524.6 524.7 524.8 524.9 524.10 524.11 524.12 524.13 524.14 524.15 524.16 524.17 524.18 524.19 524.20 524.21 524.22 524.23 524.24 524.25 524.26 524.27 524.28 524.29 524.30 524.31 524.32 524.33 525.1 525.2 525.3 525.4 525.5 525.6 525.7 525.8 525.9 525.10 525.11 525.12 525.13 525.14 525.15 525.16 525.17 525.18 525.19 525.20 525.21 525.22 525.23 525.24 525.25 525.26 525.27 525.28 525.29 525.30 525.31 526.1 526.2 526.3 526.4 526.5 526.6 526.7 526.8 526.9 526.10 526.11 526.12 526.13 526.14 526.15 526.16 526.17 526.18 526.19 526.20 526.21 526.22 526.23 526.24 526.25 526.26 526.27 526.28 526.29 526.30 526.31 526.32 526.33 527.1 527.2 527.3 527.4 527.5 527.6 527.7 527.8 527.9 527.10 527.11 527.12 527.13 527.14 527.15 527.16 527.17 527.18 527.19 527.20 527.21 527.22 527.23 527.24 527.25 527.26 527.27 527.28 527.29 527.30 527.31 527.32 527.33 527.34 528.1 528.2 528.3 528.4 528.5 528.6 528.7 528.8 528.9 528.10 528.11 528.12 528.13 528.14 528.15 528.16 528.17 528.18 528.19 528.20 528.21 528.22 528.23 528.24 528.25 528.26 528.27 528.28 528.29 528.30 528.31 528.32
528.33
529.1 529.2 529.3 529.4 529.5 529.6 529.7 529.8 529.9 529.10 529.11 529.12 529.13 529.14 529.15 529.16 529.17 529.18 529.19 529.20 529.21 529.22 529.23 529.24 529.25
529.26
529.27 529.28 529.29 529.30 529.31 530.1 530.2 530.3 530.4 530.5 530.6
530.7
530.8 530.9 530.10 530.11 530.12 530.13 530.14 530.15 530.16 530.17 530.18 530.19 530.20 530.21 530.22 530.23 530.24 530.25 530.26 530.27 530.28 530.29 530.30 530.31 530.32 530.33 530.34 531.1 531.2 531.3 531.4 531.5 531.6 531.7 531.8 531.9 531.10 531.11 531.12 531.13 531.14 531.15 531.16 531.17 531.18 531.19 531.20 531.21 531.22 531.23 531.24 531.25 531.26 531.27 531.28 531.29 531.30 531.31 531.32 532.1 532.2 532.3 532.4 532.5 532.6 532.7 532.8 532.9 532.10 532.11 532.12 532.13 532.14 532.15 532.16 532.17 532.18 532.19 532.20 532.21 532.22 532.23 532.24 532.25 532.26 532.27 532.28 532.29 532.30 532.31 532.32 532.33 532.34 533.1 533.2 533.3 533.4 533.5 533.6 533.7 533.8 533.9 533.10 533.11 533.12 533.13 533.14 533.15 533.16 533.17 533.18 533.19 533.20 533.21 533.22 533.23 533.24 533.25 533.26 533.27 533.28 533.29 533.30 533.31 533.32 534.1 534.2 534.3 534.4 534.5 534.6 534.7 534.8 534.9 534.10 534.11 534.12 534.13 534.14 534.15 534.16 534.17 534.18 534.19 534.20 534.21 534.22 534.23 534.24 534.25 534.26 534.27 534.28 534.29 534.30 534.31 534.32 534.33 534.34 535.1 535.2 535.3 535.4 535.5 535.6 535.7 535.8 535.9 535.10 535.11
535.12
535.13 535.14 535.15 535.16 535.17 535.18
535.19 535.20
535.21 535.22 535.23 535.24 535.25 535.26 535.27 535.28 535.29 535.30 535.31 536.1 536.2 536.3 536.4 536.5 536.6 536.7
536.8 536.9 536.10 536.11 536.12 536.13 536.14 536.15 536.16 536.17 536.18 536.19 536.20 536.21 536.22 536.23 536.24 536.25 536.26 536.27
536.28 536.29 536.30 536.31 537.1 537.2 537.3 537.4 537.5 537.6 537.7 537.8 537.9 537.10 537.11 537.12 537.13 537.14 537.15 537.16 537.17 537.18 537.19 537.20 537.21 537.22 537.23 537.24 537.25 537.26 537.27 537.28 537.29 537.30 537.31 538.1 538.2 538.3 538.4 538.5 538.6 538.7 538.8 538.9 538.10 538.11 538.12 538.13 538.14 538.15 538.16 538.17 538.18 538.19 538.20 538.21 538.22 538.23 538.24 538.25 538.26 538.27 538.28 538.29 538.30 538.31 538.32 538.33 539.1 539.2 539.3 539.4 539.5 539.6 539.7 539.8 539.9 539.10 539.11 539.12 539.13 539.14 539.15 539.16 539.17 539.18 539.19 539.20 539.21 539.22 539.23 539.24 539.25 539.26 539.27 539.28 539.29 539.30 539.31 539.32 539.33 540.1 540.2 540.3 540.4 540.5 540.6 540.7 540.8 540.9
540.10 540.11 540.12 540.13 540.14 540.15 540.16 540.17 540.18 540.19 540.20 540.21 540.22
540.23 540.24 540.25 540.26 540.27 540.28 540.29 540.30 540.31 540.32 541.1 541.2 541.3 541.4 541.5 541.6 541.7 541.8 541.9 541.10 541.11 541.12 541.13 541.14 541.15 541.16 541.17 541.18 541.19 541.20 541.21 541.22 541.23 541.24 541.25 541.26 541.27 541.28 541.29 541.30 541.31 541.32 541.33 542.1 542.2 542.3 542.4 542.5 542.6 542.7 542.8 542.9 542.10 542.11 542.12 542.13 542.14 542.15 542.16 542.17 542.18 542.19 542.20 542.21
542.22 542.23
542.24 542.25 542.26 542.27 542.28 542.29 542.30
543.1 543.2 543.3 543.4 543.5 543.6 543.7 543.8 543.9 543.10 543.11 543.12 543.13 543.14 543.15 543.16 543.17 543.18 543.19 543.20 543.21 543.22 543.23 543.24 543.25 543.26 543.27 543.28 543.29 543.30 544.1 544.2 544.3 544.4 544.5 544.6 544.7 544.8 544.9 544.10 544.11 544.12 544.13 544.14 544.15 544.16 544.17 544.18 544.19 544.20 544.21 544.22 544.23 544.24 544.25 544.26 544.27 544.28 544.29 544.30 544.31
545.1 545.2 545.3 545.4 545.5 545.6 545.7 545.8 545.9 545.10 545.11 545.12 545.13 545.14 545.15 545.16 545.17 545.18 545.19 545.20 545.21 545.22 545.23 545.24 545.25 545.26 545.27 545.28 545.29 545.30 545.31
546.1 546.2 546.3 546.4 546.5 546.6 546.7 546.8 546.9 546.10 546.11 546.12 546.13 546.14 546.15 546.16 546.17 546.18 546.19 546.20 546.21 546.22 546.23 546.24 546.25 546.26 546.27 546.28 546.29 546.30 547.1 547.2 547.3
547.4 547.5 547.6 547.7 547.8 547.9 547.10 547.11 547.12 547.13 547.14 547.15 547.16 547.17 547.18 547.19 547.20 547.21 547.22 547.23 547.24 547.25 547.26 547.27 547.28 547.29 547.30 548.1 548.2 548.3 548.4 548.5 548.6 548.7 548.8 548.9 548.10 548.11 548.12 548.13 548.14 548.15 548.16 548.17 548.18 548.19 548.20 548.21 548.22 548.23 548.24 548.25 548.26 548.27 548.28 548.29 548.30 549.1 549.2 549.3 549.4 549.5 549.6 549.7 549.8 549.9 549.10
549.11 549.12 549.13 549.14 549.15 549.16 549.17 549.18 549.19 549.20 549.21 549.22 549.23 549.24 549.25 549.26 549.27 549.28 549.29 549.30 549.31 549.32 550.1 550.2 550.3 550.4 550.5 550.6 550.7 550.8 550.9 550.10 550.11 550.12 550.13 550.14 550.15 550.16 550.17 550.18 550.19 550.20 550.21 550.22 550.23 550.24 550.25 550.26 550.27 550.28 550.29 550.30 550.31 550.32 550.33 551.1 551.2 551.3 551.4 551.5 551.6 551.7 551.8 551.9 551.10 551.11 551.12 551.13 551.14 551.15 551.16 551.17 551.18 551.19 551.20 551.21 551.22 551.23 551.24 551.25 551.26 551.27 551.28 551.29 551.30 551.31 551.32 551.33 552.1 552.2 552.3 552.4 552.5 552.6 552.7 552.8 552.9 552.10
552.11 552.12 552.13 552.14 552.15 552.16 552.17 552.18 552.19 552.20 552.21 552.22 552.23 552.24 552.25 552.26 552.27 552.28 552.29 552.30 552.31 552.32 553.1 553.2 553.3 553.4 553.5 553.6 553.7 553.8 553.9 553.10 553.11
553.12 553.13 553.14 553.15 553.16 553.17 553.18 553.19 553.20 553.21 553.22 553.23 553.24 553.25 553.26 553.27 553.28 553.29 553.30 553.31 553.32 553.33 554.1 554.2 554.3 554.4
554.5 554.6
554.7 554.8 554.9 554.10 554.11 554.12 554.13 554.14 554.15 554.16 554.17 554.18 554.19 554.20 554.21 554.22 554.23 554.24 554.25 554.26 554.27 554.28 554.29 554.30 554.31 555.1 555.2 555.3 555.4 555.5 555.6 555.7 555.8 555.9 555.10 555.11 555.12 555.13 555.14
555.15 555.16 555.17 555.18 555.19 555.20 555.21 555.22 555.23 555.24 555.25 555.26 555.27 555.28 555.29 555.30 555.31 555.32 556.1 556.2 556.3 556.4 556.5 556.6 556.7 556.8 556.9 556.10 556.11 556.12
556.13
556.14 556.15 556.16 556.17 556.18 556.19 556.20 556.21 556.22 556.23 556.24 556.25 556.26 556.27 556.28 556.29 556.30 556.31 557.1 557.2 557.3 557.4 557.5 557.6 557.7 557.8 557.9 557.10 557.11 557.12 557.13 557.14 557.15 557.16 557.17 557.18 557.19 557.20 557.21
557.22 557.23
557.24 557.25 557.26 557.27 557.28 557.29 557.30 557.31 557.32
558.1
558.2 558.3 558.4 558.5 558.6 558.7 558.8 558.9 558.10 558.11 558.12 558.13
558.14 558.15 558.16 558.17 558.18 558.19 558.20 558.21 558.22 558.23 558.24 558.25 558.26 558.27 558.28 558.29 558.30 559.1 559.2 559.3 559.4
559.5 559.6 559.7 559.8
559.9 559.10 559.11 559.12 559.13
559.14 559.15
559.16 559.17 559.18 559.19
559.20 559.21 559.22
559.23 559.24 559.25 559.26 559.27 559.28 559.29 559.30 559.31 560.1 560.2 560.3 560.4 560.5 560.6
560.7
560.8 560.9 560.10 560.11 560.12 560.13 560.14 560.15 560.16
560.17 560.18 560.19
560.20 560.21 560.22 560.23 560.24 560.25 560.26 560.27 560.28 560.29 560.30
561.1 561.2 561.3
561.4 561.5 561.6 561.7 561.8 561.9 561.10 561.11 561.12 561.13 561.14 561.15 561.16 561.17 561.18 561.19 561.20 561.21 561.22 561.23 561.24 561.25 561.26 561.27 561.28 561.29 561.30 561.31 561.32 561.33 561.34 562.1 562.2 562.3 562.4 562.5 562.6 562.7 562.8 562.9 562.10 562.11 562.12 562.13
562.14 562.15 562.16 562.17 562.18
562.19 562.20 562.21 562.22 562.23 562.24 562.25
562.26
562.27 562.28 562.29 562.30 562.31 562.32 563.1 563.2 563.3 563.4
563.5 563.6
563.7 563.8 563.9 563.10 563.11 563.12
563.13 563.14 563.15 563.16 563.17 563.18 563.19 563.20 563.21 563.22 563.23 563.24 563.25 563.26 563.27 563.28 563.29 563.30 563.31 564.1 564.2 564.3 564.4 564.5 564.6 564.7 564.8 564.9 564.10 564.11
564.12 564.13 564.14 564.15 564.16 564.17 564.18 564.19 564.20 564.21 564.22 564.23 564.24 564.25 564.26 564.27 564.28 564.29 564.30 565.1 565.2 565.3 565.4 565.5 565.6 565.7 565.8 565.9 565.10 565.11 565.12 565.13 565.14 565.15 565.16 565.17 565.18 565.19 565.20 565.21 565.22 565.23 565.24 565.25 565.26 565.27 565.28
565.29
566.1 566.2 566.3 566.4 566.5 566.6 566.7 566.8 566.9 566.10 566.11 566.12 566.13 566.14 566.15 566.16 566.17 566.18 566.19 566.20 566.21 566.22 566.23 566.24
566.25
566.26 566.27 566.28 566.29 566.30 566.31 567.1 567.2 567.3 567.4 567.5 567.6 567.7 567.8 567.9 567.10 567.11 567.12 567.13 567.14 567.15 567.16 567.17 567.18 567.19 567.20 567.21 567.22 567.23 567.24 567.25 567.26 567.27
567.28
567.29 567.30 567.31 567.32 567.33 568.1 568.2 568.3 568.4 568.5 568.6 568.7 568.8 568.9 568.10 568.11 568.12 568.13 568.14 568.15 568.16 568.17 568.18 568.19 568.20 568.21 568.22 568.23 568.24 568.25 568.26 568.27 568.28 568.29 568.30 568.31 568.32 568.33 569.1 569.2 569.3 569.4 569.5 569.6 569.7 569.8 569.9 569.10 569.11 569.12 569.13 569.14 569.15 569.16 569.17 569.18 569.19 569.20 569.21 569.22 569.23 569.24 569.25 569.26 569.27 569.28 569.29 569.30 569.31 570.1 570.2 570.3 570.4 570.5 570.6 570.7 570.8 570.9 570.10 570.11 570.12 570.13
570.14
570.15 570.16 570.17 570.18 570.19 570.20
570.21 570.22 570.23 570.24 570.25 570.26
570.27 570.28
570.29
571.1 571.2 571.3 571.4 571.5 571.6 571.7 571.8 571.9 571.10 571.11 571.12 571.13 571.14 571.15 571.16 571.17 571.18 571.19 571.20 571.21 571.22 571.23 571.24 571.25
571.26 571.27
571.28 571.29 571.30 571.31 571.32 572.1 572.2 572.3 572.4 572.5 572.6 572.7
572.8 572.9 572.10 572.11 572.12 572.13 572.14 572.15 572.16 572.17 572.18 572.19 572.20 572.21 572.22 572.23 572.24 572.25 572.26 572.27 572.28 572.29 572.30 572.31 572.32 572.33 572.34
573.1 573.2
573.3 573.4
573.5 573.6 573.7 573.8 573.9 573.10 573.11 573.12 573.13 573.14 573.15 573.16
573.17 573.18 573.19 573.20 573.21 573.22 573.23 573.24 573.25 573.26 573.27 573.28 573.29 573.30 573.31 574.1 574.2 574.3 574.4 574.5 574.6 574.7 574.8 574.9 574.10 574.11 574.12 574.13 574.14 574.15 574.16 574.17 574.18 574.19 574.20 574.21 574.22 574.23 574.24 574.25 574.26 574.27 574.28 574.29 574.30 574.31 574.32 574.33 575.1 575.2 575.3 575.4 575.5 575.6 575.7 575.8 575.9 575.10 575.11 575.12 575.13 575.14 575.15 575.16 575.17 575.18 575.19 575.20 575.21 575.22 575.23 575.24 575.25 575.26 575.27 575.28 575.29 575.30 575.31 575.32 575.33 575.34 576.1 576.2 576.3 576.4 576.5 576.6 576.7 576.8 576.9 576.10 576.11 576.12 576.13 576.14 576.15 576.16 576.17 576.18 576.19 576.20 576.21 576.22 576.23 576.24 576.25 576.26 576.27 576.28 576.29 576.30 576.31 576.32 576.33 576.34 576.35 577.1 577.2 577.3 577.4 577.5 577.6 577.7 577.8 577.9 577.10 577.11 577.12 577.13 577.14 577.15 577.16 577.17 577.18 577.19 577.20 577.21 577.22 577.23 577.24 577.25 577.26 577.27 577.28 577.29 577.30 577.31 577.32 577.33 577.34 577.35 578.1 578.2 578.3 578.4 578.5 578.6 578.7 578.8 578.9 578.10 578.11 578.12 578.13 578.14 578.15 578.16 578.17 578.18 578.19 578.20 578.21 578.22 578.23 578.24 578.25 578.26 578.27 578.28 578.29 578.30 578.31 578.32 578.33 578.34 579.1 579.2 579.3 579.4 579.5 579.6 579.7 579.8 579.9 579.10 579.11 579.12 579.13 579.14 579.15 579.16 579.17 579.18 579.19 579.20 579.21 579.22 579.23 579.24 579.25 579.26 579.27 579.28 579.29 579.30 579.31 579.32 579.33 579.34 580.1 580.2 580.3 580.4 580.5 580.6 580.7 580.8 580.9 580.10 580.11 580.12 580.13 580.14 580.15 580.16 580.17 580.18 580.19 580.20 580.21 580.22 580.23 580.24 580.25 580.26 580.27 580.28 580.29 580.30 580.31 580.32 580.33 581.1 581.2 581.3 581.4 581.5 581.6 581.7 581.8 581.9 581.10 581.11 581.12 581.13 581.14 581.15 581.16 581.17 581.18 581.19 581.20 581.21 581.22 581.23 581.24 581.25 581.26 581.27 581.28 581.29 581.30 581.31 581.32 581.33 581.34 581.35 582.1 582.2 582.3 582.4 582.5 582.6 582.7 582.8 582.9 582.10 582.11 582.12 582.13 582.14 582.15 582.16 582.17 582.18 582.19 582.20 582.21 582.22 582.23 582.24 582.25 582.26 582.27 582.28 582.29 582.30 582.31 582.32 582.33 582.34 582.35 583.1 583.2 583.3 583.4 583.5 583.6 583.7 583.8 583.9 583.10 583.11 583.12 583.13 583.14 583.15 583.16 583.17 583.18 583.19 583.20 583.21 583.22 583.23 583.24 583.25 583.26 583.27 583.28 583.29 583.30 583.31 583.32 584.1 584.2 584.3 584.4 584.5 584.6 584.7 584.8 584.9 584.10 584.11 584.12 584.13 584.14 584.15 584.16 584.17 584.18 584.19 584.20 584.21 584.22 584.23 584.24 584.25 584.26 584.27 584.28 584.29 584.30 584.31 584.32 584.33 584.34 584.35 585.1 585.2 585.3 585.4 585.5 585.6 585.7 585.8 585.9 585.10 585.11 585.12 585.13 585.14 585.15 585.16 585.17 585.18 585.19 585.20 585.21 585.22 585.23 585.24 585.25 585.26 585.27 585.28 585.29 585.30 585.31 585.32 585.33 586.1 586.2 586.3 586.4 586.5 586.6 586.7 586.8 586.9 586.10 586.11 586.12 586.13 586.14 586.15 586.16 586.17 586.18 586.19 586.20 586.21 586.22 586.23 586.24 586.25 586.26 586.27 586.28 586.29 586.30 586.31 586.32 586.33 586.34 587.1 587.2 587.3 587.4 587.5 587.6 587.7 587.8 587.9 587.10 587.11 587.12 587.13 587.14 587.15 587.16 587.17 587.18 587.19 587.20 587.21 587.22 587.23 587.24 587.25 587.26 587.27 587.28 587.29 587.30 587.31 587.32 587.33 587.34 587.35 588.1 588.2 588.3 588.4 588.5 588.6 588.7 588.8 588.9 588.10 588.11 588.12 588.13 588.14 588.15 588.16 588.17 588.18 588.19 588.20 588.21 588.22 588.23 588.24 588.25 588.26 588.27 588.28 588.29 588.30 588.31 588.32 588.33 588.34 588.35 589.1 589.2 589.3 589.4 589.5 589.6 589.7 589.8 589.9 589.10 589.11 589.12 589.13 589.14 589.15 589.16 589.17 589.18 589.19 589.20 589.21 589.22 589.23 589.24 589.25 589.26 589.27 589.28 589.29 589.30 589.31 589.32 589.33 589.34 590.1 590.2 590.3 590.4 590.5 590.6 590.7 590.8 590.9 590.10 590.11 590.12 590.13 590.14 590.15 590.16 590.17 590.18 590.19 590.20 590.21 590.22 590.23 590.24 590.25 590.26 590.27 590.28 590.29 590.30 590.31 590.32 590.33 590.34 590.35 591.1 591.2 591.3 591.4 591.5 591.6 591.7 591.8 591.9 591.10 591.11 591.12 591.13 591.14 591.15 591.16 591.17 591.18 591.19 591.20 591.21 591.22 591.23 591.24 591.25 591.26 591.27 591.28 591.29 591.30 591.31 591.32 591.33 592.1 592.2 592.3 592.4 592.5 592.6 592.7 592.8 592.9 592.10 592.11 592.12 592.13 592.14 592.15 592.16 592.17 592.18 592.19 592.20 592.21 592.22 592.23 592.24 592.25 592.26 592.27 592.28 592.29 592.30 592.31 592.32 592.33 592.34 592.35 593.1 593.2 593.3 593.4 593.5 593.6 593.7 593.8 593.9 593.10 593.11 593.12 593.13 593.14 593.15 593.16 593.17 593.18 593.19 593.20 593.21 593.22 593.23 593.24 593.25 593.26 593.27 593.28 593.29 593.30 593.31 593.32 593.33 593.34 593.35 594.1 594.2 594.3 594.4 594.5 594.6 594.7 594.8 594.9 594.10 594.11 594.12 594.13 594.14 594.15 594.16 594.17 594.18 594.19 594.20 594.21 594.22 594.23 594.24 594.25 594.26 594.27 594.28 594.29 594.30 594.31 594.32 594.33 594.34 594.35 595.1 595.2 595.3 595.4 595.5 595.6 595.7 595.8 595.9 595.10 595.11 595.12 595.13 595.14 595.15 595.16 595.17 595.18 595.19 595.20 595.21 595.22 595.23 595.24 595.25 595.26 595.27 595.28 595.29
595.30 595.31 595.32 595.33 595.34 596.1 596.2 596.3 596.4 596.5 596.6 596.7 596.8 596.9 596.10 596.11 596.12 596.13 596.14 596.15 596.16 596.17 596.18 596.19 596.20 596.21 596.22 596.23 596.24 596.25 596.26 596.27 596.28 596.29 596.30 596.31 596.32 596.33 596.34 596.35 597.1 597.2 597.3 597.4 597.5 597.6 597.7 597.8 597.9 597.10 597.11 597.12 597.13 597.14 597.15 597.16 597.17 597.18 597.19 597.20 597.21 597.22 597.23 597.24 597.25 597.26 597.27 597.28 597.29 597.30 597.31 597.32 597.33 598.1 598.2 598.3 598.4 598.5 598.6 598.7 598.8 598.9 598.10 598.11 598.12 598.13 598.14 598.15 598.16 598.17 598.18 598.19 598.20 598.21 598.22 598.23 598.24 598.25 598.26 598.27 598.28 598.29 598.30 598.31 598.32 598.33 599.1 599.2 599.3 599.4 599.5 599.6 599.7 599.8 599.9 599.10 599.11 599.12 599.13 599.14 599.15 599.16 599.17 599.18 599.19 599.20 599.21 599.22 599.23 599.24 599.25 599.26 599.27 599.28 599.29 599.30 599.31 599.32 599.33 599.34 600.1 600.2 600.3 600.4 600.5 600.6 600.7 600.8 600.9 600.10 600.11 600.12 600.13 600.14 600.15 600.16 600.17 600.18 600.19 600.20 600.21 600.22 600.23 600.24 600.25 600.26 600.27 600.28 600.29 600.30 600.31 600.32 600.33 601.1 601.2 601.3 601.4 601.5 601.6 601.7 601.8 601.9 601.10 601.11 601.12 601.13 601.14 601.15 601.16 601.17 601.18 601.19 601.20 601.21 601.22 601.23 601.24 601.25 601.26 601.27 601.28 601.29 601.30 601.31 601.32 601.33 601.34 602.1 602.2 602.3 602.4 602.5 602.6 602.7 602.8 602.9 602.10 602.11 602.12 602.13 602.14 602.15 602.16 602.17 602.18 602.19 602.20 602.21 602.22 602.23 602.24 602.25 602.26 602.27 602.28 602.29 602.30 602.31 602.32 602.33 602.34 603.1 603.2 603.3 603.4 603.5 603.6 603.7 603.8 603.9 603.10 603.11 603.12 603.13 603.14 603.15 603.16 603.17 603.18 603.19 603.20 603.21 603.22 603.23 603.24 603.25 603.26 603.27 603.28 603.29 603.30 603.31 603.32 603.33 603.34 603.35 604.1 604.2 604.3 604.4 604.5 604.6 604.7 604.8 604.9 604.10 604.11 604.12 604.13 604.14 604.15 604.16 604.17 604.18 604.19 604.20 604.21 604.22 604.23 604.24 604.25 604.26 604.27 604.28 604.29 604.30 604.31 604.32 604.33 605.1 605.2 605.3 605.4 605.5 605.6 605.7 605.8 605.9 605.10 605.11 605.12 605.13 605.14 605.15 605.16 605.17 605.18 605.19 605.20 605.21 605.22 605.23 605.24 605.25 605.26 605.27 605.28 605.29 605.30 605.31 605.32 605.33 605.34 606.1 606.2 606.3 606.4 606.5 606.6 606.7 606.8 606.9 606.10 606.11 606.12 606.13 606.14 606.15 606.16 606.17 606.18 606.19 606.20 606.21 606.22 606.23 606.24 606.25 606.26 606.27 606.28 606.29 606.30 606.31 606.32 606.33 607.1 607.2 607.3 607.4 607.5 607.6 607.7 607.8 607.9 607.10 607.11 607.12 607.13 607.14 607.15 607.16 607.17 607.18 607.19 607.20 607.21 607.22 607.23 607.24 607.25 607.26 607.27 607.28 607.29 607.30 607.31 607.32 607.33 607.34 607.35 608.1 608.2 608.3 608.4 608.5 608.6 608.7 608.8 608.9 608.10 608.11 608.12 608.13 608.14 608.15 608.16 608.17 608.18 608.19 608.20 608.21 608.22 608.23 608.24
608.25 608.26 608.27 608.28 608.29 608.30 608.31 608.32 608.33 608.34 609.1 609.2 609.3 609.4 609.5 609.6 609.7 609.8 609.9 609.10 609.11 609.12 609.13 609.14 609.15 609.16 609.17 609.18 609.19 609.20 609.21 609.22 609.23 609.24 609.25 609.26 609.27 609.28 609.29 609.30 609.31 609.32 609.33 609.34 609.35 610.1 610.2 610.3 610.4 610.5 610.6 610.7 610.8 610.9 610.10 610.11 610.12 610.13 610.14 610.15 610.16 610.17 610.18 610.19 610.20 610.21 610.22 610.23 610.24 610.25 610.26 610.27 610.28 610.29 610.30 610.31 610.32 610.33 610.34 611.1 611.2 611.3 611.4 611.5 611.6 611.7 611.8 611.9 611.10 611.11 611.12 611.13 611.14 611.15 611.16 611.17 611.18 611.19 611.20 611.21 611.22 611.23 611.24 611.25 611.26 611.27 611.28 611.29 611.30 611.31 611.32 612.1 612.2 612.3
612.4 612.5 612.6 612.7 612.8 612.9 612.10 612.11 612.12 612.13 612.14 612.15 612.16 612.17 612.18 612.19 612.20 612.21 612.22 612.23 612.24 612.25 612.26 612.27 612.28 612.29 612.30 612.31 612.32 612.33 612.34 613.1 613.2 613.3 613.4 613.5 613.6 613.7 613.8 613.9
613.10
613.11 613.12
613.13 613.14
613.15 613.16 613.17 613.18 613.19 613.20 613.21 613.22 613.23 613.24 613.25 613.26 613.27 613.28 613.29 613.30 613.31 613.32 613.33 613.34 614.1 614.2 614.3 614.4 614.5 614.6 614.7 614.8 614.9 614.10 614.11 614.12 614.13 614.14 614.15 614.16 614.17 614.18 614.19
614.20 614.21
614.22 614.23 614.24 614.25 614.26
614.27 614.28 614.29 614.30 614.31 614.32 614.33 614.34 615.1 615.2 615.3 615.4 615.5 615.6 615.7 615.8 615.9 615.10
615.11 615.12
615.13 615.14 615.15 615.16 615.17 615.18 615.19 615.20 615.21 615.22 615.23 615.24 615.25 615.26 615.27 615.28 615.29 615.30 615.31 615.32 615.33 615.34 616.1 616.2 616.3 616.4 616.5 616.6 616.7
616.8 616.9 616.10 616.11 616.12
616.13 616.14 616.15 616.16 616.17 616.18 616.19 616.20 616.21 616.22 616.23 616.24 616.25 616.26 616.27 616.28 616.29 616.30 616.31 616.32
617.1 617.2 617.3 617.4 617.6 617.5 617.7 617.8 617.9 617.10 617.11 617.12 617.13 617.14 617.15 617.16 617.17 617.18 617.19 617.20 617.21 617.22 617.23 617.24 617.25 617.26 617.27 617.28 617.29 617.30 617.31 617.32 617.33 617.34 617.35 618.1 618.2 618.3 618.4 618.5 618.6 618.7 618.8 618.9 618.10 618.11 618.12 618.13 618.14 618.15 618.16 618.17 618.18 618.19 618.20 618.21 618.22 618.23 618.24 618.25 618.26 618.27 618.28 618.29 618.30 618.31 618.32 618.33 618.34 619.1 619.2 619.3 619.4 619.5 619.6 619.7 619.8 619.9 619.10 619.11 619.12 619.13 619.14 619.15 619.16 619.17 619.18 619.19 619.20 619.21 619.22 619.23 619.24 619.25 619.26 619.27 619.28 619.29 619.30 619.31 619.32 619.33 619.34 619.35 620.1 620.2 620.3 620.4 620.5 620.6 620.7 620.8 620.9 620.10 620.11 620.12 620.13 620.14 620.15 620.16 620.17 620.18 620.19 620.20 620.21 620.22 620.23 620.24 620.25 620.26 620.27 620.28 620.29 620.30 620.31 620.32 620.33 620.34 620.35 621.1 621.2 621.3 621.4 621.5 621.6 621.7 621.8 621.9 621.10 621.11 621.12 621.13 621.14 621.15 621.16 621.17 621.18 621.19 621.20 621.21 621.22 621.23 621.24 621.25 621.26 621.27 621.28 621.29 621.30 621.31 621.32 621.33 621.34 622.1 622.2
622.3 622.4 622.5 622.6 622.7 622.8 622.9 622.10 622.11 622.12 622.13 622.14 622.15 622.16 622.17 622.18 622.19
622.20 622.21 622.22
622.23 622.24 622.25
A bill for an act
relating to state government; modifying provisions governing child care, child
safety and permanency, child support, economic assistance, deep poverty, housing
and homelessness, behavioral health, the medical education and research cost
account, MinnesotaCare, medical assistance, background studies, and human
services licensing; establishing the Department of Children, Youth, and Families;
making technical and conforming changes; establishing requirements for hospital
nurse staffing committees and hospital nurse workload committees; modifying
requirements of hospital core staffing plans; modifying requirements related to
hospital preparedness and incident response action plans to acts of violence;
modifying eligibility for the health professional education loan forgiveness program;
establishing the Health Care Affordability Board and Health Care Affordability
Advisory Council; establishing prescription contraceptive supply requirement;
requiring health plan coverage of prescription contraceptives, certain services
provided by a pharmacist, infertility treatment, treatment of rare diseases and
conditions, and biomarker testing; modifying managed care withhold requirements;
establishing filing requirements for a health plan's prescription drug formulary
and for items and services provided by medical and dental practices; establishing
notice and disclosure requirements for certain health care transactions; extending
moratorium on certain conversion transactions; requiring disclosure of facility fees
for telehealth; modifying provisions relating to the eligibility of undocumented
children for MinnesotaCare and of children for medical assistance; prohibiting a
medical assistance benefit plan from including cost-sharing provisions; authorizing
a MinnesotaCare buy-in option; assessing alternative payment methods in rural
health care; assessing feasibility for a health care provider directory; requiring
compliance with the No Surprises Act in billing; modifying prescription drug price
provisions and continuity of care provisions; compiling health encounter data;
modifying all-payer claims data provisions; establishing certain advisory councils,
committees, public awareness campaigns, apprenticeship programs, and grant
programs; modifying lead testing and remediation requirements; establishing
Minnesota One Health Microbial Stewardship Collaborative and cultural
communications program; providing for clinical health care training; establishing
a climate resiliency program; changing assisted living provisions; establishing a
program to monitor long COVID, a 988 suicide crisis lifeline, school-based health
centers, Healthy Beginnings, Healthy Families Act, and Comprehensive and
Collaborative Resource and Referral System for Children; establishing a
moratorium on green burials; regulating submerged closed-loop exchanger systems;
establishing a tobacco use prevention account; amending provisions relating to
adoptee birth records access; establishing Office of African American Health;
establishing Office of American Indian Health; changing certain health board fees;
establishing easy enrollment health insurance outreach program; establishing a
state-funded cost-sharing reduction program for eligible persons enrolled in certain
qualified health plans; setting certain fees; requiring reports; authorizing attorney
general and commissioner of health review and enforcement of certain health care
transactions; authorizing rulemaking; transferring money; allocating funds for a
specific purpose; making forecast adjustments; appropriating money for the
Department of Human Services, Department of Health, health-related boards,
emergency medical services regulatory board, ombudsperson for families,
ombudsperson for American Indian families, Office of the Foster Youth
Ombudsperson, Rare Disease Advisory Council, Department of Revenue,
Department of Management and Budget, Department of Children, Youth and
Families, Department of Commerce, and Health Care Affordability Board;
amending Minnesota Statutes 2022, sections 4.045; 10.65, subdivision 2; 13.10,
subdivision 5; 13.46, subdivision 4; 13.465, subdivision 8; 15.01; 15.06, subdivision
1; 15A.0815, subdivision 2; 16A.151, subdivision 2; 43A.08, subdivision 1a;
62A.02, subdivision 1; 62A.045; 62A.15, subdivision 4, by adding a subdivision;
62A.30, by adding subdivisions; 62A.673, subdivision 2; 62J.497, subdivisions
1, 3; 62J.692, subdivisions 1, 3, 4, 5, 8; 62J.824; 62J.84, subdivisions 2, 3, 4, 6,
7, 8, 9, by adding subdivisions; 62K.10, subdivision 4; 62K.15; 62U.04,
subdivisions 4, 5, 5a, 11, by adding subdivisions; 62U.10, subdivision 7; 103I.005,
subdivisions 17a, 20a, by adding a subdivision; 103I.208, subdivision 2; 119B.011,
subdivisions 2, 5, 13, 19a; 119B.025, subdivision 4; 119B.03, subdivision 4a;
119B.125, subdivisions 1, 1a, 1b, 2, 3, 4, 6, 7; 119B.13, subdivisions 1, 6; 119B.16,
subdivisions 1a, 1c, 3; 119B.161, subdivisions 2, 3; 119B.19, subdivision 7;
121A.335, subdivisions 3, 5, by adding a subdivision; 144.05, by adding a
subdivision; 144.122; 144.1501, subdivisions 1, 2, 3, 4, 5; 144.1506, subdivision
4; 144.218, subdivisions 1, 2; 144.225, subdivision 2; 144.2252; 144.226,
subdivisions 3, 4; 144.566; 144.608, subdivision 1; 144.651, by adding a
subdivision; 144.653, subdivision 5; 144.7055; 144.7067, subdivision 1; 144.9501,
subdivision 9; 144E.001, subdivision 1, by adding a subdivision; 144E.35;
145.4716, subdivision 3; 145.87, subdivision 4; 145.924; 145A.131, subdivisions
1, 2, 5; 145A.14, by adding a subdivision; 147A.08; 148B.392, subdivision 2;
150A.08, subdivisions 1, 5; 150A.091, by adding a subdivision; 150A.13,
subdivision 10; 151.065, subdivisions 1, 2, 3, 4, 6; 151.071, subdivision 2; 151.555;
151.74, subdivisions 3, 4; 152.126, subdivisions 4, 5, 6, 9; 245.095; 245.4663,
subdivision 4; 245.4889, subdivision 1; 245.735, subdivisions 3, 6, by adding a
subdivision; 245A.02, subdivision 2c; 245A.04, subdivisions 1, 7a; 245A.05;
245A.055, subdivision 2; 245A.06, subdivisions 1, 2, 4; 245A.07, subdivision 3;
245A.16, by adding a subdivision; 245A.50, subdivisions 3, 4, 5, 6, 9; 245C.02,
subdivision 13e, by adding subdivisions; 245C.03, subdivisions 1, 1a; 245C.031,
subdivision 1; 245C.04, subdivision 1; 245C.05, subdivisions 1, 2c, 4; 245C.08,
subdivision 1; 245C.10, subdivisions 2, 2a, 3, 4, 5, 6, 8, 9, 9a, 10, 11, 12, 13, 14,
15, 16, 17, 20, 21; 245C.15, subdivision 2, by adding a subdivision; 245C.17,
subdivisions 2, 3, 6; 245C.21, subdivisions 1a, 2; 245C.22, subdivision 7; 245C.23,
subdivisions 1, 2; 245C.24, subdivision 2; 245C.30, subdivision 2; 245C.32,
subdivision 2; 245E.06, subdivision 3; 245G.03, subdivision 1; 245H.01,
subdivision 3, by adding a subdivision; 245H.03, subdivisions 2, 4; 245H.06,
subdivisions 1, 2; 245H.07, subdivisions 1, 2; 245I.011, subdivision 3; 245I.20,
subdivisions 10, 13, 14, 16; 254B.02, subdivision 5; 256.01, by adding a
subdivision; 256.014, subdivisions 1, 2; 256.046, subdivision 3; 256.0471,
subdivision 1; 256.962, subdivision 5; 256.969, subdivisions 2b, 9, 25, by adding
a subdivision; 256.983, subdivision 5; 256B.04, by adding a subdivision; 256B.055,
subdivision 17; 256B.056, subdivision 7; 256B.0625, subdivisions 9, 13, 13c, 13f,
13g, 28b, 30, 31, 34, 49, by adding subdivisions; 256B.0631, subdivision 2, by
adding a subdivision; 256B.0941, by adding a subdivision; 256B.196, subdivision
2; 256B.69, subdivisions 4, 5a, 6d, 28, 36, by adding subdivisions; 256B.692,
subdivision 1; 256B.75; 256B.758; 256B.76, as amended; 256B.761; 256B.764;
256D.01, subdivision 1a; 256D.024, subdivision 1; 256D.03, by adding a
subdivision; 256D.06, subdivision 5; 256D.44, subdivision 5; 256D.63, subdivision
2; 256E.34, subdivision 4; 256E.35, subdivisions 1, 2, 3, 4a, 6, 7; 256I.03,
subdivisions 7, 13; 256I.04, subdivision 1; 256I.06, subdivisions 6, 8, by adding
a subdivision; 256J.08, subdivisions 71, 79; 256J.11, subdivision 1; 256J.21,
subdivisions 3, 4; 256J.26, subdivision 1; 256J.33, subdivisions 1, 2; 256J.35;
256J.37, subdivisions 3, 3a; 256J.425, subdivisions 1, 4, 5, 7; 256J.46, subdivisions
1, 2, 2a; 256J.95, subdivision 19; 256L.03, subdivision 5; 256L.04, subdivisions
7a, 10, by adding a subdivision; 256L.07, subdivision 1; 256L.15, subdivision 2;
256N.26, subdivision 12; 256P.01, by adding subdivisions; 256P.02, subdivision
2, by adding subdivisions; 256P.04, subdivisions 4, 8; 256P.06, subdivision 3, by
adding a subdivision; 256P.07, subdivisions 1, 2, 3, 4, 6, 7, by adding subdivisions;
259.83, subdivisions 1, 1a, 1b, by adding a subdivision; 260.761, subdivision 2,
as amended; 260C.007, subdivisions 6, 14; 260C.317, subdivision 4; 260C.80,
subdivision 1; 260E.01; 260E.02, subdivision 1; 260E.03, subdivision 22, by
adding subdivisions; 260E.09; 260E.14, subdivisions 2, 5; 260E.17, subdivision
1; 260E.18; 260E.20, subdivision 2; 260E.24, subdivisions 2, 7; 260E.33,
subdivision 1; 260E.35, subdivision 6; 270B.14, subdivision 1, by adding a
subdivision; 297F.10, subdivision 1; 403.161, subdivisions 1, 3, 5, 6, 7; 403.162,
subdivisions 1, 2, 5; 518A.31; 518A.32, subdivisions 3, 4; 518A.34; 518A.41;
518A.42, subdivisions 1, 3; 518A.65; 518A.77; 524.5-118; 609B.425, subdivision
2; 609B.435, subdivision 2; Laws 2017, First Special Session chapter 6, article 5,
section 11, as amended; Laws 2021, First Special Session chapter 7, article 6,
section 26; article 16, sections 2, subdivision 32, as amended; 3, subdivision 2, as
amended; article 17, section 5, subdivision 1; proposing coding for new law in
Minnesota Statutes, chapters 62A; 62D; 62J; 62Q; 62V; 103I; 119B; 144; 144E;
145; 148; 245; 245C; 256B; 256E; 256K; 256N; 256P; 260; 290; proposing coding
for new law as Minnesota Statutes, chapter 143; repealing Minnesota Statutes
2022, sections 62J.692, subdivisions 4a, 7, 7a; 119B.03, subdivision 4; 137.38,
subdivision 1; 144.059, subdivision 10; 144.212, subdivision 11; 245C.02,
subdivision 14b; 245C.032; 245C.11, subdivision 3; 245C.30, subdivision 1a;
256.8799; 256.9864; 256B.0631, subdivisions 1, 2, 3; 256B.69, subdivision 5c;
256J.08, subdivisions 10, 53, 61, 62, 81, 83; 256J.30, subdivisions 5, 7, 8; 256J.33,
subdivisions 3, 4, 5; 256J.34, subdivisions 1, 2, 3, 4; 256J.37, subdivision 10;
256J.425, subdivision 6; 259.83, subdivision 3; 259.89; 260C.637.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:
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
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 256.969, 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 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.
(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) new text begin Effective for discharges occurring on or after July 1, 2023, payment rates under this
section must be rebased to reflect those changes in hospital costs between the existing base
year or years and one year prior to the rate year. 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 must 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 the base year or years and
one year prior to the rate year must be measured using the hospital cost index defined in
subdivision 1, paragraph (a). The commissioner must 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 the
differential in payment rates compared to the individual hospital's costs by hospital.
new text end
new text begin
(k) Effective for discharges occurring on or after July 1, 2023, inpatient payment rates
for critical access hospitals located in Minnesota or the local trade area must be a rate equal
to 100 percent of their base year costs inflated to the year prior to the rate year using the
hospital cost index defined in subdivision 1, paragraph (a).
new text end
new text begin (l) new text end 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.
Sec. 4.
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,new text begin or if the hospital qualifies for the alternative payment rate described in
subdivision 2e,new text end 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 deleted text begin $1,500,000deleted text end new text begin
$10,000,000. The department shall calculate the aggregate difference in payments for
outpatient pharmacy claims for members enrolled with medical assistance prepaid health
plans reimbursed at the 340B rate as compared to the non-340B rate, as defined in section
256B.0625. The department shall report the results to the chairs and ranking minority
members of the legislative committees with jurisdiction over medical assistance hospital
reimbursement no later than January 1 for the previous fiscal yearnew text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or the January 1
following certification of the modernized pharmacy claims processing system, whichever
is later. The commissioner of human services shall notify the revisor of statutes when
certification of the modernized pharmacy claims processing system occurs.
new text end
Sec. 5.
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. 6.
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.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024.
new text end
Sec. 7.
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 18 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) Beginning July 1, 2023, medical assistance may be paid for a person under 26 years
of age who was in foster care on the date of attaining 18 years of age and enrolled in another
state's Medicaid program while in foster care in accordance with the Substance Use-Disorder
Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities
Act of 2018. Public Law 115-271, section 1002.
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.
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 for
children only; 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
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. 9.
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 applies to medical assistance and MinnesotaCare
coverage effective January 1, 2024.
new text end
Sec. 10.
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 fournew 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
Services, but the committee shall be staffed by an employee of the department who shall
serve as an ex officio, nonvoting member of the committee. 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 once new text end by the commissioner.
new text begin The committee members shall vote on a chair from among their membership. The chair
shall preside over all committee meetings. new text end The Formulary Committee shall meet at least
deleted text begin twicedeleted text end new text begin four 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. new text begin The Formulary Committee
is subject to the Open Meeting Law under chapter 13D. new text end The Formulary Committee expires
June 30, deleted text begin 2023deleted text end new text begin 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. 11.
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 shall not be required or utilized for:
new text end
new text begin
(1) any liquid form of a medication for a patient who utilizes tube feedings of any kind,
even if such patient has or had any paid claims for pills; and
new text end
new text begin
(2) liquid methadone. If more than one version of liquid methadone is available, the
commissioner shall select the version of liquid methadone that does not require prior
authorization.
new text end
new text begin
This paragraph applies to any multistate preferred drug list or supplemental drug rebate
program established or administered by the commissioner.
new text end
new text begin (e) 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.
Sec. 12.
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 deleted text begin anddeleted text end new text begin ,new text end appropriate medical specialists
deleted text begin and deleted text end new text begin , appropriate patient advocacy groups, and the Minnesota Rare Disease Advisory
Council; 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 definitions apply:
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 subspecialty;
new text end
new text begin
(2) "patient advocacy group" means a nonprofit organization as described in United
States Code, title 26, section 501(c)(3), that is exempt from income tax under United States
Code, title 26, section 501(a), or a public entity that supports persons with the disease state
treated by the therapeutic class of the preferred drug list being updated; and
new text end
new text begin (3) 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.new text begin The commissioner shall maintain a public list of applicable patient advocacy
groups.
new text end
(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 deleted text begin publicdeleted text end medical or clinical analysis that the commissioner
has relied on in proposing the deletion or modification, 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. 13.
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
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. 14.
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 commissioner
deleted text end
deleted text begin
shall
deleted text end
deleted text begin
seek
deleted 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
Alaskan
deleted text end
deleted text begin
Native individuals eligible
deleted text end
deleted text begin
for services
under this subdivision
deleted 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. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 15.
Minnesota Statutes 2022, section 256B.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
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. 16.
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 approval
deleted 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
Alaskan
deleted text end
deleted text begin
Native populations
deleted 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 January 1, 2026, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 17.
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 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. 18.
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 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. 19.
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
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.
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 a managed care or county-based purchasing plan
to provide coverage for a service that is not covered under medical assistance.
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 256B.0625, is amended by adding a subdivision
to read:
new text begin Subd. 71. new text end
new text begin Coverage and payment for pharmacy services. new text end
new text begin
(a) Medical assistance covers
medical treatment or services provided by a licensed pharmacist, to the extent the medical
treatment or services are within the pharmacist's scope of practice, if medical assistance
covers the same medical treatment or services provided by a licensed physician. This
requirement applies to services provided (1) under fee-for-service medical assistance, and
(2) by a managed care plan under section 256B.69 or a county-based purchasing plan under
section 256B.692.
new text end
new text begin
(b) The commissioner, and managed care and county-based purchasing plans when
providing services under sections 256B.69 and 256B.692, must reimburse a participating
pharmacist or pharmacy for a service that is also within a physician's scope of practice at
an amount no lower than the standard payment rate that would be applied when reimbursing
a physician for the service.
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 must notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 21.
Minnesota Statutes 2022, section 256B.0631, subdivision 2, is amended to read:
Subd. 2.
Exceptions.
Co-payments and deductibles shall be subject to the following
exceptions:
(1) children under the age of 21;
(2) pregnant women for services that relate to the pregnancy or any other medical
condition that may complicate the pregnancy;
(3) recipients expected to reside for at least 30 days in a hospital, nursing home, or
intermediate care facility for the developmentally disabled;
(4) recipients receiving hospice care;
(5) 100 percent federally funded services provided by an Indian health service;
(6) emergency services;
(7) family planning servicesnew text begin , including but not limited to the placement and removal of
long-acting reversible contraceptivesnew text end ;
(8) services that are paid by Medicare, resulting in the medical assistance program paying
for the coinsurance and deductible;
(9) co-payments that exceed one per day per provider for nonpreventive visits, eyeglasses,
and nonemergency visits to a hospital-based emergency room;
(10) services, fee-for-service payments subject to volume purchase through competitive
bidding;
(11) American Indians who meet the requirements in Code of Federal Regulations, title
42, sections 447.51 and 447.56;
(12) persons needing treatment for breast or cervical cancer as described under section
256B.057, subdivision 10; deleted text begin and
deleted text end
(13) services that currently have a rating of A or B from the United States Preventive
Services Task Force (USPSTF), immunizations recommended by the Advisory Committee
on Immunization Practices of the Centers for Disease Control and Prevention, and preventive
services and screenings provided to women as described in Code of Federal Regulations,
title 45, section 147.130deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(14) 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 EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024.
new text end
Sec. 22.
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) be 21 years of age or older;
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 this 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 acute 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 to the chairs and
ranking minority members of the legislative committees having jurisdiction over health and
human services by February 1, 2025, and a final report by February 1, 2027, on coverage
of recuperative care services. 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. 23.
Minnesota Statutes 2022, section 256B.196, subdivision 2, is amended to read:
Subd. 2.
Commissioner's duties.
(a) For the purposes of this subdivision and subdivision
3, the commissioner shall determine the fee-for-service outpatient hospital services upper
payment limit for nonstate government hospitals. The commissioner shall then determine
the amount of a supplemental payment to Hennepin County Medical Center and Regions
Hospital for these services that would increase medical assistance spending in this category
to the aggregate upper payment limit for all nonstate government hospitals in Minnesota.
In making this determination, the commissioner shall allot the available increases between
Hennepin County Medical Center and Regions Hospital based on the ratio of medical
assistance fee-for-service outpatient hospital payments to the two facilities. The commissioner
shall adjust this allotment as necessary based on federal approvals, the amount of
intergovernmental transfers received from Hennepin and Ramsey Counties, and other factors,
in order to maximize the additional total payments. The commissioner shall inform Hennepin
County and Ramsey County of the periodic intergovernmental transfers necessary to match
federal Medicaid payments available under this subdivision in order to make supplementary
medical assistance payments to Hennepin County Medical Center and Regions Hospital
equal to an amount that when combined with existing medical assistance payments to
nonstate governmental hospitals would increase total payments to hospitals in this category
for outpatient services to the aggregate upper payment limit for all hospitals in this category
in Minnesota. Upon receipt of these periodic transfers, the commissioner shall make
supplementary payments to Hennepin County Medical Center and Regions Hospital.
(b) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians and other billing professionals affiliated
with Hennepin County Medical Center and with Regions Hospital. The upper payment limit
shall be based on the average commercial rate or be determined using another method
acceptable to the Centers for Medicare and Medicaid Services. The commissioner shall
inform Hennepin County and Ramsey County of the periodic intergovernmental transfers
necessary to match the federal Medicaid payments available under this subdivision in order
to make supplementary payments to physicians and other billing professionals affiliated
with Hennepin County Medical Center and to make supplementary payments to physicians
and other billing professionals affiliated with Regions Hospital through HealthPartners
Medical Group equal to the difference between the established medical assistance payment
for physician and other billing professional services and the upper payment limit. Upon
receipt of these periodic transfers, the commissioner shall make supplementary payments
to physicians and other billing professionals affiliated with Hennepin County Medical Center
and shall make supplementary payments to physicians and other billing professionals
affiliated with Regions Hospital through HealthPartners Medical Group.
(c) Beginning January 1, 2010, Ramsey County may make monthly voluntary
intergovernmental transfers to the commissioner in amounts not to exceed $6,000,000 per
year. The commissioner shall increase the medical assistance capitation payments to any
licensed health plan under contract with the medical assistance program that agrees to make
enhanced payments to Regions Hospital. The increase shall be in an amount equal to the
annual value of the monthly transfers plus federal financial participation, with each health
plan receiving its pro rata share of the increase based on the pro rata share of medical
assistance admissions to Regions Hospital by those plans. For the purposes of this paragraph,
"the base amount" means the total annual value of increased medical assistance capitation
payments, including the voluntary intergovernmental transfers, under this paragraph in
calendar year 2017. For managed care contracts beginning on or after January 1, 2018, the
commissioner shall reduce the total annual value of increased medical assistance capitation
payments under this paragraph by an amount equal to ten percent of the base amount, and
by an additional ten percent of the base amount for each subsequent contract year until
December 31, 2025. Upon the request of the commissioner, health plans shall submit
individual-level cost data for verification purposes. The commissioner may ratably reduce
these payments on a pro rata basis in order to satisfy federal requirements for actuarial
soundness. If payments are reduced, transfers shall be reduced accordingly. Any licensed
health plan that receives increased medical assistance capitation payments under the
intergovernmental transfer described in this paragraph shall increase its medical assistance
payments to Regions Hospital by the same amount as the increased payments received in
the capitation payment described in this paragraph. This paragraph expires January 1, 2026.
(d) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for ambulance services affiliated with Hennepin County
Medical Center and the city of St. Paul, and ambulance services owned and operated by
another governmental entity that chooses to participate by requesting the commissioner to
determine an upper payment limit. The upper payment limit shall be based on the average
commercial rate or be determined using another method acceptable to the Centers for
Medicare and Medicaid Services. The commissioner shall inform Hennepin County, the
city of St. Paul, and other participating governmental entities of the periodic
intergovernmental transfers necessary to match the federal Medicaid payments available
under this subdivision in order to make supplementary payments to Hennepin County
Medical Center, the city of St. Paul, and other participating governmental entities equal to
the difference between the established medical assistance payment for ambulance services
and the upper payment limit. Upon receipt of these periodic transfers, the commissioner
shall make supplementary payments to Hennepin County Medical Center, the city of St.
Paul, and other participating governmental entities. A Tribal government that owns and
operates an ambulance service is not eligible to participate under this subdivision.
(e) For the purposes of this subdivision and subdivision 3, the commissioner shall
determine an upper payment limit for physicians, dentists, and other billing professionals
affiliated with the University of Minnesota and University of Minnesota Physicians. The
upper payment limit shall be based on the average commercial rate or be determined using
another method acceptable to the Centers for Medicare and Medicaid Services. The
commissioner shall inform the University of Minnesota Medical School and University of
Minnesota School of Dentistry of the periodic intergovernmental transfers necessary to
match the federal Medicaid payments available under this subdivision in order to make
supplementary payments to physicians, dentists, and other billing professionals affiliated
with the University of Minnesota and the University of Minnesota Physicians equal to the
difference between the established medical assistance payment for physician, dentist, and
other billing professional services and the upper payment limit. Upon receipt of these periodic
transfers, the commissioner shall make supplementary payments to physicians, dentists,
and other billing professionals affiliated with the University of Minnesota and the University
of Minnesota Physicians.
(f) The commissioner shall inform the transferring governmental entities on an ongoing
basis of the need for any changes needed in the intergovernmental transfers in order to
continue the payments under paragraphs (a) to (e), at their maximum level, including
increases in upper payment limits, changes in the federal Medicaid match, and other factors.
(g) The payments in paragraphs (a) to (e) shall be implemented independently of each
other, subject to federal approval and to the receipt of transfers under subdivision 3.
(h) All of the data and funding transactions related to the payments in paragraphs (a) to
(e) shall be between the commissioner and the governmental entities.new text begin The commissioner
shall not make payments to governmental entities eligible to receive payments described
in paragraphs (a) to (e) that fail to submit the data needed to compute the payments within
24 months of the initial request from the commissioner.
new text end
(i) For purposes of this subdivision, billing professionals are limited to physicians, nurse
practitioners, nurse midwives, clinical nurse specialists, physician assistants,
anesthesiologists, certified registered nurse anesthetists, dentists, dental hygienists, and
dental therapists.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
new text end
Sec. 24.
Minnesota Statutes 2022, section 256B.69, subdivision 4, is amended to read:
Subd. 4.
Limitation of choicenew text begin ; opportunity to opt outnew text end .
(a) The commissioner shall
develop criteria to determine when limitation of choice may be implemented in the
experimental countiesnew text begin , but shall provide all eligible individuals the opportunity to opt out
of enrollment in managed care under this sectionnew text end . The criteria shall ensure that all eligible
individuals in the county have continuing access to the full range of medical assistance
services as specified in subdivision 6.
(b) The commissioner shall exempt the following persons from participation in the
project, in addition to those who do not meet the criteria for limitation of choice:
(1) persons eligible for medical assistance according to section 256B.055, subdivision
1;
(2) persons eligible for medical assistance due to blindness or disability as determined
by the Social Security Administration or the state medical review team, unless:
(i) they are 65 years of age or older; or
(ii) they reside in Itasca County or they reside in a county in which the commissioner
conducts a pilot project under a waiver granted pursuant to section 1115 of the Social
Security Act;
(3) recipients who currently have private coverage through a health maintenance
organization;
(4) recipients who are eligible for medical assistance by spending down excess income
for medical expenses other than the nursing facility per diem expense;
(5) recipients who receive benefits under the Refugee Assistance Program, established
under United States Code, title 8, section 1522(e);
(6) children who are both determined to be severely emotionally disturbed and receiving
case management services according to section 256B.0625, subdivision 20, except children
who are eligible for and who decline enrollment in an approved preferred integrated network
under section 245.4682;
(7) adults who are both determined to be seriously and persistently mentally ill and
received case management services according to section 256B.0625, subdivision 20;
(8) persons eligible for medical assistance according to section 256B.057, subdivision
10;
(9) persons with access to cost-effective employer-sponsored private health insurance
or persons enrolled in a non-Medicare individual health plan determined to be cost-effective
according to section 256B.0625, subdivision 15; and
(10) persons who are absent from the state for more than 30 consecutive days but still
deemed a resident of Minnesota, identified in accordance with section 256B.056, subdivision
1, paragraph (b).
Children under age 21 who are in foster placement may enroll in the project on an elective
basis. Individuals excluded under clauses (1), (6), and (7) may choose to enroll on an elective
basis. The commissioner may enroll recipients in the prepaid medical assistance program
for seniors who are (1) age 65 and over, and (2) eligible for medical assistance by spending
down excess income.
(c) The commissioner may allow persons with a one-month spenddown who are otherwise
eligible to enroll to voluntarily enroll or remain enrolled, if they elect to prepay their monthly
spenddown to the state.
(d) The commissioner may requirenew text begin , subject to the opt-out provision under paragraph (a),new text end
those individuals to enroll in the prepaid medical assistance program who otherwise would
have been excluded under paragraph (b), clauses (1), (3), and (8), and under Minnesota
Rules, part 9500.1452, subpart 2, items H, K, and L.
(e) Before limitation of choice is implemented, eligible individuals shall be notified and
new text begin given the opportunity to opt out of managed care enrollment. new text end After notification, new text begin those
individuals who choose not to opt out new text end shall be allowed to choose only among demonstration
providers. The commissioner may assign an individual with private coverage through a
health maintenance organization, to the same health maintenance organization for medical
assistance coverage, if the health maintenance organization is under contract for medical
assistance in the individual's county of residence. After initially choosing a provider, the
recipient is allowed to change that choice only at specified times as allowed by the
commissioner. If a demonstration provider ends participation in the project for any reason,
a recipient enrolled with that provider must select a new provider but may change providers
without cause once more within the first 60 days after enrollment with the second provider.
(f) An infant born to a woman who is eligible for and receiving medical assistance and
who is enrolled in the prepaid medical assistance program shall be retroactively enrolled to
the month of birth in the same managed care plan as the mother once the child is enrolled
in medical assistance unless the child is determined to be excluded from enrollment in a
prepaid plan under this section.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024.
new text end
Sec. 25.
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, 2025.
new text end
Sec. 26.
Minnesota Statutes 2022, section 256B.69, subdivision 6d, is amended to read:
Subd. 6d.
Prescription drugs.
new text begin (a)new text end The commissioner deleted text begin maydeleted text end new text begin shallnew text end exclude or modify
coverage for new text begin outpatient new text end prescription drugs new text begin dispensed by a pharmacy to a medical assistance
enrollee new text end from the prepaid managed care contracts entered into under this section deleted text begin in order
to increase savings to the state by collecting additional prescription drug deleted text end deleted text begin rebates. The
contracts must maintain incentives for the managed care plan to manage drug deleted text end deleted text begin costs and
utilization and may require that the managed care plans maintain an open drug deleted text end deleted text begin formulary.
In order to manage drug costs and utilization, the contracts may authorize the deleted text end deleted text begin managed care
plans to use preferred drug lists and prior authorization. This subdivision is deleted text end deleted text begin contingent on
federal approval of the managed care contract changes and the collection of deleted text end deleted text begin additional
prescription drug rebatesdeleted text end new text begin . The commissioner may include, exclude, or modify coverage for
outpatient prescription drugs dispensed by a pharmacy and administered to a MinnesotaCare
enrollee from the prepaid managed care contracts entered into under this sectionnew text end .
new text begin
(b) Managed care plans and county-based purchasing plans must reimburse pharmacies
for outpatient drugs dispensed to enrollees as follows:
new text end
new text begin
(1) for brand name drugs or multisource brand name drugs prescribed in accordance
with Code of Federal Regulations, title 42, section 447.512(c), a dispensing fee equal to
one-half of the fee-for-service dispensing fee in section 256B.0625, subdivision 13e,
paragraph (a), plus the lesser of the National Average Drug Acquisition Cost for brand name
drugs; the Wholesale Acquisition Cost minus two percent; the maximum allowable cost as
defined in chapter 62W; or the submitted charges;
new text end
new text begin
(2) for generic drugs or multisource brand name drugs, unless the multisource brand
name drug is prescribed in accordance with Code of Federal Regulations, title 42, section
447.512(c), a dispensing fee equal to one-half of the fee-for-service dispensing fee in section
256B.0625, subdivision 13e, paragraph (a), plus the lesser of the National Average Drug
Acquisition Cost for brand drugs; the National Average Drug Acquisition Cost for generic
drugs; the Wholesale Acquisition Cost minus two percent; the maximum allowable cost;
or the submitted charges;
new text end
new text begin
(3) for drugs purchased through the 340B drug program, as allowed in section 62W.07,
managed care plans and county-based purchasing plans may pay a rate less than the rate
under clause (1) for brand name drugs or less than the rate under clause (2) for generic
drugs, but are not required to apply the 340B drug ceiling price limit in section 256B.0625,
subdivision 13e; and
new text end
new text begin
(4) for charges submitted by a pharmacy that are less than the rate under clause (1) for
brand name drugs or less than the rate under clause (2) for generic drugs, managed care
plans and county-based purchasing plans may pay a lower rate equal to the submitted
charges.
new text end
new text begin
(c) Contracts between managed care plans and county-based purchasing plans and
providers to whom paragraph (b) applies must allow recovery of payments from those
providers if capitation rates are adjusted in accordance with paragraph (b). Payment
recoveries must not exceed an amount equal to any increase in rates that results from
paragraph (b). Paragraph (b) must not be implemented if federal approval is not received
for paragraph (b), or if federal approval is withdrawn at any time.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
The amendments to paragraph (a) are effective January 1, 2026,
or the January 1 following certification of the modernized pharmacy claims processing
system, whichever is later. Paragraphs (b) and (c) are effective January 1, 2024, or upon
federal approval, whichever is later. The commissioner must inform the revisor of statutes
when federal approval is obtained and when certification of the modernized pharmacy claims
processing system occurs.
new text end
Sec. 27.
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. 28.
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. 29.
Minnesota Statutes 2022, section 256B.69, subdivision 28, is amended to read:
Subd. 28.
Medicare special needs plans; medical assistance basic health care.
(a)
The commissioner may contract with demonstration providers and current or former sponsors
of qualified Medicare-approved special needs plans, to provide medical assistance basic
health care services to persons with disabilities, including those with developmental
disabilities. Basic health care services include:
(1) those services covered by the medical assistance state plan except for ICF/DD services,
home and community-based waiver services, case management for persons with
developmental disabilities under section 256B.0625, subdivision 20a, and personal care and
certain home care services defined by the commissioner in consultation with the stakeholder
group established under paragraph (d); and
(2) basic health care services may also include risk for up to 100 days of nursing facility
services for persons who reside in a noninstitutional setting and home health services related
to rehabilitation as defined by the commissioner after consultation with the stakeholder
group.
The commissioner may exclude other medical assistance services from the basic health
care benefit set. Enrollees in these plans can access any excluded services on the same basis
as other medical assistance recipients who have not enrolled.
(b) The commissioner may contract with demonstration providers and current and former
sponsors of qualified Medicare special needs plans, to provide basic health care services
under medical assistance to persons who are dually eligible for both Medicare and Medicaid
and those Social Security beneficiaries eligible for Medicaid but in the waiting period for
Medicare. The commissioner shall consult with the stakeholder group under paragraph (d)
in developing program specifications for these services. Payment for Medicaid services
provided under this subdivision for the months of May and June will be made no earlier
than July 1 of the same calendar year.
(c) deleted text begin Notwithstanding subdivision 4, beginning January 1, 2012,deleted text end The commissioner shall
enroll persons with disabilities in managed care under this section, unless the individual
chooses to opt out of enrollment. The commissioner shall establish enrollment and opt out
procedures consistent with applicable enrollment procedures under this section.
(d) The commissioner shall establish a state-level stakeholder group to provide advice
on managed care programs for persons with disabilities, including both MnDHO and contracts
with special needs plans that provide basic health care services as described in paragraphs
(a) and (b). The stakeholder group shall provide advice on program expansions under this
subdivision and subdivision 23, including:
(1) implementation efforts;
(2) consumer protections; and
(3) program specifications such as quality assurance measures, data collection and
reporting, and evaluation of costs, quality, and results.
(e) Each plan under contract to provide medical assistance basic health care services
shall establish a local or regional stakeholder group, including representatives of the counties
covered by the plan, members, consumer advocates, and providers, for advice on issues that
arise in the local or regional area.
(f) The commissioner is prohibited from providing the names of potential enrollees to
health plans for marketing purposes. The commissioner shall mail no more than two sets
of marketing materials per contract year to potential enrollees on behalf of health plans, at
the health plan's request. The marketing materials shall be mailed by the commissioner
within 30 days of receipt of these materials from the health plan. The health plans shall
cover any costs incurred by the commissioner for mailing marketing materials.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024.
new text end
Sec. 30.
Minnesota Statutes 2022, section 256B.69, subdivision 36, is amended to read:
Subd. 36.
Enrollee support system.
(a) The commissioner shall establish an enrollee
support system that provides support to an enrollee before and during enrollment in a
managed care plan.
(b) The enrollee support system must:
(1) provide access to counseling for each potential enrollee on choosing a managed care
plannew text begin or opting out of managed carenew text end ;
(2) assist an enrollee in understanding enrollment in a managed care plan;
(3) provide an access point for complaints regarding enrollment, covered services, and
other related matters;
(4) provide information on an enrollee's grievance and appeal rights within the managed
care organization and the state's fair hearing process, including an enrollee's rights and
responsibilities; and
(5) provide assistance to an enrollee, upon request, in navigating the grievance and
appeals process within the managed care organization and in appealing adverse benefit
determinations made by the managed care organization to the state's fair hearing process
after the managed care organization's internal appeals process has been exhausted. Assistance
does not include providing representation to an enrollee at the state's fair hearing, but may
include a referral to appropriate legal representation sources.
(c) Outreach to enrollees through the support system must be accessible to an enrollee
through multiple formats, including telephone, Internet, in-person, and, if requested, through
auxiliary aids and services.
(d) The commissioner may designate enrollment brokers to assist enrollees on selecting
a managed care organization and providing necessary enrollment information. For purposes
of this subdivision, "enrollment broker" means an individual or entity that performs choice
counseling or enrollment activities in accordance with Code of Federal Regulations, part
42, section 438.810, or both.
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.692, subdivision 1, is amended to read:
Subdivision 1.
In general.
County boards or groups of county boards may elect to
purchase or provide health care services on behalf of persons eligible for medical assistance
who would otherwise be required to or may elect to participate in the prepaid medical
assistance program according to section 256B.69new text begin , subject to the opt-out provision of section
256B.69, subdivision 4, paragraph (a)new text end . Counties that elect to purchase or provide health
care under this section must provide all services included in prepaid managed care programs
according to section 256B.69, subdivisions 1 to 22. County-based purchasing under this
section is governed by section 256B.69, unless otherwise provided for under this section.
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.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
(c) The rate described in paragraph (b) must be increased for hospitals providing high
levels of 340B drugs. The rate adjustment must be based on four percent of each hospital's
share of the total reimbursement for 340B drugs to all critical access hospitals, but must not
exceed $3,000,000.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end 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.
deleted text begin (d)deleted text end new text begin (e)new text end 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.
deleted text begin (e)deleted text end new text begin (f)new text end 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.
deleted text begin (f)deleted text end new text begin (g)new text end 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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026, or the January 1
following certification of the modernized pharmacy claims processing system, whichever
is later. The commissioner of human services shall notify the revisor of statutes when
certification of the modernized pharmacy claims processing system occurs.
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, as amended by Laws 2023, chapter
25, section 145, is amended to read:
256B.76 PHYSICIANnew text begin , PROFESSIONAL SERVICES,new text end AND DENTAL
REIMBURSEMENT.
Subdivision 1.
Physiciannew text begin and professional servicesnew 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
Subd. 2.
Dental reimbursement.
(a) Effective for services rendered deleted text begin on or afterdeleted text end new text begin fromnew text end
October 1, 1992,new text begin to December 31, 2023,new text end the commissioner shall make payments for dental
services as follows:
(1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25 percent
above the rate in effect on June 30, 1992; and
(2) dental 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.
(b) deleted text begin Beginningdeleted text end new text begin Fromnew text end October 1, 1999,new text begin to December 31, 2023,new text end the payment for tooth
sealants and fluoride treatments shall be the lower of (1) submitted charge, or (2) 80 percent
of median 1997 charges.
(c) Effective for services rendered deleted text begin on or afterdeleted text end new text begin fromnew text end January 1, 2000,new text begin to December 31,
2023,new text end payment rates for dental services shall be increased by three percent over the rates in
effect on December 31, 1999.
(d) Effective for services provided deleted text begin on or afterdeleted text end new text begin fromnew text end January 1, 2002,new text begin to December 31,
2023,new text end payment for diagnostic examinations and dental x-rays provided to children under
age 21 shall be the lower of (1) the submitted charge, or (2) 85 percent of median 1999
charges.
(e) The increases listed in paragraphs (b) and (c) shall be implemented January 1, 2000,
for managed care.
(f) Effective for dental services rendered on or after October 1, 2010, by a state-operated
dental clinic, payment shall be paid on a reasonable cost basis that is based on the Medicare
principles of reimbursement. This payment shall be effective for services rendered on or
after January 1, 2011, to recipients enrolled in managed care plans or county-based
purchasing plans.
(g) Beginning in fiscal year 2011, if the payments to state-operated dental clinics in
paragraph (f), including state and federal shares, are less than $1,850,000 per fiscal year, a
supplemental state payment equal to the difference between the total payments in paragraph
(f) and $1,850,000 shall be paid from the general fund to state-operated services for the
operation of the dental clinics.
deleted text begin
(h) Effective for services rendered on or after January 1, 2014, through December 31,
2021, payment rates for dental services shall be increased by five percent from the rates in
effect on December 31, 2013. This increase does not apply to state-operated dental clinics
in paragraph (f), federally qualified health centers, rural health centers, and Indian health
services. Effective January 1, 2014, payments made to managed care plans and county-based
purchasing plans under sections 256B.69, 256B.692, and 256L.12 shall reflect the payment
increase described in this paragraph.
deleted text end
deleted text begin
(i) Effective for services provided on or after January 1, 2017, through December 31,
2021, the commissioner shall increase payment rates by 9.65 percent for dental services
provided outside of the seven-county metropolitan area. This increase does not apply to
state-operated dental clinics in paragraph (f), federally qualified health centers, rural health
centers, or Indian health services. Effective January 1, 2017, payments to managed care
plans and county-based purchasing plans under sections 256B.69 and 256B.692 shall reflect
the payment increase described in this paragraph.
deleted text end
deleted text begin
(j) Effective for services provided on or after July 1, 2017, through December 31, 2021,
the commissioner shall increase payment rates by 23.8 percent for dental services provided
to enrollees under the age of 21. This rate increase does not apply to state-operated dental
clinics in paragraph (f), federally qualified health centers, rural health centers, or Indian
health centers. This rate increase does not apply to managed care plans and county-based
purchasing plans.
deleted text end
deleted text begin (k)deleted text end new text begin (h)new text end Effective for services provided on or after January 1, 2022, the commissioner
shall exclude from medical assistance and MinnesotaCare payments for dental services to
public health and community health clinics the 20 percent increase authorized under Laws
1989, chapter 327, section 5, subdivision 2, paragraph (b).
deleted text begin (l)deleted text end new text begin (i)new text end Effective for services provided deleted text begin on or afterdeleted text end new text begin fromnew text end January 1, 2022,new text begin to December 31,
2023,new text end the commissioner shall increase payment rates by 98 percent for all dental services.
This rate increase does not apply to state-operated dental clinics, federally qualified health
centers, rural health centers, or Indian health services.
deleted text begin (m)deleted text end new text begin (j)new text end Managed care plans and county-based purchasing plans shall reimburse providers
at a level that is at least equal to the rate paid under fee-for-service for dental services. If,
for any coverage 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 an amount equal
to any increase in rates that results from this provision. If, for any coverage year, federal
approval is not received for this paragraph, the commissioner shall not implement this
paragraph for subsequent coverage years.
new text begin
(k) Effective for services provided on or after January 1, 2024, payment for dental
services must be the lower of submitted charges or the percentile of 2018-submitted charges
from claims paid by the commissioner so that the total aggregate expenditures does not
exceed the total spend as outlined in the applicable paragraphs (a) to (k). This paragraph
does not apply to federally qualified health centers, rural health centers, state-operated dental
clinics, or Indian health centers.
new text end
new text begin
(l) Beginning January 1, 2027, and every three years thereafter, the commissioner shall
rebase payment rates for dental services to a percentile of submitted charges for the applicable
base year using charge data from claims paid by the commissioner so that the total aggregate
expenditures does not exceed the total spend as outlined in paragraph (k) plus the change
in the Medicare Economic Index (MEI). In 2027, the change in the MEI must be measured
from midyear of 2024 and 2026. For each subsequent rebasing, the change in the MEI must
be measured between the years that are one year after the rebasing years. The base year
used for each rebasing must be the calendar year that is two years prior to the effective date
of the rebasing. This paragraph does not apply to federally qualified health centers, rural
health centers, state-operated dental clinics, or Indian health centers.
new text end
Subd. 3.
Dental services grants.
(a) The commissioner shall award grants to community
clinics or other nonprofit community organizations, political subdivisions, professional
associations, or other organizations that demonstrate the ability to provide dental services
effectively to public program recipients. Grants may be used to fund the costs related to
coordinating access for recipients, developing and implementing patient care criteria,
upgrading or establishing new facilities, acquiring furnishings or equipment, recruiting new
providers, or other development costs that will improve access to dental care in a region.
In awarding grants, the commissioner shall give priority to applicants that plan to serve
areas of the state in which the number of dental providers is not currently sufficient to meet
the needs of recipients of public programs or uninsured individuals. The commissioner shall
consider the following in awarding the grants:
(1) potential to successfully increase access to an underserved population;
(2) the ability to raise matching funds;
(3) the long-term viability of the project to improve access beyond the period of initial
funding;
(4) the efficiency in the use of the funding; and
(5) the experience of the proposers in providing services to the target population.
(b) The commissioner shall monitor the grants and may terminate a grant if the grantee
does not increase dental access for public program recipients. The commissioner shall
consider grants for the following:
(1) implementation of new programs or continued expansion of current access programs
that have demonstrated success in providing dental services in underserved areas;
(2) a pilot program for utilizing hygienists outside of a traditional dental office to provide
dental hygiene services; and
(3) a program that organizes a network of volunteer dentists, establishes a system to
refer eligible individuals to volunteer dentists, and through that network provides donated
dental care services to public program recipients or uninsured individuals.
Subd. 4.
Critical access dental providers.
deleted text begin
(a) The commissioner shall increase
reimbursements to dentists and dental clinics deemed by the commissioner to be critical
access dental providers. For dental services rendered on or after July 1, 2016, through
December 31, 2021, the commissioner shall increase reimbursement by 37.5 percent above
the reimbursement rate that would otherwise be paid to the critical access dental provider,
except as specified under paragraph (b). The commissioner shall pay the managed care
plans and county-based purchasing plans in amounts sufficient to reflect increased
reimbursements to critical access dental providers as approved by the commissioner.
deleted text end
deleted text begin
(b) For dental services rendered on or after July 1, 2016, through December 31, 2021,
by a dental clinic or dental group that meets the critical access dental provider designation
under paragraph (f), clause (4), and is owned and operated by a health maintenance
organization licensed under chapter 62D, the commissioner shall increase reimbursement
by 35 percent above the reimbursement rate that would otherwise be paid to the critical
access provider.
deleted text end
deleted text begin (c)deleted text end new text begin (a)new text end The commissioner shall increase reimbursement to dentists and dental clinics
deemed by the commissioner to be critical access dental providers. For dental services
provided on or after January 1, 2022, by a dental provider deemed to be a critical access
dental provider under paragraph deleted text begin (f)deleted text end new text begin (d)new text end , the commissioner shall increase reimbursement by
20 percent above the reimbursement rate that would otherwise be paid to the critical access
dental provider. This paragraph does not apply to federally qualified health centers, rural
health centers, state-operated dental clinics, or Indian health centers.
deleted text begin (d)deleted text end new text begin (b)new text end Managed care plans and county-based purchasing plans shall increase
reimbursement to critical access dental providers by at least the amount specified in paragraph
deleted text begin (c)deleted text end new text begin (c)new text end . If, for any coverage 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
an amount equal to any increase in rates that results from this provision. If, for any coverage
year, federal approval is not received for this paragraph, the commissioner shall not
implement this paragraph for subsequent coverage years.
deleted text begin (e)deleted text end new text begin (c)new text end Critical access dental payments made under this subdivision for dental services
provided by a critical access dental provider to an enrollee of a managed care plan or
county-based purchasing plan must not reflect any capitated payments or cost-based payments
from the managed care plan or county-based purchasing plan. The managed care plan or
county-based purchasing plan must base the additional critical access dental payment on
the amount that would have been paid for that service had the dental provider been paid
according to the managed care plan or county-based purchasing plan's fee schedule that
applies to dental providers that are not paid under a capitated payment or cost-based payment.
deleted text begin (f)deleted text end new text begin (d)new text end The commissioner shall designate the following dentists and dental clinics as
critical access dental providers:
(1) nonprofit community clinics that:
(i) have nonprofit status in accordance with chapter 317A;
(ii) have tax exempt status in accordance with the Internal Revenue Code, section
501(c)(3);
(iii) are established to provide oral health services to patients who are low income,
uninsured, have special needs, and are underserved;
(iv) have professional staff familiar with the cultural background of the clinic's patients;
(v) charge for services on a sliding fee scale designed to provide assistance to low-income
patients based on current poverty income guidelines and family size;
(vi) do not restrict access or services because of a patient's financial limitations or public
assistance status; and
(vii) have free care available as needed;
(2) federally qualified health centers, rural health clinics, and public health clinics;
(3) hospital-based dental clinics owned and operated by a city, county, or former state
hospital as defined in section 62Q.19, subdivision 1, paragraph (a), clause (4);
(4) a dental clinic or dental group owned and operated by a nonprofit corporation in
accordance with chapter 317A with more than 10,000 patient encounters per year with
patients who are uninsured or covered by medical assistance or MinnesotaCare;
(5) a dental clinic owned and operated by the University of Minnesota or the Minnesota
State Colleges and Universities system; and
(6) private practicing dentists if:
(i) the dentist's office is located within the seven-county metropolitan area and more
than 50 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare; or
(ii) the dentist's office is located outside the seven-county metropolitan area and more
than 25 percent of the dentist's patient encounters per year are with patients who are uninsured
or covered by medical assistance or MinnesotaCare.
Subd. 5.
Outpatient rehabilitation facility.
An entity that operates both a Medicare
certified comprehensive outpatient rehabilitation facility and a facility which was certified
prior to January 1, 1993, that is licensed under Minnesota Rules, parts 9570.2000 to
9570.3400, and for whom at least 33 percent of the clients receiving rehabilitation services
in the most recent calendar year are medical assistance recipients, shall be reimbursed by
the commissioner for rehabilitation services at rates that are 38 percent greater than the
maximum reimbursement rate allowed under subdivision 1, paragraph (a), clause (2), when
those services are (1) provided within the comprehensive outpatient rehabilitation facility
and (2) provided to residents of nursing facilities owned by the entity.
Subd. 6.
Medicare relative value units.
Effective for services rendered on or after
January 1, 2007, the commissioner shall make payments for physician and professional
services based on the Medicare relative value units (RVU's). This change shall be budget
neutral and the cost of implementing RVU's will be incorporated in the established conversion
factor.
Subd. 7.
Payment for certain primary care services and immunization
administration.
Payment for certain primary care services and immunization administration
services rendered on or after January 1, 2013, through December 31, 2014, shall be made
in accordance with section 1902(a)(13) of the Social Security Act.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 35.
Minnesota Statutes 2022, section 256B.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, must be increased by eight 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, must be annually adjusted
according to the Consumer Price Index for medical care services. 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
Sec. 36.
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 must be increased by ten percent. This increase does not
apply to federally qualified health centers, rural health centers, or Indian health services.
new text end
Sec. 37.
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 deleted text begin anddeleted text end new text begin ;new text end to American Indians as defined in Code of Federal
Regulations, title 42, section 600.5new text begin ; or 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 .
(b) The commissioner shall 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 EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 38.
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. 39. new text begin REPORT; MODIFY WITHHOLD PROVISIONS.
new text end
new text begin
By January 1, 2024, the commissioner of human services must submit a report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
human services finance and policy evaluating the utility of the performance targets described
in Minnesota Statutes 2022, section 256B.69, subdivision 5a, paragraphs (e) to (g). The
report must include the applicable performance rates of managed care organizations and
county-based purchasing plans in the past three years, projected impacts on performance
rates for the next three years resulting from a repeal of Minnesota Statutes 2022, section
256B.69, subdivision 5a, paragraphs (e) to (g), measures that the commissioner anticipates
taking to continue monitoring and improving the applicable performance rates of managed
care organizations and county-based purchasing plans upon a repeal of Minnesota Statutes
2022, section 256B.69, subdivision 5a, paragraphs (e) to (g), proposals for additional
performance targets that may improve quality of care for enrollees, and any additional
legislative actions that may be required as the result of a repeal of Minnesota Statutes 2022,
section 256B.69, subdivision 5a, paragraphs (e) to (g).
new text end
ARTICLE 2
HEALTH INSURANCE
Section 1.
Minnesota Statutes 2022, section 62A.02, subdivision 1, is amended to read:
Subdivision 1.
Filing.
new text begin (a) new text end For purposes of this section, "health plan" means a health plan
as defined in section 62A.011 or a policy of accident and sickness insurance as defined in
section 62A.01. No health plan shall be issued or delivered to any person in this state, nor
shall any application, rider, or endorsement be used in connection with the health plan, until
a copy of its form and of the classification of risks and the premium rates pertaining to the
form have been filed with the commissioner. The filing for nongroup health plan forms
shall include a statement of actuarial reasons and data to support the rate. For health benefit
plans as defined in section 62L.02, and for health plans to be issued to individuals, the health
carrier shall file with the commissioner the information required in section 62L.08,
subdivision 8. For group health plans for which approval is sought for sales only outside
of the small employer market as defined in section 62L.02, this section applies only to
policies or contracts of accident and sickness insurance. All forms intended for issuance in
the individual or small employer market must be accompanied by a statement as to the
expected loss ratio for the form. Premium rates and forms relating to specific insureds or
proposed insureds, whether individuals or groups, need not be filed, unless requested by
the commissioner.
new text begin
(b) The filing must include the health plan's prescription drug formulary. Proposed
revisions to the health plan's prescription drug formulary must be filed with the commissioner
no later than August 1 of the application year.
new text end
new text begin
(c) The provisions of paragraph (b) shall not be severable from section 62Q.83. If any
provision of paragraph (b) or its application to any individual, entity, or circumstance is
found to be void for any reason, section 62Q.83 shall be void also.
new text end
Sec. 2.
new text begin
[62A.0412] COVERAGE OF INFERTILITY TREATMENT.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
This section applies to all large group health plans that provide
maternity benefits to Minnesota residents. This section only applies to large group health
plans.
new text end
new text begin Subd. 2. new text end
new text begin Required coverage. new text end
new text begin
(a) Every health plan under subdivision 1 must provide
comprehensive coverage for the diagnosis of infertility, treatment for infertility, and standard
fertility preservation services that are:
new text end
new text begin
(1) considered medically necessary by the enrollee's treating health care provider; and
new text end
new text begin
(2) recognized by either the American Society for Reproductive Medicine, the American
College of Obstetrics and Gynecologists, or the American Society of Clinical Oncology.
new text end
new text begin
(b) Coverage under this section must include but is not limited to ovulation induction,
procedures and devices to monitor ovulation, artificial insemination, oocyte retrieval
procedures, in vitro fertilization, gamete intrafallopian transfer, oocyte replacement,
cryopreservation techniques, micromanipulation of gametes, and standard fertility
preservation services.
new text end
new text begin
(c) Coverage under this section must include unlimited embryo transfers, but may impose
a limit of four completed oocyte retrievals. Single embryo transfer must be used when
medically appropriate and recommended by the treating health care provider.
new text end
new text begin
(d) Coverage for surgical reversal of elective sterilization is not required under this
section.
new text end
new text begin
(e) Cost-sharing requirements, including co-payments, deductibles, and coinsurance for
infertility coverage, must not be greater than the cost-sharing requirements for maternity
coverage under the enrollee's health plan.
new text end
new text begin
(f) Health plans under subdivision 1 may not include in the coverage under this section:
new text end
new text begin
(1) any exclusions, limitations, or other restrictions on coverage of fertility medications
that are different from those imposed on other prescription medications;
new text end
new text begin
(2) any exclusions, limitations, or other restrictions on coverage of any fertility services
based on a covered individual's participation in fertility services provided by or to a third
party; or
new text end
new text begin
(3) any benefit maximums, waiting periods, or any other limitations on coverage for the
diagnosis of infertility, treatment of infertility, and standard fertility preservation services,
except as provided in paragraphs (c) and (d), that are different from those imposed upon
benefits for services not related to infertility.
new text end
new text begin Subd. 3. new text end
new text begin Definitions. new text end
new text begin
(a) For the purposes of this section, the definitions in this
subdivision have the meanings given them.
new text end
new text begin
(b) "Infertility" means a disease, condition, or status characterized by:
new text end
new text begin
(1) the failure of a person with a uterus to establish a pregnancy or to carry a pregnancy
to live birth after 12 months of unprotected sexual intercourse for a person under the age
of 35 or six months for a person 35 years of age or older, regardless of whether a pregnancy
resulting in miscarriage occurred during such time;
new text end
new text begin
(2) a person's inability to reproduce either as a single individual or with the person's
partner without medical intervention; or
new text end
new text begin
(3) a licensed health care provider's findings based on a patient's medical, sexual, and
reproductive history; age; physical findings; or diagnostic testing.
new text end
new text begin
(c) "Diagnosis of and treatment for infertility" means the recommended procedures and
medications from the direction of a licensed health care provider that are consistent with
established, published, or approved medical practices or professional guidelines from the
American College of Obstetricians and Gynecologists or the American Society for
Reproductive Medicine.
new text end
new text begin
(d) "Standard fertility preservation services" means procedures that are consistent with
the established medical practices or professional guidelines published by the American
Society for Reproductive Medicine or the American Society of Clinical Oncology for a
person who has a medical condition or is expected to undergo medication therapy, surgery,
radiation, chemotherapy, or other medical treatment that is recognized by medical
professionals to cause a risk of impairment to fertility.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective August 1, 2023, and applies to all large
group health plans issued or renewed on or after that date.
new text end
Sec. 3.
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. 4.
Minnesota Statutes 2022, section 62A.15, is amended by adding a subdivision to
read:
new text begin Subd. 3d. new text end
new text begin Pharmacist. new text end
new text begin
All policies or contracts referred to in subdivision 1 must provide
benefits relating to expenses incurred for medical treatment or services provided by a licensed
pharmacist, according to the requirements of section 151.01, to the extent the medical
treatment or services are within the pharmacist's scope of practice, if such a policy or contract
provides the benefits relating to expenses incurred for the same medical treatment or services
provided by a licensed physician.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to policies
or contracts offered, issued, or renewed on or after that date.
new text end
Sec. 5.
Minnesota Statutes 2022, section 62A.15, subdivision 4, is amended to read:
Subd. 4.
Denial of benefits.
(a) No carrier referred to in subdivision 1 may, in the
payment of claims to employees in this state, deny benefits payable for services covered by
the policy or contract if the services are lawfully performed by a licensed chiropractor, a
licensed optometrist, a registered nurse meeting the requirements of subdivision 3a, a licensed
physician assistant, deleted text begin ordeleted text end a licensed acupuncture practitionernew text begin , or a licensed pharmacistnew text end .
(b) When carriers referred to in subdivision 1 make claim determinations concerning
the appropriateness, quality, or utilization of chiropractic health care for Minnesotans, any
of these determinations that are made by health care professionals must be made by, or
under the direction of, or subject to the review of licensed doctors of chiropractic.
(c) When a carrier referred to in subdivision 1 makes a denial of payment claim
determination concerning the appropriateness, quality, or utilization of acupuncture services
for individuals in this state performed by a licensed acupuncture practitioner, a denial of
payment claim determination that is made by a health professional must be made by, under
the direction of, or subject to the review of a licensed acupuncture practitioner.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025, and applies to policies
or contracts offered, issued, or renewed on or after that date.
new text end
Sec. 6.
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. 7.
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 deducible 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. 8.
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. 9.
new text begin
[62D.1071] COVERAGE OF LICENSED PHARMACIST SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Pharmacist. new text end
new text begin
All health maintenance contracts must provide benefits
relating to expenses incurred for medical treatment or services provided by a licensed
pharmacist, to the extent the medical treatment or services are within the pharmacist's scope
of practice, if the health maintenance contract provides benefits relating to expenses incurred
for the same medical treatment or services provided by a licensed physician.
new text end
new text begin Subd. 2. new text end
new text begin Denial of benefits. new text end
new text begin
When paying claims for enrollees in Minnesota, a health
maintenance organization must not deny payment for medical services covered by an
enrollee's health maintenance contract if the services are lawfully performed by a licensed
pharmacist.
new text end
new text begin Subd. 3. new text end
new text begin Medication therapy management. new text end
new text begin
This section does not apply to or affect
the coverage or reimbursement for medication therapy management services under section
62Q.676 or 256B.0625, subdivisions 5, 13h, and 28a.
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. 10.
Minnesota Statutes 2022, section 62J.497, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For the purposes of this section, the following terms have
the meanings given.
(b) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
30. Dispensing does not include the direct administering of a controlled substance to a
patient by a licensed health care professional.
(c) "Dispenser" means a person authorized by law to dispense a controlled substance,
pursuant to a valid prescription.
(d) "Electronic media" has the meaning given under Code of Federal Regulations, title
45, part 160.103.
(e) "E-prescribing" means the transmission using electronic media of prescription or
prescription-related information between a prescriber, dispenser, pharmacy benefit manager,
or group purchaser, either directly or through an intermediary, including an e-prescribing
network. E-prescribing includes, but is not limited to, two-way transmissions between the
point of care and the dispenser and two-way transmissions related to eligibility, formulary,
and medication history information.
(f) "Electronic prescription drug program" means a program that provides for
e-prescribing.
(g) "Group purchaser" has the meaning given in section 62J.03, subdivision 6.
(h) "HL7 messages" means a standard approved by the standards development
organization known as Health Level Seven.
(i) "National Provider Identifier" or "NPI" means the identifier described under Code
of Federal Regulations, title 45, part 162.406.
(j) "NCPDP" means the National Council for Prescription Drug Programs, Inc.
(k) "NCPDP Formulary and Benefits Standard" means the most recent version of the
National Council for Prescription Drug Programs Formulary and Benefits Standard or the
most recent standard adopted by the Centers for Medicare and Medicaid Services for
e-prescribing under Medicare Part D as required by section 1860D-4(e)(4)(D) of the Social
Security Act and regulations adopted under it. The standards shall be implemented according
to the Centers for Medicare and Medicaid Services schedule for compliance.
new text begin
(l) "NCPDP Real-Time Prescription Benefit Standard" means the most recent National
Council for Prescription Drug Programs Real-Time Prescription Benefit Standard adopted
by the Centers for Medicare and Medicaid Services for e-prescribing under Medicare Part
D as required by section 1860D-4(e)(2) of the Social Security Act, and regulations adopted
pursuant to that section.
new text end
deleted text begin (l)deleted text end new text begin (m)new text end "NCPDP SCRIPT Standard" means the most recent version of the National
Council for Prescription Drug Programs SCRIPT Standard, or the most recent standard
adopted by the Centers for Medicare and Medicaid Services for e-prescribing under Medicare
Part D as required by section 1860D-4(e)(4)(D) of the Social Security Act, and regulations
adopted under it. The standards shall be implemented according to the Centers for Medicare
and Medicaid Services schedule for compliance.
deleted text begin (m)deleted text end new text begin (n)new text end "Pharmacy" has the meaning given in section 151.01, subdivision 2.
new text begin
(o) "Pharmacy benefit manager" has the meaning given in section 62W.02, subdivision
15.
new text end
deleted text begin (n)deleted text end new text begin (p)new text end "Prescriber" means a licensed health care practitioner, other than a veterinarian,
as defined in section 151.01, subdivision 23.
deleted text begin (o)deleted text end new text begin (q)new text end "Prescription-related information" means information regarding eligibility for
drug benefits, medication history, or related health or drug information.
deleted text begin (p)deleted text end new text begin (r)new text end "Provider" or "health care provider" has the meaning given in section 62J.03,
subdivision 8.
new text begin
(s) "Real-time prescription benefit tool" means a tool that is capable of being integrated
into a prescriber's e-prescribing system and that provides a prescriber with up-to-date and
patient-specific formulary and benefit information at the time the prescriber submits a
prescription.
new text end
Sec. 11.
Minnesota Statutes 2022, section 62J.497, subdivision 3, is amended to read:
Subd. 3.
Standards for electronic prescribing.
(a) Prescribers and dispensers must use
the NCPDP SCRIPT Standard for the communication of a prescription or prescription-related
information.
(b) Providers, group purchasers, prescribers, and dispensers must use the NCPDP SCRIPT
Standard for communicating and transmitting medication history information.
(c) Providers, group purchasers, prescribers, and dispensers must use the NCPDP
Formulary and Benefits Standard for communicating and transmitting formulary and benefit
information.
(d) Providers, group purchasers, prescribers, and dispensers must use the national provider
identifier to identify a health care provider in e-prescribing or prescription-related transactions
when a health care provider's identifier is required.
(e) Providers, group purchasers, prescribers, and dispensers must communicate eligibility
information and conduct health care eligibility benefit inquiry and response transactions
according to the requirements of section 62J.536.
new text begin
(f) Group purchasers and pharmacy benefit managers must use a real-time prescription
benefit tool that complies with the NCPDP Real-Time Prescription Benefit Standard and
that, at a minimum, notifies a prescriber:
new text end
new text begin
(1) if a prescribed drug is covered by the patient's group purchaser or pharmacy benefit
manager;
new text end
new text begin
(2) if a prescribed drug is included on the formulary or preferred drug list of the patient's
group purchaser or pharmacy benefit manager;
new text end
new text begin
(3) of any patient cost-sharing for the prescribed drug;
new text end
new text begin
(4) if prior authorization is required for the prescribed drug; and
new text end
new text begin
(5) of a list of any available alternative drugs that are in the same class as the drug
originally prescribed and for which prior authorization is not required.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024.
new text end
Sec. 12.
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. 13.
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. 14.
new text begin
[62J.826] MEDICAL AND DENTAL PRACTICES; CURRENT STANDARD
CHARGES; COMPARISON TOOL.
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, and must report to the commissioner,
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 and must report the file to the commissioner in a manner and frequency
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 and reporting the file to the commissioner.
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. 15.
Minnesota Statutes 2022, section 62J.84, subdivision 2, is amended to read:
Subd. 2.
Definitions.
(a) For purposes of this sectionnew text begin and section 62J.841new text end , 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).
(c) "Brand name drug" means a drug that is produced or distributed pursuant to:
(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 151.252new text begin , but does
not include an entity required to be licensed under that section solely because the entity
repackages or relabels drugsnew text end .new text begin The provisions of this paragraph shall not be severable from
section 62Q.83. If this paragraph or its application to any individual, entity, or circumstance
is found to be void for any reason, section 62Q.83 shall be void also.
new text end
(g) "New prescription drug" or "new drug" means a prescription drug approved for
marketing by the United States Food and Drug Administrationnew 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) "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
(o) "Pharmacy" or "pharmacy provider" means a place of business licensed by the Board
of Pharmacy under section 151.19 in which prescription drugs are prepared, compounded,
or dispensed under the supervision of a pharmacist.
new text end
new text begin
(p) "Pharmacy benefits manager" or "PBM" means an entity licensed to act as a pharmacy
benefits manager under section 62W.03.
new text end
new text begin
(q) "Pricing unit" means the smallest dispensable amount of a prescription drug product
that could be dispensed.
new text end
new text begin
(r) "Reporting entity" means any manufacturer, pharmacy, pharmacy benefits manager,
wholesale drug distributor, or any other entity required to submit data under this section.
new text end
new text begin
(s) "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. 16.
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;
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
(c) The manufacturer may submit any documentation necessary to support the information
reported under this subdivision.
Sec. 17.
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 less 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 less 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;
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. 18.
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 3deleted text begin , 4, and 5deleted text end new text begin to 6 and 9 to
14new text end , and the manufacturers of those prescription drugs; deleted text begin and
deleted text end
(2) information reported to the commissioner under subdivisions 3deleted text begin , 4, and 5deleted text end new text begin to 6 and 9
to 14new text end deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(3) information reported to the commissioner under section 62J.841, subdivision 2.
new 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; ornew text begin , subject to section
62J.841, subdivision 2, paragraph (e),new text end is trade secret information under section 13.37,
subdivision 1, paragraph (b); ornew text begin , subject to section 62J.841, subdivision 2, paragraph (e),
new text end is trade secret information pursuant to the Defend Trade Secrets Act of 2016, United States
Code, title 18, section 1836, as amended. If a manufacturer believes information should be
withheld from public disclosure pursuant to this paragraph, the manufacturer must clearly
and specifically identify that information and describe the legal basis in writing when the
manufacturer submits the information under this section. If the commissioner disagrees
with the manufacturer's request to withhold information from public disclosure, the
commissioner shall provide the manufacturer 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.
new text begin
(f) The provisions in this subdivision referencing 62J.841 shall not be severable from
section 62Q.83. If any reference to section 62J.841 or its application to any individual,
entity, or circumstance is found to be void for any reason, section 62Q.83 shall be void also.
new text end
Sec. 19.
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 sectionnew text begin and section 62J.841new text end ; in posting information
pursuant to subdivision 6; and in taking any other action for the purpose of implementing
this sectionnew text begin and section 62J.841new text end .
(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 new text begin and section
62J.841 new text end 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 .
new text begin
(c) The provisions in this subdivision referencing 62J.841 shall not be severable from
section 62Q.83. If any reference to section 62J.841 or its application to any individual,
entity, or circumstance is found to be void for any reason, section 62Q.83 shall be void also.
new text end
Sec. 20.
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 sectionnew text begin and section
62J.841new text end ;
deleted text begin (2)deleted text end new text begin (3)new text end failing to provide information required under this sectionnew text begin and section 62J.841new text end ;
deleted text begin or
deleted text end
deleted text begin (3)deleted text end new text begin (4)new text end providing inaccurate or incomplete information under this sectionnew text begin and section
62J.841; or
new text end
new text begin (5) failing to comply with section 62J.841, subdivisions 2, paragraph (e), and 4new text end .
(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.
(c) The commissioner shall impose civil penalties under this section new text begin and section 62J.841
new text end as provided in section 144.99, subdivision 4.
(d) The commissioner may remit or mitigate civil penalties under this section new text begin and section
62J.841 new text end upon terms and conditions the commissioner considers proper and consistent with
public health and safety.
(e) Civil penalties collected under this section new text begin and section 62J.841 new text end shall be deposited in
the health care access fund.
new text begin
(f) The provisions in this subdivision referencing 62J.841 shall not be severable from
section 62Q.83. If any reference to section 62J.841 or its application to any individual,
entity, or circumstance is found to be void for any reason, section 62Q.83 shall be void also.
new text end
Sec. 21.
Minnesota Statutes 2022, section 62J.84, subdivision 9, is amended to read:
Subd. 9.
Legislative report.
(a) No later than May 15, deleted text begin 2022deleted text end new text begin 2024new text end , 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 sectionnew text begin and section 62J.841new text end ,
including but not limited to the effectiveness in addressing the following goals:
(1) promoting transparency in pharmaceutical pricing for the statenew text begin , health carriers,new text end and
other payers;
(2) enhancing the understanding on pharmaceutical spending trends; and
(3) assisting the statenew text begin , health carriers,new text end and other payers in the management of
pharmaceutical costsnew text begin and limiting formulary changes due to prescription drug cost increases
during a coverage yearnew text end .
(b) The report must include a summary of the information submitted to the commissioner
under subdivisions 3deleted text begin , 4, and 5deleted text end new text begin to 6 and 9 to 14new text end new text begin , and section 62J.841new text end .
new text begin
(c) The provisions in this subdivision shall not be severable from section 62Q.83. If this
subdivision or its application to any individual, entity, or circumstance is found to be void
for any reason, section 62Q.83 shall be void also.
new text end
Sec. 22.
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 department intends to request data under
subdivisions 9 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 department shall consider drug product families that include prescription
drugs:
new text end
new text begin
(1) that triggered reporting under subdivisions 3, 4, or 6 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 period 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 9 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. 23.
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 or 6 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. 24.
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 9.
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
Sec. 25.
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 9.
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. 26.
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 Wholesaler prescription drug substantial public interest reporting. new text end
new text begin
(a)
Beginning January 1, 2024, a wholesaler must submit to the commissioner the information
described in paragraph (b) for any prescription drug included in a notification to report
issued to the wholesaler by the department under subdivision 10.
new text end
new text begin
(b) For each of the drugs described in paragraph (a), the wholesaler 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 wholesaler may submit any documentation necessary to support the information
reported under this subdivision.
new text end
Sec. 27.
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. 28.
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. 29.
new text begin
[62J.841] REPORTING PRESCRIPTION DRUG PRICES; FORMULARY
DEVELOPMENT AND PRICE STABILITY.
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 terms in this subdivision
have the meanings given.
new text end
new text begin
(b) "Average wholesale price" means the customary reference price for sales by a drug
wholesaler to a retail pharmacy, as established and published by the manufacturer.
new text end
new text begin
(c) "National drug code" means the numerical code maintained by the United States
Food and Drug Administration and includes the label code, product code, and package code.
new text end
new text begin
(d) "Wholesale acquisition cost" has the meaning given in United States Code, title 42,
section 1395w-3a(c)(6)(B).
new text end
new text begin
(e) "Unit" has the meaning given in United States Code, title 42, section 1395w-3a(b)(2).
new text end
new text begin Subd. 2. new text end
new text begin Price reporting. new text end
new text begin
(a) Beginning July 31, 2024, and by July 31 of each year
thereafter, a manufacturer must report to the commissioner the information in paragraph
(b) for every drug with a wholesale acquisition cost of $100 or more for a 30-day supply
or for a course of treatment lasting less than 30 days, as applicable to the next calendar year.
new text end
new text begin
(b) A manufacturer shall report a drug's:
new text end
new text begin
(1) national drug code, labeler code, and the manufacturer name associated with the
labeler code;
new text end
new text begin
(2) brand name, if applicable;
new text end
new text begin
(3) generic name, if applicable;
new text end
new text begin
(4) wholesale acquisition cost for one unit;
new text end
new text begin
(5) measure that constitutes a wholesale acquisition cost unit;
new text end
new text begin
(6) average wholesale price; and
new text end
new text begin
(7) status as brand name or generic.
new text end
new text begin
(c) The effective date of the information described in paragraph (b) must be included in
the report to the commissioner.
new text end
new text begin
(d) A manufacturer must report the information described in this subdivision in the form
and manner specified by the commissioner.
new text end
new text begin
(e) Information reported under this subdivision is classified as public data not on
individuals, as defined in section 13.02, subdivision 14, and must not be classified by the
manufacturer as trade secret information, as defined in section 13.37, subdivision 1, paragraph
(b).
new text end
new text begin
(f) A manufacturer's failure to report the information required by this subdivision is
grounds for disciplinary action under section 151.071, subdivision 2.
new text end
new text begin Subd. 3. new text end
new text begin Public posting of prescription drug price information. new text end
new text begin
By October 1 of each
year, beginning October 1, 2024, the commissioner must post the information reported
under subdivision 2 on the department's website, as required by section 62J.84, subdivision
6.
new text end
new text begin Subd. 4. new text end
new text begin Price change. new text end
new text begin
(a) If a drug subject to price reporting under subdivision 2 is
included in the formulary of a health plan submitted to and approved by the commissioner
of commerce for the next calendar year under section 62A.02, subdivision 1, the manufacturer
may increase the wholesale acquisition cost of the drug for the next calendar year only after
providing the commissioner with at least 90 days written notice.
new text end
new text begin
(b) A manufacturer's failure to meet the requirements of paragraph (a) is grounds for
disciplinary action under section 151.071, subdivision 2.
new text end
new text begin Subd. 5. new text end
new text begin Not severable. new text end
new text begin
The provisions of this section shall not be severable from section
62Q.83. If any provision of this section or its application to any individual, entity, or
circumstance is found to be void for any reason, section 62Q.83 shall be void also.
new text end
Sec. 30.
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. 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. 31.
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 the enrollee
or a parent or guardian of a minor enrollee has been notified of the diagnosis, 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
(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 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 Exclusions. new text end
new text begin
(a) This section does not apply to health care coverage offered by
the State Employee Group Insurance Program.
new text end
new text begin
(b) 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. 32.
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. 33.
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. 34.
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. 35.
new text begin
[62Q.83] PRESCRIPTION DRUG BENEFIT TRANSPARENCY AND
MANAGEMENT.
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) "Drug" has the meaning given in section 151.01, subdivision 5.
new text end
new text begin
(c) "Enrollee contract term" means the 12-month term during which benefits associated
with health plan company products are in effect. For managed care plans and county-based
purchasing plans under section 256B.69 and chapter 256L, it means a single calendar year.
new text end
new text begin
(d) "Formulary" means a list of prescription drugs that has been developed by clinical
and pharmacy experts and that represents the health plan company's medically appropriate
and cost-effective prescription drugs approved for use.
new text end
new text begin
(e) "Health plan company" has the meaning given in section 62Q.01, subdivision 4, and
includes an entity that performs pharmacy benefits management for the health plan company.
For purposes of this definition, "pharmacy benefits management" means the administration
or management of prescription drug benefits provided by the health plan company for the
benefit of the plan's enrollees and may include but is not limited to procurement of
prescription drugs, clinical formulary development and management services, claims
processing, and rebate contracting and administration.
new text end
new text begin
(f) "Prescription" has the meaning given in section 151.01, subdivision 16a.
new text end
new text begin Subd. 2. new text end
new text begin Prescription drug benefit disclosure. new text end
new text begin
(a) A health plan company that provides
prescription drug benefit coverage and uses a formulary must make the plan's formulary
and related benefit information available by electronic means and, upon request, in writing,
at least 30 days prior to annual renewal dates.
new text end
new text begin
(b) Formularies must be organized and disclosed consistent with the most recent version
of the United States Pharmacopeia's Model Guidelines.
new text end
new text begin
(c) For each item or category of items on the formulary, the specific enrollee benefit
terms must be identified, including enrollee cost-sharing and expected out-of-pocket costs.
new text end
new text begin Subd. 3. new text end
new text begin Formulary changes. new text end
new text begin
(a) Once a formulary has been established, a health plan
company may, at any time during the enrollee's contract term:
new text end
new text begin
(1) expand its formulary by adding drugs to the formulary;
new text end
new text begin
(2) reduce co-payments or coinsurance; or
new text end
new text begin
(3) move a drug to a benefit category that reduces an enrollee's cost.
new text end
new text begin
(b) A health plan company may remove a brand name drug from the plan's formulary
or place a brand name drug in a benefit category that increases an enrollee's cost only upon
the addition to the formulary of a generic or multisource brand name drug rated as
therapeutically equivalent according to the FDA Orange Book or a biologic drug rated as
interchangeable according to the FDA Purple Book at a lower cost to the enrollee, or a
biosimilar as defined by United States Code, title 42, section 262(i)(2), and upon at least a
60-day notice to prescribers, pharmacists, and affected enrollees.
new text end
new text begin
(c) A health plan company may change utilization review requirements or move drugs
to a benefit category that increases an enrollee's cost during the enrollee's contract term
upon at least a 60-day notice to prescribers, pharmacists, and affected enrollees, provided
that these changes do not apply to enrollees who are currently taking the drugs affected by
these changes for the duration of the enrollee's contract term.
new text end
new text begin
(d) A health plan company may remove any drugs from the plan's formulary that have
been deemed unsafe by the Food and Drug Administration, that have been withdrawn by
either the Food and Drug Administration or the product manufacturer, or when an
independent source of research, clinical guidelines, or evidence-based standards has issued
drug-specific warnings or recommended changes in drug usage.
new text end
new text begin
(e) Health plan companies, managed care plans, and county-based purchasing plans
under section 256B.69 and chapter 256L may update their formulary or preferred drug list
quarterly, provided that these changes do not apply to enrollees who are currently taking
the drugs affected by these changes for the duration of the calendar year.
new text end
new text begin Subd. 4. new text end
new text begin Exclusion. new text end
new text begin
This section does not apply to health plans offered under the state
employee group insurance program.
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, sold, issued, or renewed on or after that date.
new text end
Sec. 36.
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. 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 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. 37.
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 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. The commissioner shall establish procedures and safeguards to protect the
integrity and confidentiality of any data that it maintains.
Sec. 38.
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 self-insurers that elected to have the third-party administrator submit encounter
data and data on contracted prices from the self-insurer's health plan for the upcoming plan
year;
new text end
new text begin
(2) the self-insurers that declined to have the third-party administrator submit encounter
data and data on contracted prices from the self-insurer's health plan for the upcoming plan
year; and
new text end
new text begin
(3) data deemed necessary by the commissioner to identify and track the status of
reporting of data from self-insured health plans.
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. 39.
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, and health
care providers in developing the data reported under this subdivision and standardized
reporting forms.
new text end
Sec. 40.
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 and 5deleted text end new text begin to 5bnew text end for the following
purposes:
(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 patients, payers, or providers;
(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) 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 discerned.
deleted text begin
(c) Nothing in this subdivision shall be construed to prohibit the commissioner from
deleted text end
deleted text begin
using the data collected under subdivision 4 to complete the state-based risk adjustment
deleted text end
deleted text begin
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)
deleted text end
deleted text begin
The commissioner shall consult with the all-payer claims database work group
deleted text end
deleted text begin
established under subdivision 12 regarding the technical considerations necessary to create
deleted text end
deleted text begin
the public use files of summary data described in paragraph (a), clause (5).
deleted text end
Sec. 41.
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 may make any data submitted under this section, including data classified as
private or nonpublic, available to individuals and organizations engaged in efforts to research
or affect transformation in health care outcomes, access, quality, disparities, or spending,
provided use of the data serves a public benefit and is not employed to:
new text end
new text begin
(1) create an unfair market advantage for any participant in the health care market in the
state of Minnesota, health plan companies, payers, and providers;
new text end
new text begin
(2) reidentify or attempt to reidentify an individual in the data; and
new text end
new text begin
(3) publicly report details derived from the data regarding any contract between a health
plan company and a provider.
new text end
new text begin
(b) To implement the provisions in paragraph (a), the commissioner must:
new text end
new text begin
(1) establish detailed requirements for data access; a process for data users to apply for
access to and use of 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 stakeholders;
new text end
new text begin
(2) develop a fee schedule to support the cost of expanded use of the data, provided the
fees charged under the schedule do not create a barrier to access 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 users, and the ability of the proposed user to
successfully safeguard the data.
new text end
Sec. 42.
Minnesota Statutes 2022, section 62U.10, subdivision 7, is amended to read:
Subd. 7.
Outcomes reporting; savings determination.
(a) deleted text begin Beginning November 1,
2016, anddeleted text end Each November 1 deleted text begin thereafterdeleted text end , the commissioner of health shall determine the
actual total private and public health care and long-term care spending for Minnesota
residents related to each health indicator projected in subdivision 6 for the most recent
calendar year available. The commissioner shall determine the difference between the
projected and actual spending for each health indicator and for each year, and determine
the savings attributable to changes in these health indicators. The assumptions and research
methods used to calculate actual spending must be determined to be appropriate by an
independent actuarial consultant. If the actual spending is less than the projected spending,
the commissioner, in consultation with the commissioners of human services and management
and budget, shall use the proportion of spending for state-administered health care programs
to total private and public health care spending for each health indicator for the calendar
year two years before the current calendar year to determine the percentage of the calculated
aggregate savings amount accruing to state-administered health care programs.
(b) The commissioner may use the data submitted under section 62U.04, subdivisions
4 deleted text begin and 5,deleted text end new text begin to 5b, new text end to complete the activities required under this section, but may only report
publicly on regional data aggregated to granularity of 25,000 lives or greater for this purpose.
Sec. 43.
Minnesota Statutes 2022, section 151.071, subdivision 2, is amended to read:
Subd. 2.
Grounds for disciplinary action.
new text begin (a) new text end The following conduct is prohibited and
is grounds for disciplinary action:
(1) failure to demonstrate the qualifications or satisfy the requirements for a license or
registration contained in this chapter or the rules of the board. The burden of proof is on
the applicant to demonstrate such qualifications or satisfaction of such requirements;
(2) obtaining a license by fraud or by misleading the board in any way during the
application process or obtaining a license by cheating, 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) for a pharmacist, pharmacy technician, pharmacist intern, applicant for a pharmacist
or pharmacy license, or applicant for a pharmacy technician or pharmacist intern registration,
conviction of a felony reasonably related to the practice of pharmacy. Conviction as used
in this subdivision includes a conviction of an offense that if committed in this state would
be deemed a felony 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 thereon. The board may delay the issuance of a new license or
registration if the applicant has been charged with a felony until the matter has been
adjudicated;
(4) for a facility, other than a pharmacy, licensed or registered by the board, if an owner
or applicant is convicted of a felony reasonably related to the operation of the facility. The
board may delay the issuance of a new license or registration if the owner or applicant has
been charged with a felony until the matter has been adjudicated;
(5) for a controlled substance researcher, conviction of a felony reasonably related to
controlled substances or to the practice of the researcher's profession. The board may delay
the issuance of a registration if the applicant has been charged with a felony until the matter
has been adjudicated;
(6) disciplinary action taken by another state or by one of this state's health licensing
agencies:
(i) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration in another state or jurisdiction, failure to report to the board that
charges or allegations regarding the person's license or registration have been brought in
another state or jurisdiction, or having been refused a license or registration by any other
state or jurisdiction. The board may delay the issuance of a new license or registration if an
investigation or disciplinary action is pending in another state or jurisdiction until the
investigation or action has been dismissed or otherwise resolved; and
(ii) revocation, suspension, restriction, limitation, or other disciplinary action against a
license or registration issued by another of this state's health licensing agencies, failure to
report to the board that charges regarding the person's license or registration have been
brought by another of this state's health licensing agencies, or having been refused a license
or registration by another of this state's health licensing agencies. The board may delay the
issuance of a new license or registration if a disciplinary action is pending before another
of this state's health licensing agencies until the action has been dismissed or otherwise
resolved;
(7) for a pharmacist, pharmacy, pharmacy technician, or pharmacist intern, violation of
any order of the board, of any of the provisions of this chapter or any rules of the board or
violation of any federal, state, or local law or rule reasonably pertaining to the practice of
pharmacy;
(8) for a facility, other than a pharmacy, licensed by the board, violations of any order
of the board, of any of the provisions of this chapter or the rules of the board or violation
of any federal, state, or local law relating to the operation of the facility;
(9) engaging in any unethical conduct; 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; or pharmacy practice that is professionally incompetent, in that it may create
unnecessary danger to any patient's life, health, or safety, in any of which cases, proof of
actual injury need not be established;
(10) aiding or abetting an unlicensed person in the practice of pharmacy, except that it
is not a violation of this clause for a pharmacist to supervise a properly registered pharmacy
technician or pharmacist intern if that person is performing duties allowed by this chapter
or the rules of the board;
(11) for an individual licensed or registered by the board, adjudication as mentally ill
or developmentally disabled, or as a chemically dependent person, a person dangerous to
the public, a sexually dangerous person, or a person who has a sexual psychopathic
personality, by a court of competent jurisdiction, within or without this state. Such
adjudication shall automatically suspend a license for the duration thereof unless the board
orders otherwise;
(12) for a pharmacist or pharmacy intern, engaging in unprofessional conduct as specified
in the board's rules. In the case of a pharmacy technician, engaging in conduct specified in
board rules that would be unprofessional if it were engaged in by a pharmacist or pharmacist
intern or performing duties specifically reserved for pharmacists under this chapter or the
rules of the board;
(13) for a pharmacy, operation of the pharmacy without a pharmacist present and on
duty except as allowed by a variance approved by the board;
(14) for a pharmacist, the inability to practice pharmacy with reasonable skill and safety
to patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills. In the case of registered pharmacy technicians,
pharmacist interns, or controlled substance researchers, the inability to carry out duties
allowed under this chapter or the rules of the board with reasonable skill and safety to
patients by reason of illness, use of alcohol, drugs, narcotics, chemicals, or any other type
of material or as a result of any mental or physical condition, including deterioration through
the aging process or loss of motor skills;
(15) for a pharmacist, pharmacy, pharmacist intern, pharmacy technician, medical gas
dispenser, or controlled substance researcher, revealing a privileged communication from
or relating to a patient except when otherwise required or permitted by law;
(16) for a pharmacist or pharmacy, 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) fee splitting, including without limitation:
(i) paying, offering to pay, receiving, or agreeing to receive, a commission, rebate,
kickback, or other form of remuneration, directly or indirectly, for the referral of patients;
(ii) referring a patient to any health care provider as defined in sections 144.291 to
144.298 in which the licensee or registrant has a financial or economic interest as defined
in section 144.6521, subdivision 3, unless the licensee or registrant has disclosed the
licensee's or registrant's financial or economic interest in accordance with section 144.6521;
and
(iii) any arrangement through which a pharmacy, in which the prescribing practitioner
does not have a significant ownership interest, fills a prescription drug order and the
prescribing practitioner is involved in any manner, directly or indirectly, in setting the price
for the filled prescription that is charged to the patient, the patient's insurer or pharmacy
benefit manager, or other person paying for the prescription or, in the case of veterinary
patients, the price for the filled prescription that is charged to the client or other person
paying for the prescription, except that a veterinarian and a pharmacy may enter into such
an arrangement provided that the client or other person paying for the prescription is notified,
in writing and with each prescription dispensed, about the arrangement, unless such
arrangement involves pharmacy services provided for livestock, poultry, and agricultural
production systems, in which case client notification would not be required;
(18) engaging in abusive or fraudulent billing practices, including violations of the
federal Medicare and Medicaid laws or state medical assistance laws or rules;
(19) 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;
(20) failure to make reports as required by section 151.072 or to cooperate with an
investigation of the board as required by section 151.074;
(21) knowingly providing false or misleading information that is directly related to the
care of a patient unless done for an accepted therapeutic purpose such as the dispensing and
administration of a placebo;
(22) 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 must investigate any complaint of a violation of section 609.215, subdivision 1
or 2;
(23) for a pharmacist, practice of pharmacy under a lapsed or nonrenewed license. For
a pharmacist intern, pharmacy technician, or controlled substance researcher, performing
duties permitted to such individuals by this chapter or the rules of the board under a lapsed
or nonrenewed registration. For a facility required to be licensed under this chapter, operation
of the facility under a lapsed or nonrenewed license or registration; deleted text begin and
deleted text end
(24) for a pharmacist, pharmacist intern, or pharmacy technician, termination or discharge
from the health professionals services program for reasons other than the satisfactory
completion of the programdeleted text begin .deleted text end new text begin ; and
new text end
new text begin
(25) for a drug manufacturer, failure to comply with section 62J.841.
new text end
new text begin
(b) The provisions in clause (25) shall not be severable from section 62Q.83. If clause
(25) or its application to any individual, entity, or circumstance is found to be void for any
reason, section 62Q.83 shall be void also.
new text end
Sec. 44. 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. 45. new text begin COMMISSIONER OF COMMERCE.
new text end
new text begin
The commissioner of commerce shall consult with health plan companies, pharmacies,
and pharmacy benefit managers to develop guidance to implement coverage for the pharmacy
services required by Minnesota Statutes, sections 62A.15, subdivisions 3d and 4; and
62D.1071.
new text end
ARTICLE 3
KEEPING NURSES AT THE BEDSIDE
Section 1.
Minnesota Statutes 2022, section 144.1501, subdivision 1, is amended to read:
Subdivision 1.
Definitions.
(a) For purposes of this section, the following definitions
apply.
(b) "Advanced dental therapist" means an individual who is licensed as a dental therapist
under section 150A.06, and who is certified as an advanced dental therapist under section
150A.106.
(c) "Alcohol and drug counselor" means an individual who is licensed as an alcohol and
drug counselor under chapter 148F.
(d) "Dental therapist" means an individual who is licensed as a dental therapist under
section 150A.06.
(e) "Dentist" means an individual who is licensed to practice dentistry.
(f) "Designated rural area" means a statutory and home rule charter city or township that
is outside the seven-county metropolitan area as defined in section 473.121, subdivision 2,
excluding the cities of Duluth, Mankato, Moorhead, Rochester, and St. Cloud.
(g) "Emergency circumstances" means those conditions that make it impossible for the
participant to fulfill the service commitment, including death, total and permanent disability,
or temporary disability lasting more than two years.
(h) new text begin "Hospital nurse" means an individual who is licensed as a registered nurse and who
is providing direct patient care in a nonprofit hospital setting.
new text end
new text begin (i) new text end "Mental health professional" means an individual providing clinical services in the
treatment of mental illness who is qualified in at least one of the ways specified in section
245.462, subdivision 18.
deleted text begin (i)deleted text end new text begin (j)new text end "Medical resident" means an individual participating in a medical residency in
family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
deleted text begin (j)deleted text end new text begin (k)new text end "Midlevel practitioner" means a nurse practitioner, nurse-midwife, nurse
anesthetist, advanced clinical nurse specialist, or physician assistant.
deleted text begin (k)deleted text end new text begin (l)new text end "Nurse" means an individual who has completed training and received all licensing
or certification necessary to perform duties as a licensed practical nurse or registered nurse.
deleted text begin (l)deleted text end new text begin (m)new text end "Nurse-midwife" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse-midwives.
deleted text begin (m)deleted text end new text begin (n)new text end "Nurse practitioner" means a registered nurse who has graduated from a program
of study designed to prepare registered nurses for advanced practice as nurse practitioners.
deleted text begin (n)deleted text end new text begin (o)new text end "Pharmacist" means an individual with a valid license issued under chapter 151.
deleted text begin (o)deleted text end new text begin (p)new text end "Physician" means an individual who is licensed to practice medicine in the areas
of family practice, internal medicine, obstetrics and gynecology, pediatrics, or psychiatry.
deleted text begin (p)deleted text end new text begin (q)new text end "Physician assistant" means a person licensed under chapter 147A.
new text begin
(r) "PSLF program" means the federal Public Service Loan Forgiveness program
established under Code of Federal Regulations, title 34, section 685.219.
new text end
deleted text begin (q)deleted text end new text begin (s)new text end "Public health nurse" means a registered nurse licensed in Minnesota who has
obtained a registration certificate as a public health nurse from the Board of Nursing in
accordance with Minnesota Rules, chapter 6316.
deleted text begin (r)deleted text end new text begin (t)new text end "Qualified educational loan" means a government, commercial, or foundation loan
for actual costs paid for tuition, reasonable education expenses, and reasonable living
expenses related to the graduate or undergraduate education of a health care professional.
deleted text begin (s)deleted text end new text begin (u)new text end "Underserved urban community" means a Minnesota urban area or population
included in the list of designated primary medical care health professional shortage areas
(HPSAs), medically underserved areas (MUAs), or medically underserved populations
(MUPs) maintained and updated by the United States Department of Health and Human
Services.
Sec. 2.
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; an intermediate care
facility for persons with developmental disability; 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; a housing with services establishment as defined in section 144D.01,
subdivision 4; 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; deleted text begin and
deleted text end
(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 303new text begin ; and
new text end
new text begin (7) for nurses who are enrolled in the PSLF program, employed as a hospital nurse by
a nonprofit hospital that is an eligible employer under the PSLF program, and providing
direct care to patients at the nonprofit hospitalnew text end .
(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. 3.
Minnesota Statutes 2022, section 144.1501, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
(a) To be eligible to participate in the loan forgiveness program, an
individual must:
(1) be a medical or dental resident; a licensed pharmacist; or be enrolled in a training or
education program to become a dentist, dental therapist, advanced dental therapist, mental
health professional, alcohol and drug counselor, pharmacist, public health nurse, midlevel
practitioner, registered nurse, or a licensed practical nurse. The commissioner may also
consider applications submitted by graduates in eligible professions who are licensed and
in practice; and
(2) submit an application to the commissioner of health.new text begin Nurses applying under
subdivision 2, paragraph (a), clause (7), must also include proof that the applicant is enrolled
in the PSLF program and confirmation that the applicant is employed as a hospital nurse.
new text end
(b) An applicant selected to participate must sign a contract to agree to serve a minimum
three-year full-time service obligation according to subdivision 2, which shall begin no later
than March 31 following completion of required training, with the exception ofnew text begin :
new text end
new text begin (1) new text end a nurse, who must agree to serve a minimum two-year full-time service obligation
according to subdivision 2, which shall begin no later than March 31 following completion
of required trainingnew text begin ;
new text end
new text begin
(2) a nurse selected under subdivision 2, paragraph (a), clause (7), must agree to continue
as a hospital nurse for the repayment period of the participant's eligible loan under the PSLF
program; and
new text end
new text begin (3) a nurse who agrees to teach according to subdivision 2, paragraph (a), clause (3),
must sign a contract to agree to teach for a minimum of two yearsnew text end .
Sec. 4.
Minnesota Statutes 2022, section 144.1501, subdivision 4, is amended to read:
Subd. 4.
Loan forgiveness.
new text begin (a) new text end The commissioner of health may select applicants each
year for participation in the loan forgiveness program, within the limits of available funding.
In considering applications, the commissioner shall give preference to applicants who
document diverse cultural competencies. The commissioner shall distribute available funds
for loan forgiveness proportionally among the eligible professions according to the vacancy
rate for each profession in the required geographic area, facility type, teaching area, patient
group, or specialty type specified in subdivision 2new text begin , except for hospital nursesnew text end . The
commissioner shall allocate funds for physician loan forgiveness so that 75 percent of the
funds available are used for rural physician loan forgiveness and 25 percent of the funds
available are used for underserved urban communities and pediatric psychiatry loan
forgiveness. If the commissioner does not receive enough qualified applicants each year to
use the entire allocation of funds for any eligible profession, the remaining funds may be
allocated proportionally among the other eligible professions according to the vacancy rate
for each profession in the required geographic area, patient group, or facility type specified
in subdivision 2. Applicants are responsible for securing their own qualified educational
loans. The commissioner shall select participants based on their suitability for practice
serving the required geographic area or facility type specified in subdivision 2, as indicated
by experience or training. The commissioner shall give preference to applicants closest to
completing their training. new text begin Except as specified in paragraphs (b) and (c), new text end for each year that
a participant meets the service obligation required under subdivision 3, up to a maximum
of four years, the commissioner shall make annual disbursements directly to the participant
equivalent to 15 percent of the average educational debt for indebted graduates in their
profession in the year closest to the applicant's selection for which information is available,
not to exceed the balance of the participant's qualifying educational loans. Before receiving
loan repayment disbursements and as requested, the participant must complete and return
to the commissioner a confirmation of practice form provided by the commissioner verifying
that the participant is practicing as required under subdivisions 2 and 3. The participant
must provide the commissioner with verification that the full amount of loan repayment
disbursement received by the participant has been applied toward the designated loans.
After each disbursement, verification must be received by the commissioner and approved
before the next loan repayment disbursement is made. Participants who move their practice
remain eligible for loan repayment as long as they practice as required under subdivision
2.
new text begin
(b) For hospital nurses, the commissioner of health shall select applicants each year for
participation in the hospital nursing education loan forgiveness program, within limits of
available funding for hospital nurses. Applicants are responsible for applying for and
maintaining eligibility for the PSLF program. For each year that a participant meets the
eligibility requirements described in subdivision 3, the commissioner shall make an annual
disbursement directly to the participant in an amount equal to the minimum loan payments
required to be paid by the participant under the participant's repayment plan established for
the participant under the PSLF program for the previous loan year. Before receiving the
annual loan repayment disbursement, the participant must complete and return to the
commissioner a confirmation of practice form provided by the commissioner, verifying that
the participant continues to meet the eligibility requirements under subdivision 3. The
participant must provide the commissioner with verification that the full amount of loan
repayment disbursement received by the participant has been applied toward the loan for
which forgiveness is sought under the PSLF program.
new text end
new text begin
(c) For each year that a participant who is a nurse and who has agreed to teach according
to subdivision 2 meets the teaching obligation required in subdivision 3, the commissioner
shall make annual disbursements directly to the participant equivalent to 15 percent of the
average annual educational debt for indebted graduates in the nursing profession in the year
closest to the participant's selection for which information is available, not to exceed the
balance of the participant's qualifying educational loans.
new text end
Sec. 5.
Minnesota Statutes 2022, section 144.1501, subdivision 5, is amended to read:
Subd. 5.
Penalty for nonfulfillment.
If a participant does not fulfill the required
minimum commitment of service according to subdivision 3deleted text begin ,deleted text end new text begin or, for hospital nurses, the
secretary of education determines that the participant does not meet eligibility requirements
for the PSLF,new text end the commissioner of health shall collect from the participant the total amount
paid to the participant under the loan forgiveness program plus interest at a rate established
according to section 270C.40. The commissioner shall deposit the money collected in the
health care access fund to be credited to the health professional education loan forgiveness
program account established in subdivision 2. The commissioner shall allow waivers of all
or part of the money owed the commissioner as a result of a nonfulfillment penalty if
emergency circumstances prevented fulfillment of the minimum service commitmentnew text begin or,
for hospital nurses, if the PSLF program is discontinued before the participant's service
commitment is fulfillednew text end .
Sec. 6.
Minnesota Statutes 2022, section 144.566, is amended to read:
144.566 VIOLENCE AGAINST HEALTH CARE WORKERS.
Subdivision 1.
Definitions.
(a) The following definitions apply to this section and have
the meanings given.
(b) "Act of violence" means an act by a patient or visitor against a health care worker
that includes kicking, scratching, urinating, sexually harassing, or any act defined in sections
609.221 to 609.2241.
(c) "Commissioner" means the commissioner of health.
(d) "Health care worker" means any person, whether licensed or unlicensed, employed
by, volunteering in, or under contract with a hospital, who has direct contact with a patient
of the hospital for purposes of either medical care or emergency response to situations
potentially involving violence.
(e) "Hospital" means any facility licensed as a hospital under section 144.55.
(f) "Incident response" means the actions taken by hospital administration and health
care workers during and following an act of violence.
(g) "Interfere" means to prevent, impede, discourage, or delay a health care worker's
ability to report acts of violence, including by retaliating or threatening to retaliate against
a health care worker.
(h) "Preparedness" means the actions taken by hospital administration and health care
workers to prevent a single act of violence or acts of violence generally.
(i) "Retaliate" means to discharge, discipline, threaten, otherwise discriminate against,
or penalize a health care worker regarding the health care worker's compensation, terms,
conditions, location, or privileges of employment.
new text begin
(j) "Workplace violence hazards" means locations and situations where violent incidents
are more likely to occur, including, as applicable, but not limited to locations isolated from
other health care workers; health care workers working alone; health care workers working
in remote locations; health care workers working late night or early morning hours; locations
where an assailant could prevent entry of responders or other health care workers into a
work area; locations with poor illumination; locations with poor visibility; lack of effective
escape routes; obstacles and impediments to accessing alarm systems; locations within the
facility where alarm systems are not operational; entryways where unauthorized entrance
may occur, such as doors designated for staff entrance or emergency exits; presence, in the
areas where patient contact activities are performed, of furnishings or objects that could be
used as weapons; and locations where high-value items, currency, or pharmaceuticals are
stored.
new text end
Subd. 2.
deleted text begin Hospital dutiesdeleted text end new text begin Action plans and action plan reviews requirednew text end .
deleted text begin (a)deleted text end All
hospitals must design and implement preparedness and incident response action plans to
acts of violence by January 15, 2016, and reviewnew text begin and updatenew text end the plan at least annually
thereafter.new text begin The plan must be in writing; specific to the workplace violence hazards and
corrective measures for the units, services, or operations of the hospital; and available to
health care workers at all times.
new text end
new text begin Subd. 3. new text end
new text begin Action plan committees. new text end
deleted text begin (b)deleted text end A hospital shall designate a committee of
representatives of health care workers employed by the hospital, including nonmanagerial
health care workers, nonclinical staff, administrators, patient safety experts, and other
appropriate personnel to develop preparedness and incident response action plans to acts
of violence. The hospital shall, in consultation with the designated committee, implement
the plans under deleted text begin paragraph (a)deleted text end new text begin subdivision 2new text end . Nothing in this deleted text begin paragraphdeleted text end new text begin subdivisionnew text end shall
require the establishment of a separate committee solely for the purpose required by this
subdivision.
new text begin Subd. 4. new text end
new text begin Required elements of action plans; generally. new text end
new text begin
The preparedness and incident
response action plans to acts of violence must include:
new text end
new text begin
(1) effective procedures to obtain the active involvement of health care workers and
their representatives in developing, implementing, and reviewing the plan, including their
participation in identifying, evaluating, and correcting workplace violence hazards, designing
and implementing training, and reporting and investigating incidents of workplace violence;
new text end
new text begin
(2) names or job titles of the persons responsible for implementing the plan; and
new text end
new text begin
(3) effective procedures to ensure that supervisory and nonsupervisory health care
workers comply with the plan.
new text end
new text begin Subd. 5. new text end
new text begin Required elements of action plans; evaluation of risk factors. new text end
new text begin
(a) The
preparedness and incident response action plans to acts of violence must include assessment
procedures to identify and evaluate workplace violence hazards for each facility, unit,
service, or operation, including community-based risk factors and areas surrounding the
facility, such as employee parking areas and other outdoor areas. Procedures shall specify
the frequency that environmental assessments take place.
new text end
new text begin
(b) The preparedness and incident response action plans to acts of violence must include
assessment tools, environmental checklists, or other effective means to identify workplace
violence hazards.
new text end
new text begin Subd. 6. new text end
new text begin
Required elements of action plans; review of workplace violence
incidents.
new text end
new text begin
The preparedness and incident response action plans to acts of violence must
include procedures for reviewing all workplace violence incidents that occurred in the
facility, unit, service, or operation within the previous year, whether or not an injury occurred.
new text end
new text begin Subd. 7. new text end
new text begin Required elements of action plans; reporting workplace violence. new text end
new text begin
The
preparedness and incident response action plans to acts of violence must include:
new text end
new text begin
(1) effective procedures for health care workers to document information regarding
conditions that may increase the potential for workplace violence incidents and communicate
that information without fear of reprisal to other health care workers, shifts, or units;
new text end
new text begin
(2) effective procedures for health care workers to report a violent incident, threat, or
other workplace violence concern without fear of reprisal;
new text end
new text begin
(3) effective procedures for the hospital to accept and respond to reports of workplace
violence and to prohibit retaliation against a health care worker who makes such a report;
new text end
new text begin
(4) a policy statement stating the hospital will not prevent a health care worker from
reporting workplace violence or take punitive or retaliatory action against a health care
worker for doing so;
new text end
new text begin
(5) effective procedures for investigating health care worker concerns regarding workplace
violence or workplace violence hazards;
new text end
new text begin
(6) procedures for informing health care workers of the results of the investigation arising
from a report of workplace violence or from a concern about a workplace violence hazard
and of any corrective actions taken;
new text end
new text begin
(7) effective procedures for obtaining assistance from the appropriate law enforcement
agency or social service agency during all work shifts. The procedure may establish a central
coordination procedure; and
new text end
new text begin
(8) a policy statement stating the hospital will not prevent a health care worker from
seeking assistance and intervention from local emergency services or law enforcement when
a violent incident occurs or take punitive or retaliatory action against a health care worker
for doing so.
new text end
new text begin Subd. 8. new text end
new text begin Required elements of action plans; coordination with other employers. new text end
new text begin
The
preparedness and incident response action plans to acts of violence must include methods
the hospital will use to coordinate implementation of the plan with other employers whose
employees work in the same health care facility, unit, service, or operation and to ensure
that those employers and their employees understand their respective roles as provided in
the plan. These methods must ensure that all employees working in the facility, unit, service,
or operation are provided the training required by subdivision 11 and that workplace violence
incidents involving any employee are reported, investigated, and recorded.
new text end
new text begin Subd. 9. new text end
new text begin
Required elements of action plans; white supremacist affiliation and support
prohibited.
new text end
new text begin
(a) The preparedness and incident response action plans to acts of violence
must include a policy statement stating that security personnel employed by the hospital or
assigned to the hospital by a contractor are prohibited from affiliating with, supporting, or
advocating for white supremacist groups, causes, or ideologies or participating in, or actively
promoting, an international or domestic extremist group that the Federal Bureau of
Investigation has determined supports or encourages illegal, violent conduct.
new text end
new text begin
(b) For purposes of this subdivision, white supremacist groups, causes, or ideologies
include organizations and associations and ideologies that promote white supremacy and
the idea that white people are superior to Black, Indigenous, and people of color (BIPOC);
promote religious and racial bigotry; seek to exacerbate racial and ethnic tensions between
BIPOC and non-BIPOC; or engage in patently hateful and inflammatory speech, intimidation,
and violence against BIPOC as means of promoting white supremacy.
new text end
new text begin Subd. 10. new text end
new text begin Required elements of action plans; training. new text end
new text begin
(a) The preparedness and
incident response action plans to acts of violence must include:
new text end
new text begin
(1) procedures for developing and providing the training required in subdivision 11 that
permits health care workers and their representatives to participate in developing the training;
and
new text end
new text begin
(2) a requirement for cultural competency training and equity, diversity, and inclusion
training.
new text end
new text begin
(b) The preparedness and incident response action plans to acts of violence must include
procedures to communicate with health care workers regarding workplace violence matters,
including:
new text end
new text begin
(1) how health care workers will document and communicate to other health care workers
and between shifts and units information regarding conditions that may increase the potential
for workplace violence incidents;
new text end
new text begin
(2) how health care workers can report a violent incident, threat, or other workplace
violence concern;
new text end
new text begin
(3) how health care workers can communicate workplace violence concerns without
fear of reprisal; and
new text end
new text begin
(4) how health care worker concerns will be investigated, and how health care workers
will be informed of the results of the investigation and any corrective actions to be taken.
new text end
new text begin Subd. 11. new text end
new text begin Training required. new text end
deleted text begin (c)deleted text end A hospital deleted text begin shalldeleted text end new text begin mustnew text end provide training to all health
care workers employed or contracted with the hospital on safety during acts of violence.
Each health care worker must receive safety training deleted text begin annually and upon hiredeleted text end new text begin during the
health care worker's orientation and before the health care worker completes a shift
independently, and annually thereafternew text end . Training must, at a minimum, include:
(1) safety guidelines for response to and de-escalation of an act of violence;
(2) ways to identify potentially violent or abusive situationsnew text begin , including aggression and
violence predicting factorsnew text end ; deleted text begin and
deleted text end
(3) the hospital's deleted text begin incident response reaction plan and violence prevention plandeleted text end new text begin
preparedness and incident response action plans for acts of violence, including how the
health care worker may report concerns about workplace violence within each hospital's
reporting structure without fear of reprisal, how the hospital will address workplace violence
incidents, and how the health care worker can participate in reviewing and revising the plan;
and
new text end
new text begin (4) any resources available to health care workers for coping with incidents of violence,
including but not limited to critical incident stress debriefing or employee assistance
programsnew text end .
new text begin Subd. 12. new text end
new text begin Annual review and update of action plans. new text end
deleted text begin (d)deleted text end new text begin (a)new text end As part of its annual
reviewnew text begin of preparedness and incident response action plansnew text end required under deleted text begin paragraph (a)deleted text end new text begin
subdivision 2new text end , the hospital must review with the designated committee:
(1) the effectiveness of its preparedness and incident response action plansnew text begin , including
the sufficiency of security systems, alarms, emergency responses, and security personnel
availabilitynew text end ;
(2) new text begin security risks associated with specific units, areas of the facility with uncontrolled
access, late night shifts, early morning shifts, and areas surrounding the facility such as
employee parking areas and other outdoor areas;
new text end
new text begin (3) new text end the most recent gap analysis as provided by the commissioner; deleted text begin and
deleted text end
deleted text begin (3)deleted text end new text begin (4)new text end the number of acts of violence that occurred in the hospital during the previous
year, including injuries sustained, if any, and the unit in which the incident occurreddeleted text begin .deleted text end new text begin ;
new text end
new text begin
(5) evaluations of staffing, including staffing patterns and patient classification systems
that contribute to, or are insufficient to address, the risk of violence; and
new text end
new text begin
(6) any reports of discrimination or abuse that arise from security resources, including
from the behavior of security personnel.
new text end
new text begin
(b) As part of the annual update of preparedness and incident response action plans
required under subdivision 2, the hospital must incorporate corrective actions into the action
plan to address workplace violence hazards identified during the annual action plan review,
reports of workplace violence, reports of workplace violence hazards, and reports of
discrimination or abuse that arise from the security resources.
new text end
new text begin Subd. 13. new text end
new text begin Action plan updates. new text end
new text begin
Following the annual review of the action plan, a hospital
must update the action plans to reflect the corrective actions the hospital will implement to
mitigate the hazards and vulnerabilities identified during the annual review.
new text end
new text begin Subd. 14. new text end
new text begin Requests for additional staffing. new text end
new text begin
A hospital shall create and implement a
procedure for a health care worker to officially request of hospital supervisors or
administration that additional staffing be provided. The hospital must document all requests
for additional staffing made because of a health care worker's concern over a risk of an act
of violence. If the request for additional staffing to reduce the risk of violence is denied,
the hospital must provide the health care worker who made the request a written reason for
the denial and must maintain documentation of that communication with the documentation
of requests for additional staffing. A hospital must make documentation regarding staffing
requests available to the commissioner for inspection at the commissioner's request. The
commissioner may use documentation regarding staffing requests to inform the
commissioner's determination on whether the hospital is providing adequate staffing and
security to address acts of violence, and may use documentation regarding staffing requests
if the commissioner imposes a penalty under subdivision 18.
new text end
new text begin Subd. 15. new text end
new text begin Disclosure of action plans. new text end
deleted text begin (e)deleted text end new text begin (a)new text end A hospital deleted text begin shalldeleted text end new text begin mustnew text end make itsnew text begin most recentnew text end
action plans and deleted text begin the information listed in paragraph (d)deleted text end new text begin most recent action plan reviews new text end
available to local law enforcementnew text begin , all direct care staffnew text end and, if any of its workers are
represented by a collective bargaining unit, to the exclusive bargaining representatives of
those collective bargaining units.
new text begin
(b) Beginning January 1, 2025, a hospital must annually submit to the commissioner its
most recent action plan and the results of the most recent annual review conducted under
subdivision 12.
new text end
new text begin Subd. 16. new text end
new text begin Legislative report required. new text end
new text begin
(a) Beginning January 15, 2026, the commissioner
must compile the information into a single annual report and submit the report to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
care by January 15 of each year.
new text end
new text begin
(b) This subdivision does not expire.
new text end
new text begin Subd. 17. new text end
new text begin Interference prohibited. new text end
deleted text begin (f)deleted text end A hospital, including any individual, partner,
association, or any person or group of persons acting directly or indirectly in the interest of
the hospital, deleted text begin shalldeleted text end new text begin mustnew text end not interfere with or discourage a health care worker if the health
care worker wishes to contact law enforcement or the commissioner regarding an act of
violence.
new text begin Subd. 18. new text end
new text begin Penalties. new text end
deleted text begin (g)deleted text end new text begin Notwithstanding section 144.653, subdivision 6,new text end the
commissioner may impose deleted text begin an administrativedeleted text end new text begin anew text end fine of up to deleted text begin $250deleted text end new text begin $10,000new text end for failure to
comply with the requirements of this deleted text begin subdivisiondeleted text end new text begin sectionnew text end . new text begin The commissioner must allow
the hospital at least 30 calendar days to correct a violation of this section before assessing
a fine.
new text end
Sec. 7.
Minnesota Statutes 2022, section 144.608, subdivision 1, is amended to read:
Subdivision 1.
Trauma Advisory Council established.
(a) A Trauma Advisory Council
is established to advise, consult with, and make recommendations to the commissioner on
the development, maintenance, and improvement of a statewide trauma system.
(b) The council shall consist of the following members:
(1) a trauma surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery who practices in a level I or II trauma hospital;
(2) a general surgeon certified by the American Board of Surgery or the American
Osteopathic Board of Surgery whose practice includes trauma and who practices in a
designated rural area as defined under section 144.1501, subdivision 1deleted text begin , paragraph (e)deleted text end ;
(3) a neurosurgeon certified by the American Board of Neurological Surgery who
practices in a level I or II trauma hospital;
(4) a trauma program nurse manager or coordinator practicing in a level I or II trauma
hospital;
(5) an emergency physician certified by the American Board of Emergency Medicine
or the American Osteopathic Board of Emergency Medicine whose practice includes
emergency room care in a level I, II, III, or IV trauma hospital;
(6) a trauma program manager or coordinator who practices in a level III or IV trauma
hospital;
(7) a physician certified by the American Board of Family Medicine or the American
Osteopathic Board of Family Practice whose practice includes emergency department care
in a level III or IV trauma hospital located in a designated rural area as defined under section
144.1501, subdivision 1deleted text begin , paragraph (e)deleted text end ;
(8) a nurse practitioner, as defined under section 144.1501, subdivision 1deleted text begin , paragraph (l)deleted text end ,
or a physician assistant, as defined under section 144.1501, subdivision 1, deleted text begin paragraph (o),deleted text end
whose practice includes emergency room care in a level IV trauma hospital located in a
designated rural area as defined under section 144.1501, subdivision 1deleted text begin , paragraph (e)deleted text end ;
(9) a physician certified in pediatric emergency medicine by the American Board of
Pediatrics or certified in pediatric emergency medicine by the American Board of Emergency
Medicine or certified by the American Osteopathic Board of Pediatrics whose practice
primarily includes emergency department medical care in a level I, II, III, or IV trauma
hospital, or a surgeon certified in pediatric surgery by the American Board of Surgery whose
practice involves the care of pediatric trauma patients in a trauma hospital;
(10) an orthopedic surgeon certified by the American Board of Orthopaedic Surgery or
the American Osteopathic Board of Orthopedic Surgery whose practice includes trauma
and who practices in a level I, II, or III trauma hospital;
(11) the state emergency medical services medical director appointed by the Emergency
Medical Services Regulatory Board;
(12) a hospital administrator of a level III or IV trauma hospital located in a designated
rural area as defined under section 144.1501, subdivision 1deleted text begin , paragraph (e)deleted text end ;
(13) a rehabilitation specialist whose practice includes rehabilitation of patients with
major trauma injuries or traumatic brain injuries and spinal cord injuries as defined under
section 144.661;
(14) an attendant or ambulance director who is an EMT, EMT-I, or EMT-P within the
meaning of section 144E.001 and who actively practices with a licensed ambulance service
in a primary service area located in a designated rural area as defined under section 144.1501,
subdivision 1deleted text begin , paragraph (e)deleted text end ; and
(15) the commissioner of public safety or the commissioner's designee.
Sec. 8.
Minnesota Statutes 2022, section 144.653, subdivision 5, is amended to read:
Subd. 5.
Correction orders.
Whenever a duly authorized representative of the state
commissioner of health finds upon inspection of a facility required to be licensed under the
provisions of sections 144.50 to 144.58 that the licensee of such facility is not in compliance
with sections 144.411 to 144.417, 144.50 to 144.58, 144.651,new text begin 144.7051 to 144.7058,new text end or
626.557, or the applicable rules promulgated under those sections, a correction order shall
be issued to the licensee. The correction order shall state the deficiency, cite the specific
rule violated, and specify the time allowed for correction.
Sec. 9.
new text begin
[144.7051] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Applicability. new text end
new text begin
For the purposes of sections 144.7051 to 144.7058, the
terms defined in this section have the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Concern for safe staffing form. new text end
new text begin
"Concern for safe staffing form" means a
standard uniform form developed by the commissioner that may be used by any individual
to report unsafe staffing situations while maintaining the privacy of patients.
new text end
new text begin Subd. 3. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of health.
new text end
new text begin Subd. 4. new text end
new text begin Daily staffing schedule. new text end
new text begin
"Daily staffing schedule" means the actual number
of full-time equivalent nonmanagerial care staff assigned to an inpatient care unit and
providing care in that unit during a 24-hour period and the actual number of patients assigned
to each direct care registered nurse present and providing care in the unit.
new text end
new text begin Subd. 5. new text end
new text begin Direct-care registered nurse. new text end
new text begin
"Direct-care registered nurse" means a registered
nurse, as defined in section 148.171, subdivision 20, who is nonsupervisory and
nonmanagerial and who directly provides nursing care to patients more than 60 percent of
the time.
new text end
new text begin Subd. 6. new text end
new text begin Emergency. new text end
new text begin
"Emergency" means a period when replacement staff are not able
to report for duty for the next shift or a period of increased patient need because of unusual,
unpredictable, or unforeseen circumstances, including but not limited to an act of terrorism,
a disease outbreak, adverse weather conditions, or a natural disaster that impacts continuity
of patient care.
new text end
new text begin Subd. 7. new text end
new text begin Hospital. new text end
new text begin
"Hospital" means any setting that is licensed under this chapter as a
hospital.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 10.
new text begin
[144.7053] HOSPITAL NURSE STAFFING COMMITTEE.
new text end
new text begin Subdivision 1. new text end
new text begin Hospital nurse staffing committee required. new text end
new text begin
(a) Each hospital must
establish and maintain a functioning hospital nurse staffing committee. A hospital may
assign the functions and duties of a hospital nurse staffing committee to an existing committee
provided the existing committee meets the membership requirements applicable to a hospital
nurse staffing committee.
new text end
new text begin
(b) The commissioner is not required to verify compliance with this section by an on-site
visit.
new text end
new text begin Subd. 2. new text end
new text begin Staffing committee membership. new text end
new text begin
(a) At least 35 percent of the hospital nurse
staffing committee's membership must be direct care registered nurses typically assigned
to a specific unit for an entire shift and at least 15 percent of the committee's membership
must be other direct care workers typically assigned to a specific unit for an entire shift. A
hospital's nurse staffing committee's membership must consist of at least one nurse from
each unit covered by the hospital's core staffing plan. Direct care registered nurses and other
direct care workers who are members of a collective bargaining unit shall be appointed or
elected to the committee according to the guidelines of the applicable collective bargaining
agreement. If there is no collective bargaining agreement, direct care registered nurses shall
be elected to the committee by direct care registered nurses employed by the hospital and
other direct care workers shall be elected to the committee by other direct care workers
employed by the hospital.
new text end
new text begin
(b) The hospital shall appoint 50 percent of the hospital nurse staffing committee's
membership.
new text end
new text begin Subd. 3. new text end
new text begin Staffing committee compensation. new text end
new text begin
A hospital must treat participation in the
hospital nurse staffing committee meetings by any hospital employee as scheduled work
time and compensate each committee member at the employee's existing rate of pay. A
hospital must relieve all direct care registered nurse members of the hospital nurse staffing
committee of other work duties during the times when the committee meets.
new text end
new text begin Subd. 4. new text end
new text begin Staffing committee meeting frequency. new text end
new text begin
Each hospital nurse staffing committee
must meet at least quarterly.
new text end
new text begin Subd. 5. new text end
new text begin Staffing committee duties. new text end
new text begin
(a) Each hospital nurse staffing committee shall
create, implement, continuously evaluate, and update as needed evidence-based written
core staffing plans to guide the creation of daily staffing schedules for each inpatient care
unit of the hospital. Each hospital nurse staffing committee must adopt a core staffing plan
annually by a majority vote of all members.
new text end
new text begin
(b) Each hospital nurse staffing committee must:
new text end
new text begin
(1) establish a secure, uniform, and easily accessible method for any hospital employee,
patient, or patient family member to submit directly to the committee a concern for safe
staffing form;
new text end
new text begin
(2) review each concern for safe staffing form;
new text end
new text begin
(3) forward a copy of all concern for safe staffing forms to the relevant hospital nurse
workload committee;
new text end
new text begin
(4) review the documentation of compliance maintained by the hospital under section
144.7056, subdivision 10;
new text end
new text begin
(5) conduct a trend analysis of the data related to all reported concerns regarding safe
staffing;
new text end
new text begin
(6) develop a mechanism for tracking and analyzing staffing trends within the hospital;
new text end
new text begin
(7) submit a nurse staffing report to the commissioner;
new text end
new text begin
(8) assist the commissioner in compiling data for the Nursing Workforce Report by
encouraging participation in the commissioner's independent study on reasons licensed
registered nurses are leaving the profession; and
new text end
new text begin
(9) record in the committee minutes for each meeting a summary of the discussions and
recommendations of the committee. Each committee must maintain the minutes, records,
and distributed materials for five years.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 11.
new text begin
[144.7054] HOSPITAL NURSE WORKLOAD COMMITTEE.
new text end
new text begin Subdivision 1. new text end
new text begin Hospital nurse workload committee required. new text end
new text begin
(a) Each hospital must
establish and maintain functioning hospital nurse workload committees for each unit. A
hospital designated as a critical access hospital under section 144.1483, clause (9), may
assign the functions and duties of its nurse workload committees to the hospital's nurse
staffing committee.
new text end
new text begin
(b) The commissioner is not required to verify compliance with this section by an on-site
visit.
new text end
new text begin Subd. 2. new text end
new text begin Workload committee membership. new text end
new text begin
(a) At least 35 percent of each workload
committee's membership must be direct care registered nurses typically assigned to the unit
for an entire shift and at least 15 percent of the committee's membership must be other direct
care workers typically assigned to the unit for an entire shift. Direct care registered nurses
and other direct care workers who are members of a collective bargaining unit shall be
appointed or elected to the committee according to the guidelines of the applicable collective
bargaining agreement. If there is no collective bargaining agreement, direct care registered
nurses shall be elected to the committee by direct care registered nurses typically assigned
to the unit for an entire shift and other direct care workers shall be elected to the committee
by other direct care workers typically assigned to the unit for an entire shift.
new text end
new text begin
(b) The hospital shall appoint 50 percent of each unit's nurse workload committee's
membership.
new text end
new text begin
(c) Notwithstanding paragraphs (a) and (b), if a hospital has established a staffing
committee through collective bargaining, the composition of that committee prevails.
new text end
new text begin Subd. 3. new text end
new text begin Workload committee compensation. new text end
new text begin
A hospital must treat participation in a
hospital nurse workload committee meeting by any hospital employee as scheduled work
time and compensate each committee member at the employee's existing rate of pay. A
hospital must relieve all direct care registered nurse members of a hospital nurse workload
committee of other work duties during the times when the committee meets.
new text end
new text begin Subd. 4. new text end
new text begin Workload committee meeting frequency. new text end
new text begin
Each hospital nurse workload
committee must meet at least monthly whenever the committee is in receipt of an unresolved
concern for safe staffing form.
new text end
new text begin Subd. 5. new text end
new text begin Workload committee duties. new text end
new text begin
(a) Each hospital nurse workload committee
must create, implement, and maintain dispute resolution procedures to guide the committee's
development and implementation of solutions to the staffing concerns raised in concern for
safe staffing forms that have been forwarded to the committee. The dispute resolution
procedures must include a two-step process. If the nurse workforce committee is not able
to implement a solution to the concerns raised in a concern for safe staffing form, the
workload committee must refer the matter to the hospital nurse staffing committee within
15 calendar days of the events described in the concern for safe staffing form. If after both
the nurses and hospitals have attempted in good faith to resolve the concern either side may
move forward to an expedited arbitration process with an arbitrator who has expertise in
patient care that must be completed within 30 calendar days of the dispute being escalated
to the hospital nurse staffing committee.
new text end
new text begin
(b) In the event both parties believe that they have reached an impasse prior to the 15-
or 30-day deadline, the parties may move to the next appropriate step. The committee must
use the expedited arbitration process for any complaint that remains unresolved 45 days
after the submission of the concern for safe staffing form that gave rise to the complaint.
new text end
new text begin
(c) Each hospital nurse workload committee must attempt to expeditiously resolve
staffing issues the committee determines arise from a violation of the hospital's core staffing
plan.
new text end
new text begin
(d) If the majority of the members of the workload committee agree that the concerns
raised can be reasonably grouped together or considered together because multiple forms
were submitted from one patient care unit on one date or shift, then the committee can
decide to submit them as one occurrence.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 12.
Minnesota Statutes 2022, section 144.7055, is amended to read:
144.7055 new text begin HOSPITAL CORE new text end STAFFING PLAN deleted text begin REPORTSdeleted text end .
Subdivision 1.
Definitions.
(a) For the purposes of deleted text begin this sectiondeleted text end new text begin sections 144.7051 to
144.7058new text end , the following terms have the meanings given.
(b) "Core staffing plan" means deleted text begin the projected number of full-time equivalent
nonmanagerial care staff that will be assigned in a 24-hour period to an inpatient care unitdeleted text end new text begin
a plan described in subdivision 2new text end .
(c) "Nonmanagerial care staff" means registered nurses, licensed practical nurses, and
other health care workers, which may include but is not limited to nursing assistants, nursing
aides, patient care technicians, and patient care assistants, who perform nonmanagerial
direct patient care functions for more than 50 percent of their scheduled hours on a given
patient care unit.
(d) "Inpatient care unit"new text begin or "unit"new text end means a designated inpatient area for assigning patients
and staff for which a deleted text begin distinct staffing plandeleted text end new text begin daily staffing schedulenew text end exists and that operates
24 hours per day, seven days per week in a hospital setting. Inpatient care unit does not
include any hospital-based clinic, long-term care facility, or outpatient hospital department.
(e) "Staffing hours per patient day" means the number of full-time equivalent
nonmanagerial care staff who will ordinarily be assigned to provide direct patient care
divided by the expected average number of patients upon which such assignments are based.
deleted text begin
(f) "Patient acuity tool" means a system for measuring an individual patient's need for
nursing care. This includes utilizing a professional registered nursing assessment of patient
condition to assess staffing need.
deleted text end
Subd. 2.
Hospitalnew text begin corenew text end staffing deleted text begin reportdeleted text end new text begin plansnew text end .
(a) The deleted text begin chief nursing executive or nursing
designeedeleted text end new text begin hospital nurse staffing committeenew text end of every deleted text begin reportingdeleted text end hospital deleted text begin in Minnesota under
section 144.50 willdeleted text end new text begin mustnew text end develop a core staffing plan for each deleted text begin patientdeleted text end new text begin inpatientnew text end care unit.
new text begin
(b) The commissioner is not required to verify compliance with this section by an on-site
visit.
new text end
deleted text begin (b)deleted text end new text begin (c)new text end Core staffing plans deleted text begin shalldeleted text end new text begin mustnew text end specifynew text begin all of the following:
new text end
new text begin (1) new text end thenew text begin projected number ofnew text end full-time equivalent deleted text begin fordeleted text end new text begin nonmanagerial care staff that will
be assigned in a 24-hour period tonew text end each deleted text begin patientdeleted text end new text begin inpatientnew text end care unit deleted text begin for each 24-hour period.deleted text end new text begin ;
new text end
new text begin
(2) the maximum number of patients on each inpatient care unit for whom a direct care
nurse can typically safely care;
new text end
new text begin
(3) criteria for determining when circumstances exist on each inpatient care unit such
that a direct care nurse cannot safely care for the typical number of patients and when
assigning a lower number of patients to each nurse on the inpatient unit would be appropriate;
new text end
new text begin
(4) a procedure for each inpatient care unit to make shift-to-shift adjustments in staffing
levels when such adjustments are required by patient acuity and nursing intensity in the
unit;
new text end
new text begin
(5) a contingency plan for each inpatient unit to safely address circumstances in which
patient care needs unexpectedly exceed the staffing resources provided for in a daily staffing
schedule. A contingency plan must include a method to quickly identify, for each daily
staffing schedule, additional direct care registered nurses who are available to provide direct
care on the inpatient care unit;
new text end
new text begin
(6) strategies to enable direct care registered nurses to take breaks they are entitled to
under law or under an applicable collective bargaining agreement; and
new text end
new text begin
(7) strategies to eliminate patient boarding in emergency departments that do not rely
on requiring direct care registered nurses to work additional hours to provide care.
new text end
deleted text begin (c)deleted text end new text begin (d) Core staffing plans must ensure that:
new text end
new text begin
(1) the person creating a daily staffing schedule has sufficiently detailed information to
create a daily staffing schedule that meets the requirements of the plan;
new text end
new text begin
(2) daily staffing schedules do not rely on assigning individual nonmanagerial care staff
to work overtime hours in excess of 16 hours in a 24-hour period or to work consecutive
24-hour periods requiring 16 or more hours;
new text end
new text begin
(3) a direct care registered nurse is not required or expected to perform functions outside
the nurse's professional license;
new text end
new text begin
(4) a light duty direct care registered nurse is given appropriate assignments;
new text end
new text begin
(5) a charge nurse does not have patient assignments; and
new text end
new text begin
(6) daily staffing schedules do not interfere with applicable collective bargaining
agreements.
new text end
new text begin Subd. 2a. new text end
new text begin Development of hospital core staffing plans. new text end
new text begin (a) new text end Prior to deleted text begin submittingdeleted text end new text begin
completing or updatingnew text end the core staffing plan, deleted text begin as required in subdivision 3, hospitals shalldeleted text end new text begin
a hospital nurse staffing committee mustnew text end consult with representatives of the hospital medical
staff, managerial and nonmanagerial care staff, and other relevant hospital personnel about
the core staffing plan and the expected average number of patients upon which thenew text begin corenew text end
staffing plan is based.
new text begin
(b) When developing a core staffing plan, a hospital nurse staffing committee must
consider all of the following:
new text end
new text begin
(1) the individual needs and expected census of each inpatient care unit;
new text end
new text begin
(2) unit-specific patient acuity, including fall risk and behaviors requiring intervention,
such as physical aggression toward self or others or destruction of property;
new text end
new text begin
(3) unit-specific demands on direct care registered nurses' time, including: frequency of
admissions, discharges, and transfers; frequency and complexity of patient evaluations and
assessments; frequency and complexity of nursing care planning; planning for patient
discharge; assessing for patient referral; patient education; and implementing infectious
disease protocols;
new text end
new text begin
(4) the architecture and geography of the inpatient care unit, including the placement of
patient rooms, treatment areas, nursing stations, medication preparation areas, and equipment;
new text end
new text begin
(5) mechanisms and procedures to provide for one-to-one patient observation for patients
on psychiatric or other units;
new text end
new text begin
(6) the stress that direct-care nurses experience when required to work extreme amounts
of overtime, such as shifts in excess of 12 hours or multiple consecutive double shifts;
new text end
new text begin
(7) the need for specialized equipment and technology on the unit;
new text end
new text begin
(8) other special characteristics of the unit or community patient population, including
age, cultural and linguistic diversity and needs, functional ability, communication skills,
and other relevant social and socioeconomic factors;
new text end
new text begin
(9) the skill mix of personnel other than direct care registered nurses providing or
supporting direct patient care on the unit;
new text end
new text begin
(10) mechanisms and procedures for identifying additional registered nurses who are
available for direct patient care when patients' unexpected needs exceed the planned workload
for direct care staff; and
new text end
new text begin
(11) demands on direct care registered nurses' time not directly related to providing
direct care on a unit, such as involvement in quality improvement activities, professional
development, service to the hospital, including serving on the hospital nurse staffing
committee or the hospital nurse workload committee, and service to the profession.
new text end
new text begin Subd. 2b. new text end
new text begin Failure to develop hospital core staffing plans. new text end
new text begin
If a hospital nurse staffing
committee cannot approve a hospital core staffing plan by a majority vote, the members of
the nurse staffing committee must enter an expedited arbitration process with an arbitrator
who understands patient care needs.
new text end
new text begin Subd. 2c. new text end
new text begin Objections to hospital core staffing plans. new text end
new text begin
(a) If hospital management objects
to a core staffing plan approved by a majority vote of the hospital nurse staffing committee,
the hospital may elect to attempt to amend the core staffing plan through arbitration.
new text end
new text begin
(b) During an ongoing dispute resolution process, a hospital must continue to implement
the core staffing plan as written and approved by the hospital nurse staffing committee.
new text end
new text begin
(c) If the dispute resolution process results in an amendment to the core staffing plan,
the hospital must implement the amended core staffing plan.
new text end
new text begin Subd. 2d. new text end
new text begin Mandatory submission of core staffing plan to commissioner. new text end
new text begin
Each hospital
must submit to the commissioner the core staffing plans approved by the hospital's nurse
staffing committee. A hospital must submit any substantial updates to any previously
approved plan, including any amendments to the plan resulting from arbitration, within 30
calendar days of approval of the update by the committee or the conclusion of arbitration.
new text end
Subd. 3.
Standard electronic reporting developed.
deleted text begin
(a) Hospitals must submit the core
staffing plans to the Minnesota Hospital Association by January 1, 2014. The Minnesota
Hospital Association shall include each reporting hospital's core staffing plan on the
Minnesota Hospital Association's Minnesota Hospital Quality Report website by April 1,
2014. any substantial changes to the core staffing plan shall be updated within 30 days.
deleted text end
deleted text begin (b)deleted text end The Minnesota Hospital Association shall include on its website for each reporting
hospital on a quarterly basis the actual direct patient care hours per patient and per unit.
Hospitals must submit the direct patient care report to the Minnesota Hospital Association
by July 1, 2014, and quarterly thereafter.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2025.
new text end
Sec. 13.
new text begin
[144.7056] IMPLEMENTATION OF HOSPITAL CORE STAFFING PLANS.
new text end
new text begin Subdivision 1. new text end
new text begin Plan implementation required. new text end
new text begin
(a) A hospital must implement the core
staffing plans approved annually by a majority vote of its hospital nurse staffing committee.
Nothing in sections 144.7051 to 144.7058 relieves the chief nursing executive of a hospital
from fulfilling the chief nursing executive's duties under Code of Federal Regulations, title
42, section 482.23. If at any time the chief nursing executive believes the types and numbers
of nursing personnel and staff required under the hospital's core staffing plan are insufficient
to provide nursing care for a unit in the hospital, the chief nursing executive may increase
the staffing on that unit beyond the levels required by the plan.
new text end
new text begin
(b) A core staffing plan does not apply during an emergency and a hospital is not out of
compliance with its core staffing plan during an emergency. A nurse may be required to
accept an additional patient assignment in an emergency.
new text end
new text begin
(c) The commissioner is required to verify compliance with this section by on-site visits
during routine hospital surveys.
new text end
new text begin Subd. 2. new text end
new text begin Public posting of core staffing plans. new text end
new text begin
A hospital must post its core staffing
plan for each inpatient care unit in a public area on the relevant unit.
new text end
new text begin Subd. 3. new text end
new text begin Public posting of compliance with plan. new text end
new text begin
For each publicly posted core staffing
plan, a hospital must post a notice stating whether the current staffing on the unit complies
with the hospital's core staffing plan for that unit. The public notice of compliance must
include a list of the number of nonmanagerial care staff working on the unit during the
current shift and the number of patients assigned to each direct care registered nurse working
on the unit during the current shift. The list must enumerate the nonmanagerial care staff
by health care worker type. The public notice of compliance must be posted immediately
adjacent to the publicly posted core staffing plan.
new text end
new text begin Subd. 4. new text end
new text begin Public posting of emergency department wait times. new text end
new text begin
A hospital must maintain
on its website and publicly display in its emergency department the approximate wait time
for patients who are not in critical need of emergency care. The approximate wait time must
be updated at least hourly.
new text end
new text begin Subd. 5. new text end
new text begin Public distribution of core staffing plan and notice of compliance. new text end
new text begin
(a) A
hospital must include with the posted materials described in subdivisions 2 and 3 a statement
that individual copies of the posted materials are available upon request to any patient on
the unit, visitor of a patient on the unit, or prospective patient. The statement must include
specific instructions for obtaining copies of the posted materials.
new text end
new text begin
(b) A hospital must, within four hours after the request, provide individual copies of all
the posted materials described in subdivisions 2 and 3 to any patient on the unit or to any
visitor of a patient on the unit who requests the materials.
new text end
new text begin Subd. 6. new text end
new text begin Reporting noncompliance. new text end
new text begin
(a) Any hospital employee, patient, or patient
family member may submit a concern for safe staffing form to report an instance of
noncompliance with a hospital's core staffing plan, to object to the contents of a core staffing
plan, or to challenge the process of the hospital nurse staffing committee.
new text end
new text begin
(b) A hospital must not interfere with or retaliate against a hospital employee for
submitting a concern for safe staffing form.
new text end
new text begin
(c) The commissioner of labor and industry may investigate any report of interference
with or retaliation against a hospital employee for submitting a concern for safe staffing
form. The commissioner of labor and industry may fine a hospital up to $250,000 if the
commissioner finds the hospital interfered with or retaliated against a hospital employee
for submitting a concern for safe staffing form.
new text end
new text begin Subd. 7. new text end
new text begin Documentation of compliance. new text end
new text begin
Each hospital must document compliance with
its core nursing plans and maintain records demonstrating compliance for each inpatient
care unit for five years. Each hospital must provide to its nurse staffing committee access
to all documentation required under this subdivision.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2025.
new text end
Sec. 14.
new text begin
[144.7057] HOSPITAL NURSE STAFFING REPORTS.
new text end
new text begin Subdivision 1. new text end
new text begin Nurse staffing report required. new text end
new text begin
Each hospital nurse staffing committee
must submit quarterly nurse staffing reports to the commissioner. Reports must be submitted
within 60 days of the end of the quarter.
new text end
new text begin Subd. 2. new text end
new text begin Nurse staffing report. new text end
new text begin
Nurse staffing reports submitted to the commissioner
by a hospital nurse staffing committee must:
new text end
new text begin
(1) identify any suspected incidents of the hospital failing during the reporting quarter
to meet the standards of one of its core staffing plans;
new text end
new text begin
(2) identify each occurrence of the hospital accepting an elective surgery at a time when
the unit performing the surgery is out of compliance with its core staffing plan;
new text end
new text begin
(3) identify problems of insufficient staffing, including but not limited to:
new text end
new text begin
(i) inappropriate number of direct care registered nurses scheduled in a unit;
new text end
new text begin
(ii) inappropriate number of direct care registered nurses present and delivering care in
a unit;
new text end
new text begin
(iii) inappropriately experienced direct care registered nurses scheduled for a particular
unit;
new text end
new text begin
(iv) inappropriately experienced direct care registered nurses present and delivering care
in a unit;
new text end
new text begin
(v) inability for nurse supervisors to adjust daily nursing schedules for increased patient
acuity or nursing intensity in a unit; and
new text end
new text begin
(vi) chronically unfilled direct care positions within the hospital;
new text end
new text begin
(4) identify any units that pose a risk to patient safety due to inadequate staffing;
new text end
new text begin
(5) propose solutions to solve insufficient staffing;
new text end
new text begin
(6) propose solutions to reduce risks to patient safety in inadequately staffed units; and
new text end
new text begin
(7) describe staffing trends within the hospital.
new text end
new text begin Subd. 3. new text end
new text begin Public posting of nurse staffing reports. new text end
new text begin
The commissioner must include on
its website each quarterly nurse staffing report submitted to the commissioner under
subdivision 1.
new text end
new text begin Subd. 4. new text end
new text begin Standardized reporting. new text end
new text begin
The commissioner shall develop and provide to each
hospital nurse staffing committee a uniform format or standard form the committee must
use to comply with the nurse staffing reporting requirements under this section. The format
or form developed by the commissioner must present the reported information in a manner
allowing patients and the public to clearly understand and compare staffing patterns and
actual levels of staffing across reporting hospitals. The commissioner must include, in the
uniform format or on the standardized form, space to allow the reporting hospital to include
a description of additional resources available to support unit-level patient care and a
description of the hospital.
new text end
new text begin Subd. 5. new text end
new text begin Penalties. new text end
new text begin
Notwithstanding section 144.653, subdivisions 5 and 6, the
commissioner may impose an immediate fine of up to $5,000 for each instance of a failure
to report an elective surgery requiring reporting under subdivision 2, clause (2). The facility
may request a hearing on the immediate fine under section 144.653, subdivision 8.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2025.
new text end
Sec. 15.
new text begin
[144.7058] GRADING OF COMPLIANCE WITH CORE STAFFING PLANS.
new text end
new text begin Subdivision 1. new text end
new text begin Grading compliance with core staffing plans. new text end
new text begin
By January 1, 2026, the
commissioner must develop a uniform annual grading system that evaluates each hospital's
compliance with its own core staffing plan. The commissioner must assign each hospital a
compliance grade based on a review of the hospital's nurse staffing report submitted under
section 144.7057. The commissioner must assign a failing compliance grade to any hospital
that has not been in compliance with its staffing plan for six or more months during the
reporting year.
new text end
new text begin Subd. 2. new text end
new text begin Grading factors. new text end
new text begin
When grading a hospital's compliance with its core staffing
plan, the commissioner must consider at least the following factors:
new text end
new text begin
(1) the number of assaults and injuries occurring in the hospital involving patients;
new text end
new text begin
(2) the prevalence of infections, pressure ulcers, and falls among patients;
new text end
new text begin
(3) emergency department wait times;
new text end
new text begin
(4) readmissions;
new text end
new text begin
(5) use of restraints and other behavior interventions;
new text end
new text begin
(6) employment turnover rates among direct care registered nurses and other direct care
health care workers;
new text end
new text begin
(7) except in instances when nurses volunteer for overtime, prevalence of overtime
among direct care registered nurses and other direct care health care workers;
new text end
new text begin
(8) prevalence of missed shift breaks among direct care registered nurses and other direct
care health care workers;
new text end
new text begin
(9) frequency of incidents of being out of compliance with a core staffing plan;
new text end
new text begin
(10) the extent of noncompliance with a core staffing plan; and
new text end
new text begin
(11) number of inpatient psychiatric units.
new text end
new text begin Subd. 3. new text end
new text begin Public disclosure of compliance grades. new text end
new text begin
Beginning January 1, 2027, the
commissioner must publish a compliance grade for each hospital on the department website
with a link to the hospital's core staffing plan, the hospital's nurse staffing reports, and an
accessible and easily understandable explanation of what the compliance grade means.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2026.
new text end
Sec. 16.
new text begin
[144.7059] RETALIATION AGAINST NURSES PROHIBITED.
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) "Emergency" means a period when replacement staff are not able to report for duty
for the next shift, or a period of increased patient need, because of unusual, unpredictable,
or unforeseen circumstances, including but not limited to an act of terrorism, a disease
outbreak, adverse weather conditions, or a natural disaster, that impacts continuity of patient
care.
new text end
new text begin
(c) "Nurse" has the meaning given in section 148.171, subdivision 9, and includes nurses
employed by the state.
new text end
new text begin
(d) "Taking action against" means discharging, disciplining, threatening, reporting to
the Board of Nursing, discriminating against, or penalizing regarding compensation, terms,
conditions, location, or privileges of employment.
new text end
new text begin Subd. 2. new text end
new text begin Prohibited actions. new text end
new text begin
Except as provided in subdivision 5, a hospital or other
entity licensed under sections 144.50 to 144.58, and its agent, or other health care facility
licensed by the commissioner of health, and the facility's agent, is prohibited from taking
action against a nurse solely on the ground that the nurse fails to accept an assignment of
one or more additional patients because the nurse reasonably determines that accepting an
additional patient assignment may create an unnecessary danger to a patient's life, health,
or safety or may otherwise constitute a ground for disciplinary action under section 148.261.
This subdivision does not apply to a nursing facility, an intermediate care facility for persons
with developmental disabilities, or a licensed boarding care home.
new text end
new text begin Subd. 3. new text end
new text begin State nurses. new text end
new text begin
Subdivision 2 applies to nurses employed by the state regardless
of the type of facility where the nurse is employed and regardless of the facility's license,
if the nurse is involved in resident or patient care.
new text end
new text begin Subd. 4. new text end
new text begin Collective bargaining rights. new text end
new text begin
This section does not diminish or impair the
rights of a person under any collective bargaining agreement.
new text end
new text begin Subd. 5. new text end
new text begin Emergency. new text end
new text begin
A nurse may be required to accept an additional patient assignment
in an emergency.
new text end
new text begin Subd. 6. new text end
new text begin Enforcement. new text end
new text begin
The commissioner of labor and industry may enforce this section
by issuing a compliance order under section 177.27, subdivision 4. The commissioner of
labor and industry may assess a fine of up to $5,000 for each violation of this section.
new text end
Sec. 17.
Minnesota Statutes 2022, section 144.7067, subdivision 1, is amended to read:
Subdivision 1.
Establishment of reporting system.
(a) The commissioner shall establish
an adverse health event reporting system designed to facilitate quality improvement in the
health care system. The reporting system shall not be designed to punish errors by health
care practitioners or health care facility employees.
(b) The reporting system shall consist of:
(1) mandatory reporting by facilities of 27 adverse health care events;
(2) new text begin mandatory reporting by facilities of whether the unit where an adverse event occurred
was in compliance with the core staffing plan for the unit at the time of the adverse event;
new text end
new text begin (3) new text end mandatory completion of a root cause analysis and a corrective action plan by the
facility and reporting of the findings of the analysis and the plan to the commissioner or
reporting of reasons for not taking corrective action;
deleted text begin (3)deleted text end new text begin (4)new text end analysis of reported information by the commissioner to determine patterns of
systemic failure in the health care system and successful methods to correct these failures;
deleted text begin (4)deleted text end new text begin (5)new text end sanctions against facilities for failure to comply with reporting system
requirements; and
deleted text begin (5)deleted text end new text begin (6)new text end communication from the commissioner to facilities, health care purchasers, and
the public to maximize the use of the reporting system to improve health care quality.
(c) The commissioner is not authorized to select from or between competing alternate
acceptable medical practices.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2025.
new text end
Sec. 18.
Minnesota Statutes 2022, section 147A.08, is amended to read:
147A.08 EXEMPTIONS.
(a) This chapter does not apply to, control, prevent, or restrict the practice, service, or
activities of persons listed in section 147.09, clauses (1) to (6) and (8) to (13)deleted text begin ,deleted text end new text begin ;new text end persons
regulated under section 214.01, subdivision 2deleted text begin ,deleted text end new text begin ;new text end or deleted text begin personsdeleted text end new text begin midlevel practitioners, nurses,
or nurse-midwives asnew text end defined in section 144.1501, subdivision 1deleted text begin , paragraphs (i), (k), and
(l)deleted text end .
(b) Nothing in this chapter shall be construed to require licensure of:
(1) a physician assistant student enrolled in a physician assistant educational program
accredited by the Accreditation Review Commission on Education for the Physician Assistant
or by its successor agency approved by the board;
(2) a physician assistant employed in the service of the federal government while
performing duties incident to that employment; or
(3) technicians, other assistants, or employees of physicians who perform delegated
tasks in the office of a physician but who do not identify themselves as a physician assistant.
Sec. 19. new text begin BEST PRACTICES TOOLKIT DEVELOPMENT.
new text end
new text begin
The commissioner of health must convene a stakeholder group that will meet for six
months to develop a toolkit with best practices for implementation of workload committee
and hospital staffing committees. The toolkit and best practices must include a
recommendation that each hospital utilize a federal mediator or the Office of Collaboration
and Dispute Resolution to moderate the establishment of committees in each hospital. The
commissioner must make the toolkit with the recommended best practices available to
hospitals by July 1, 2024.
new text end
Sec. 20. new text begin DIRECTION TO COMMISSIONER OF HEALTH; DEVELOPMENT OF
ANALYTICAL TOOLS.
new text end
new text begin
(a) The commissioner of health, in consultation with the Minnesota Nurses Association
and other professional nursing organizations, must develop a means of analyzing available
adverse event data, available staffing data, and available data from concern for safe staffing
forms to examine potential causal links between adverse events and understaffing.
new text end
new text begin
(b) The commissioner must develop an initial means of conducting the analysis described
in paragraph (a) by January 1, 2025, and publish a public report on the commissioner's
initial findings by January 1, 2026.
new text end
new text begin
(c) By January 1, 2024, the commissioner must submit to the chairs and ranking minority
members of the house and senate committees with jurisdiction over the regulation of hospitals
a report on the available data, potential sources of additional useful data, and any additional
statutory authority the commissioner requires to collect additional useful information from
hospitals.
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. 21. new text begin DIRECTION TO COMMISSIONER OF HEALTH; NURSING
WORKFORCE REPORT.
new text end
new text begin
(a) The commissioner of health must publish a public report on the current status of the
state's nursing workforce employed by hospitals. In preparing the report, the commissioner
shall utilize information collected in collaboration with the Board of Nursing as directed
under Minnesota Statutes, sections 144.051 and 144.052, on Minnesota's supply of active
licensed nurses and reasons licensed nurses are leaving direct care positions at hospitals;
information collected and shared by the Minnesota Hospital Association on retention by
hospitals of licensed nurses; information collected through an independent study on reasons
licensed nurses are choosing not to renew their licenses and leaving the profession; and
other publicly available data the commissioner deems useful.
new text end
new text begin
(b) The commissioner must publish the report by January 1, 2026.
new text end
Sec. 22. new text begin DIRECTION TO COMMISSIONER OF HEALTH; KEEPING NURSES
AT THE BEDSIDE ACT IMPACT EVALUATION.
new text end
new text begin
By October 1, 2023, the commissioner of health must contract with the commissioner
of management and budget for the services of the Impact Evaluation Unit to design and
implement a rigorous causal impact evaluation using time-series data or other evaluation
methods as determined by the Impact Evaluation Unit to estimate the causal impact of the
implementation of Minnesota Statutes, sections 144.7051 to 144.7059, on patient care, nurse
job satisfaction, nurse retention, and other outcomes as determined by the commissioner
and the Impact Evaluation Unit. The Impact Evaluation Unit may subcontract with other
research organizations to assist with the design or implementation of the impact evaluation.
By February 15, 2024, the commissioner of health must submit to the chairs and ranking
minority members of the legislative committees with jurisdiction over health finance and
policy draft legislation specifying any additional authorities the commissioner and the Impact
Evaluation Unit may require to collect the data required to conduct a successful impact
evaluation of the implementation of Minnesota Statutes, sections 144.7051 to 144.7059.
By October 1, 2024, the Impact Evaluation Unit must begin collecting baseline data. By
June 30, 2027, the Impact Evaluation Unit must submit to the commissioner of health a
public initial report on the status of the evaluation project and any preliminary results.
new text end
Sec. 23. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES.
new text end
new text begin
The commissioner of human services must define as a direct educational expense the
reasonable child care costs incurred by a nursing facility employee scholarship recipient
while the recipient is receiving a wage from the scholarship sponsoring facility, provided
the scholarship recipient is making reasonable progress, as defined by the commissioner,
toward the educational goal for which the scholarship was granted.
new text end
Sec. 24. new text begin INITIAL IMPLEMENTATION OF THE KEEPING NURSES AT THE
BEDSIDE ACT.
new text end
new text begin
(a) By October 1, 2024, each hospital must establish and convene a hospital nurse staffing
committee as described under Minnesota Statutes, section 144.7053, and a hospital nurse
workload committee as described under Minnesota Statutes, section 144.7054.
new text end
new text begin
(b) By October 1, 2025, each hospital must implement core staffing plans developed by
its hospital nurse staffing committee and satisfy the plan posting requirements under
Minnesota Statutes, section 144.7056.
new text end
new text begin
(c) By October 1, 2025, each hospital must submit to the commissioner of health core
staffing plans meeting the requirements of Minnesota Statutes, section 144.7055.
new text end
new text begin
(d) By October 1, 2025, the commissioner of health must develop a standard concern
for safe staffing form and provide an electronic means of submitting the form to the relevant
hospital nurse staffing committee. The commissioner must base the form on the existing
concern for safe staffing form maintained by the Minnesota Nurses' Association.
new text end
new text begin
(e) By January 1, 2026, the commissioner of health must provide electronic access to
the uniform format or standard form for nurse staffing reporting described under Minnesota
Statutes, section 144.7057, subdivision 4.
new text end
Sec. 25. new text begin REVISOR INSTRUCTION.
new text end
new text begin
In Minnesota Statutes, section 144.7055, the revisor shall renumber paragraphs (b) to
(e) alphabetically as individual subdivisions under Minnesota Statutes, section 144.7051.
The revisor shall make any necessary changes to sentence structure for this renumbering
while preserving the meaning of the text. The revisor shall also make necessary
cross-reference changes in Minnesota Statutes and Minnesota Rules consistent with the
renumbering.
new text end
ARTICLE 4
DEPARTMENT OF HEALTH
Section 1.
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. 2.
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. 3.
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.
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 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 system 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 potable water
as the heat transfer fluidnew text end ; and
(4) deleted text begin determine groundwater flow direction or velocitydeleted text end new text begin is operated using nonconsumptive
recirculationnew text end .
new text begin
A submerged closed-loop heat exchanger also includes submersible pumps, a heat exchanger
device, piping, and other necessary appurtenances.
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. 5.
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. 6.
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. 7.
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, in addition to the notification fee for
water supply wells, $275, 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. 8.
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 act, a person must not
install a submerged closed loop heat exchanger in a water supply well without a permit
granted by the commissioner as provided in section 103I.210. A submerged closed loop
heat exchanger system approved by a variance granted by the commissioner prior to the
effective date of this act 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 Setbacks. new text end
new text begin
A water supply well containing a submerged closed-loop heat
exchanger that is used for the sole purpose of heating and cooling and does not remove
water from an aquifer is exempt from the isolation distance requirements of Minnesota
Rules, part 4725.4450, or a successor rule on the same topic, and in no instance will the
setback distance be greater than ten feet. A water supply well that does not comply with the
isolation distance requirements of Minnesota Rules, part 4725.4450, must not be used for
any other water supply well purpose.
new text end
new text begin Subd. 3. 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 screened interval of a water supply well constructed to contain a submerged
closed loop heat exchanger completed within a single aquifer may be designed and
constructed using any combination of screen, casing, leader, riser, sump, or other piping
combinations, so long as the screen configuration does not interconnect aquifers.
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 chapter 103I and Minnesota Rules, chapter 4725.
new text end
new text begin Subd. 4. 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.
new text end
Sec. 9.
new text begin
[103I.210] SUBMERGED CLOSED LOOP HEAT EXCHANGER SYSTEM;
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 closed
loop heat exchangers;
new text end
new text begin
(2) the name, address, and signature of the owner of the property on which the device
will be installed;
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 device location;
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; and
new text end
new text begin
(6) a diagram of the proposed system.
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) If a permit application contains all of the information required in paragraph (a) and
for which the technical specifications are consistent with the requirements of paragraph (a),
the commissioner may only deny the permit if the commissioner determines that the proposed
submerged closed loop heat exchanger system creates a new material risk to human health
and the environment by adversely affecting the migration of an existing groundwater
contamination plume.
new text end
new text begin
(e) Within 30 days of submission of a complete permit application, the commissioner
must either issue the permit or notify the applicant that the commissioner has determined
that the proposed submerged closed loop heat exchanger system may create a material risk
to human health and the environment by adversely affecting the migration of an existing
groundwater plume. If the commissioner determines the system may create a material risk,
the commissioner must make a final determination as to whether the proposed system poses
such material risk within 30 days after initial notice is provided to the applicant. The
commissioner may extend this 30-day period with the consent of the applicant. An application
is deemed to have been granted if the commissioner fails to notify the applicant that the
commissioner has determined that the proposed submerged closed loop heat exchanger
system may create a material risk to human health and the environment by adversely affecting
the migration of an existing groundwater within 30 days of submission of a complete
application or if the commissioner fails to make a final determination regarding such potential
material risks within 30 days after notifying the applicant.
new text end
new text begin
(f) The commissioner must not limit the number of permits available or the size of
systems. A project may consist of more than one submerged closed loop heat exchanger.
Installing a submerged closed loop heat exchanger must not be subject to additional review
or requirements with regards to the construction of a water supply well, beyond the
requirements promulgated in chapter 103I, and Minnesota Rules, chapter 4725. A variance
is not required to install or operate a submerged closed loop heat exchanger.
new text end
new text begin
(g) Permit holders must comply with this chapter, and Minnesota Rules, chapter 4725.
new text end
new text begin
(h) 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 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 will 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; and
new text end
new text begin
(11) requirement to obtain approval from the commissioner prior to deviation of the
approved plans and conditions of the permit.
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 121A.335, subdivision 3, is amended to read:
Subd. 3.
Frequency of testing.
deleted text begin (a)deleted text end 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.
deleted text begin
(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 minimized. This includes, when a school district or
charter school finds the presence of lead at a level where action should be taken as set by
the guidance in any water source that can provide cooking or drinking water, immediately
shutting off the water source or making it unavailable until the hazard has been minimized.
deleted text end
Sec. 11.
Minnesota Statutes 2022, section 121A.335, subdivision 5, is amended to read:
Subd. 5.
Reporting.
new text begin (a) new text end A school district or charter school 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 new text begin directly new text end notify parentsnew text begin annuallynew text end 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 begin If a test conducted under subdivision 3, paragraph
(a), reveals the presence of lead above a level where action should be taken as set by the
guidance, the school district or charter school must, within 30 days of receiving the test
result, either remediate the presence of lead to below the level set in guidance, verified by
retest, or directly notify parents of the test result. The school district or charter school must
make the water source unavailable until the hazard has been minimized.
deleted text end
new text begin
(b) Results of testing, and any planned remediation steps, shall be made available within
30 days of receiving results.
new text end
new text begin
(c) A school district or charter school that has tested for lead in drinking water shall
report the results of testing, and any planned remediation steps to the school board at the
next available school board meeting or within 30 days of receiving results, whichever is
sooner.
new text end
new text begin
(d) The school district or charter school shall maintain records of lead testing in drinking
water records electronically or by paper copy for at least 15 years.
new text end
new text begin
(e) Beginning July 1, 2024, school districts and charter schools must report their test
results and remediation activities to the commissioner of health annually on or before July
1 of each year.
new text end
Sec. 12.
Minnesota Statutes 2022, section 121A.335, is amended by adding a subdivision
to read:
new text begin Subd. 6. new text end
new text begin Remediation. new text end
new text begin
(a) A school district or charter school that finds lead above five
parts per billion at a specific location providing cooking or drinking water within a facility
must formulate, make publicly available, and implement a plan to remediate the lead in
drinking water. The plan must be consistent with established guidelines and recommendations
to ensure exposure to lead is remediated.
new text end
new text begin
(b) When lead is found above five parts per billion the water fixture shall immediately
be shut off or made unavailable for consumption until the hazard has been minimized as
verified by a test.
new text end
new text begin
(c) If the school district or charter school receives water from a public water supply that
has an action level exceedance of the federal Lead and Copper Rule, it may delay remediation
activities until the public water system meets state and federal requirements for the Lead
and Copper Rule. If the school district or charter school receives water from a lead service
line or other lead infrastructure owned by the public water supply, the school district may
delay remediation of fixtures until the lead service line is fully replaced. The school must
ensure that any fixture testing above five parts per billion is not used for consumption until
remediation activities are complete.
new text end
Sec. 13.
Minnesota Statutes 2022, section 144.05, is amended by adding a subdivision to
read:
new text begin Subd. 8. new text end
new text begin Grant program reporting. new text end
new text begin
The commissioner must submit a report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health by December 31, 2023, and by each December 31 thereafter on the following
information:
new text end
new text begin
(1) the number of grant programs administered by the commissioner that required a
full-time equivalent staff appropriation or administrative appropriation in order to implement;
new text end
new text begin
(2) the total amount of funds appropriated to the commissioner for full-time equivalent
staff or administration for all the grant programs; and
new text end
new text begin
(3) for each grant program administered by the commissioner:
new text end
new text begin
(i) the amount of funds appropriated to the commissioner for full-time equivalent staff
or administration to administer that particular grant program;
new text end
new text begin
(ii) the actual amount of funds that were spent on full-time equivalent staff or
administration to administer that particular grant program; and
new text end
new text begin
(iii) if there were funds appropriated that were not spent on full-time equivalent staff or
administration to administer that particular grant program, what the funds were actually
spent on.
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 director shall serve in the
unclassified service. 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 organizations and agencies in fields including but not limited to health
care, veterinary medicine, animal agriculture, academic institutions, and industry and
community organizations to inform strategies for education, practice improvement, and
research in all settings where antimicrobials 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 Annual report. new text end
new text begin
The commissioner of health shall report annually by January
15 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
and the collaborative research in the previous year and describe goals for the following year.
new text end
Sec. 15.
new text begin
[144.0701] SPECIAL GUERILLA UNIT VETERANS 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 grant
program to offer culturally specific and specialized assistance to support the health and
well-being of special guerilla unit veterans.
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, applicants
must be a nonprofit organization or a nongovernmental organization that offers culturally
specific and specialized assistance to support the health and well-being of special guerilla
unit veterans.
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 at a time and in a 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 funds must be used to offer programming and culturally
specific and specialized assistance to support the health and well-being of special guerilla
unit veterans.
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
which includes limited English proficient (LEP) populations, African American, LGBTQ+,
and people with disabilities; and
new text end
new text begin
(2) a position that works with department leadership and division 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 and 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
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 contracts
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) The commissioner of health shall report annually by January 15 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 year and describe goals for the following year.
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 Members. new text end
new text begin
(a) 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 and to the chairs and ranking minority members
of the legislative committees with primary jurisdiction over health policy and finance 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 or reimbursement for travel and expenses, or
both, incurred for council activities is governed in accordance with 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; and 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
The person appointed to head the Office of American Indian Health
must report annually by January 15 to the chairs and ranking minority members of the
legislative committees with primary jurisdiction over health policy and finance on the work
of the office during the previous year and the goals for the office for the following year.
new text end
Sec. 21.
new text begin
[144.0758] AMERICAN INDIAN 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 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
should 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 at the 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 144.218, 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. 26.
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. 27.
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. 28.
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. 29.
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) 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
(d) 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. 30.
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. 31.
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. 32.
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. 33.
new text begin
[144.3832] PUBLIC WATER SYSTEM INFRASTRUCTURE
STRENGTHENING GRANTS.
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 establish a
grant program to ensure the uninterrupted delivery of safe water through emergency power
supplies and back-up wells, backflow prevention, water reuse, increased cybersecurity,
floodplain mapping, support for very small water system infrastructure, and piloting solar
farms in source water protection areas.
new text end
new text begin Subd. 2. new text end
new text begin Grants authorized. new text end
new text begin
(a) The commissioner shall award grants for emergency
power supplies, back-up wells, and cross connection prevention programs through a request
for proposals process to public water systems. The commissioner shall give priority to small
and very small public water systems that serve populations of less than 3,300 and 500
respectively. The commissioner shall award matching grants to public water systems that
serve populations of less than 500 for infrastructure improvements supporting system
operations and resiliency.
new text end
new text begin
(b) Grantees must address one or more areas of infrastructure strengthening with the
goals of:
new text end
new text begin
(1) ensuring the uninterrupted delivery of safe and affordable water to their customers;
new text end
new text begin
(2) anticipating and mitigating potential threats arising from climate change such as
flooding and drought;
new text end
new text begin
(3) providing resiliency to maintain drinking water supply capacity in case of a loss of
power;
new text end
new text begin
(4) providing redundancy by having more than one source of water in case the main
source of water fails; or
new text end
new text begin
(5) preventing contamination by cross connections through a self-sustaining cross
connection control program.
new text end
Sec. 34.
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. An organization 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 organization 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. 35.
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) "Tobacco" has the meaning given in section 609.685, subdivision 1, paragraph (a).
new text end
new text begin
(d) "Tobacco-related devices" has the meaning given in section 609.685, subdivision 1,
paragraph (b).
new text end
new text begin
(e) "Nicotine delivery product" has the meaning given in section 609.6855, subdivision
1, paragraph (c).
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. 36.
new text begin
[144.4962] 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 Eligibility; application. new text end
new text begin
(a) Local and Tribal public health organizations are
eligible to receive grants as provided in this section. 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
(b) A local or Tribal public health organization 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
organization 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. 37.
new text begin
[144.557] REQUIREMENTS FOR CERTAIN HEALTH CARE ENTITY
TRANSACTIONS.
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 meaning given.
new text end
new text begin
(b) "Captive professional entity" means a professional corporation, limited liability
company, or other entity formed to render professional services in which a beneficial owner
is a health care provider employed by, controlled by, or subject to the direction of a hospital
or hospital system.
new text end
new text begin
(c) "Commissioner" means the commissioner of health.
new text end
new text begin
(d) "Control," including the terms "controlling," "controlled by," and "under common
control with," means the possession, direct or indirect, of the power to direct or cause the
direction of the management and policies of a person, whether through the ownership of
voting securities, membership in an entity formed under chapter 317A, by contract other
than a commercial contract for goods or nonmanagement services, or otherwise, unless the
power is the result of an official position with, corporate office held by, or court appointment
of, the person. Control is presumed to exist if any person, directly or indirectly, owns,
controls, holds with the power to vote, or holds proxies representing, 40 percent or more of
the voting securities of any other person, or if any person, directly or indirectly, constitutes
40 percent or more of the membership of an entity formed under chapter 317A. The
commissioner may determine, after furnishing all persons in interest notice and opportunity
to be heard and making specific findings of fact to support such determination, that control
exists in fact, notwithstanding the absence of a presumption to that effect.
new text end
new text begin
(e) "Health care entity" means:
new text end
new text begin
(1) a hospital;
new text end
new text begin
(2) a hospital system;
new text end
new text begin
(3) a captive professional entity;
new text end
new text begin
(4) a medical foundation;
new text end
new text begin
(5) a health care provider group practice;
new text end
new text begin
(6) an entity organized or controlled by an entity listed in clauses (1) to (5); or
new text end
new text begin
(7) an entity that owns or exercises control over an entity listed in clauses (1) to (5).
new text end
new text begin
(f) "Health care provider" means a physician licensed under chapter 147, a physician
assistant licensed under chapter 147A, or an advanced practice registered nurse as defined
in section 148.171, subdivision 3, who provides health care services, including but not
limited to medical care, consultation, diagnosis, or treatment.
new text end
new text begin
(g) "Health care provider group practice" means two or more health care providers legally
organized in a partnership, professional corporation, limited liability company, medical
foundation, nonprofit corporation, faculty practice plan, or other similar entity:
new text end
new text begin
(1) in which each health care provider who is a member of the group provides
substantially the full range of services that a health care provider routinely provides, including
but not limited to medical care, consultation, diagnosis, and treatment, through the joint use
of shared office space, facilities, equipment, or personnel;
new text end
new text begin
(2) for which substantially all services of the health care providers who are group
members are provided through the group and are billed in the name of the group practice
and amounts so received are treated as receipts of the group; or
new text end
new text begin
(3) in which the overhead expenses of, and the income from, the group are distributed
in accordance with methods previously determined by members of the group.
new text end
new text begin
An entity that otherwise meets the definition of health care provider group practice in this
paragraph shall be considered a health care provider group practice even if its shareholders,
partners, members, or owners include a single-health care provider professional corporation,
limited liability company, or another entity in which any beneficial owner is an individual
health care provider and which is formed to render professional services.
new text end
new text begin
(h) "Hospital" means a health care facility licensed as a hospital under sections 144.50
to 144.56.
new text end
new text begin
(i) "Medical foundation" means a nonprofit legal entity through which physicians or
other health care providers perform research or provide medical services.
new text end
new text begin
(j) "Transaction" means a single action, or a series of actions within a five-year period,
which occurs in part within the state of Minnesota or involves a health care entity formed
or licensed in Minnesota, that constitutes:
new text end
new text begin
(1) a merger or exchange of a health care entity with another entity;
new text end
new text begin
(2) the sale, lease, or transfer of 40 percent or more of the assets of a health care entity
to another entity;
new text end
new text begin
(3) the granting of a security interest of 40 percent or more of the property and assets
of a health care entity to another entity;
new text end
new text begin
(4) the transfer of 40 percent or more of the shares or other ownership of the health care
entity to another entity;
new text end
new text begin
(5) an addition, removal, withdrawal, substitution, or other modification of one or more
members of the health care entity's governing body that transfers control, responsibility for,
or governance of the health care entity to another entity;
new text end
new text begin
(6) the creation of a new health care entity;
new text end
new text begin
(7) substantial investment of 40 percent or more in a health care entity that results in
sharing of revenues without a change in ownership or voting shares;
new text end
new text begin
(8) an addition, removal, withdrawal, substitution, or other modification of the members
of a health care entity formed under chapter 317A that results in a change of 40 percent or
more of the membership of the health care entity; or
new text end
new text begin
(9) any other transfer of control of a health care entity to, or acquisition of control of a
health care entity by, another entity.
new text end
new text begin
A transaction does not include an action or series of actions which meets one or more of
the criteria set forth in clauses (1) to (9) if, immediately prior to all such actions, the health
care entity directly, or indirectly through one or more intermediaries, controls, or is controlled
by, or is under common control with, all other parties to the action or series of actions.
new text end
new text begin Subd. 2. new text end
new text begin Notice required. new text end
new text begin
(a) This subdivision applies to all transactions where:
new text end
new text begin
(1) the health care entity involved in the transaction has average revenue of at least
$40,000,000 per year; or
new text end
new text begin
(2) an entity created by the transaction is projected to have average revenue of at least
$40,000,000 per year once the entity is operating at full capacity.
new text end
new text begin
(b) A health care entity must provide notice to the attorney general and the commissioner
and comply with this subdivision before entering into a transaction. Notice must be provided
at least 90 days before the proposed completion date for the transaction.
new text end
new text begin
(c) As part of the notice required under this subdivision, at least 90 days before the
proposed completion date of the transaction, a health care entity must affirmatively disclose
the following to the attorney general and the commissioner:
new text end
new text begin
(1) the entities involved in the transaction;
new text end
new text begin
(2) the leadership of the entities involved in the transaction, including all directors, board
members, and officers;
new text end
new text begin
(3) the services provided by each entity and the attributed revenue for each entity by
location;
new text end
new text begin
(4) the primary service area for each location;
new text end
new text begin
(5) the proposed service area for each location;
new text end
new text begin
(6) the current relationships between the entities and the health care providers and
practices affected, the locations of affected health care providers and practices, the services
provided by affected health care providers and practices, and the proposed relationships
between the entities and the health care providers and practices affected;
new text end
new text begin
(7) the terms of the transaction agreement or agreements;
new text end
new text begin
(8) the acquisition price;
new text end
new text begin
(9) markets in which the entities expect postmerger synergies to produce a competitive
advantage;
new text end
new text begin
(10) potential areas of expansion, whether in existing markets or new markets;
new text end
new text begin
(11) plans to close facilities, reduce workforce, or reduce or eliminate services;
new text end
new text begin
(12) the experts and consultants used to evaluate the transaction;
new text end
new text begin
(13) the number of full-time equivalent positions at each location before and after the
transaction by job category, including administrative and contract positions; and
new text end
new text begin
(14) any other information requested by the attorney general or commissioner.
new text end
new text begin
(d) As part of the notice required under this subdivision, at least 90 days before the
proposed completion date of the transaction, a health care entity must affirmatively produce
the following to the attorney general and the commissioner:
new text end
new text begin
(1) the current governing documents for all entities involved in the transaction and any
amendments to these documents;
new text end
new text begin
(2) the transaction agreement or agreements and all related agreements;
new text end
new text begin
(3) any collateral agreements related to the principal transaction, including leases,
management contracts, and service contracts;
new text end
new text begin
(4) all expert or consultant reports or valuations conducted in evaluating the transaction,
including any valuation of the assets that are subject to the transaction prepared within three
years preceding the anticipated transaction completion date and any reports of financial or
economic analysis conducted in anticipation of the transaction;
new text end
new text begin
(5) the results of any projections or modeling of health care utilization or financial
impacts related to the transaction, including but not limited to copies of reports by appraisers,
accountants, investment bankers, actuaries, and other experts;
new text end
new text begin
(6) a financial and economic analysis and report prepared by an independent expert or
consultant on the effects of the transaction;
new text end
new text begin
(7) an impact analysis report prepared by an independent expert or consultant on the
effects of the transaction on communities and the workforce, including any changes in
availability or accessibility of services;
new text end
new text begin
(8) all documents reflecting the purposes of or restrictions on any related nonprofit
entity's charitable assets;
new text end
new text begin
(9) copies of all filings submitted to federal regulators, including any Hart-Scott-Rodino
filing the entities submitted to the Federal Trade Commission in connection with the
transaction;
new text end
new text begin
(10) a certification sworn under oath by each board member and chief executive officer
for any nonprofit entity involved in the transaction containing the following: an explanation
of how the completed transaction is in the public interest, addressing the factors in subdivision
5, paragraph (a); a disclosure of each declarant's compensation and benefits relating to the
transaction for the three years following the transaction's anticipated completion date; and
a disclosure of any conflicts of interest;
new text end
new text begin
(11) audited and unaudited financial statements from all entities involved in the
transaction and tax filings for all entities involved in the transaction covering the preceding
five fiscal years; and
new text end
new text begin
(12) any other information or documents requested by the attorney general or
commissioner.
new text end
new text begin
(e) The attorney general may extend the notice and waiting period required under
paragraph (b) for an additional 90 days by notifying the health care entity in writing of the
extension.
new text end
new text begin
(f) The attorney general may waive all or any part of the notice and waiting period
required under paragraph (b).
new text end
new text begin
(g) The attorney general or the commissioner may hold public listening sessions or
forums to obtain input on the transaction from providers or community members who may
be impacted by the transaction.
new text end
new text begin
(h) The attorney general or the commissioner may bring an action in district court to
compel compliance with the notice requirements in this subdivision.
new text end
new text begin Subd. 3. new text end
new text begin Prohibited transactions. new text end
new text begin
No health care entity may enter into a transaction
that will:
new text end
new text begin
(1) substantially lessen competition; or
new text end
new text begin
(2) tend to create a monopoly or monopsony.
new text end
new text begin Subd. 4. new text end
new text begin Additional requirements for nonprofit health care entities. new text end
new text begin
A health care
entity that is incorporated under chapter 317A or organized under section 322C.1101, or
that is a subsidiary of any such entity, must, before entering into a transaction, ensure that:
new text end
new text begin
(1) the transaction complies with chapters 317A and 501B and other applicable laws;
new text end
new text begin
(2) the transaction does not involve or constitute a breach of charitable trust;
new text end
new text begin
(3) the nonprofit health care entity will receive full and fair value for its public benefit
assets, provided that this requirement is waived if application for waiver is made to the
attorney general and the attorney general determines a waiver from this requirement is in
the public interest;
new text end
new text begin
(4) the value of the public benefit assets to be transferred has not been manipulated in
a manner that causes or has caused the value of the assets to decrease;
new text end
new text begin
(5) the proceeds of the transaction will be used in a manner consistent with the public
benefit for which the assets are held by the nonprofit health care entity;
new text end
new text begin
(6) the transaction will not result in a breach of fiduciary duty; and
new text end
new text begin
(7) there are procedures and policies in place to prohibit any officer, director, trustee,
or other executive of the nonprofit health care entity from directly or indirectly benefiting
from the transaction.
new text end
new text begin Subd. 5. new text end
new text begin Attorney general enforcement and supplemental authority. new text end
new text begin
(a) The attorney
general may bring an action in district court to enjoin or unwind a transaction or seek other
equitable relief necessary to protect the public interest if a health care entity or transaction
violates this section, if the transaction is contrary to the public interest, or if both a health
care entity or transaction violates this section and the transaction is contrary to the public
interest. Factors informing whether a transaction is contrary to the public interest include
but are not limited to whether the transaction:
new text end
new text begin
(1) will harm public health;
new text end
new text begin
(2) will reduce the affected community's continued access to affordable and quality care
and to the range of services historically provided by the entities or will prevent members
in the affected community from receiving a comparable or better patient experience;
new text end
new text begin
(3) will have a detrimental impact on competing health care options within primary and
dispersed service areas;
new text end
new text begin
(4) will reduce delivery of health care to disadvantaged, uninsured, underinsured, and
underserved populations and to populations enrolled in public health care programs;
new text end
new text begin
(5) will have a substantial negative impact on medical education and teaching programs,
health care workforce training, or medical research;
new text end
new text begin
(6) will have a negative impact on the market for health care services, health insurance
services, or skilled health care workers;
new text end
new text begin
(7) will increase health care costs for patients; or
new text end
new text begin
(8) will adversely impact provider cost trends and containment of total health care
spending.
new text end
new text begin
(b) The attorney general may enforce this section under section 8.31.
new text end
new text begin
(c) Failure of the entities involved in a transaction to provide timely information as
required by the attorney general or the commissioner shall be an independent and sufficient
ground for a court to enjoin or unwind the transaction or provide other equitable relief,
provided the attorney general notified the entities of the inadequacy of the information
provided and provided the entities with a reasonable opportunity to remedy the inadequacy.
new text end
new text begin
(d) The attorney general shall consult with the commissioner to determine whether a
transaction is contrary to the public interest. Any information exchanged between the attorney
general and the commissioner according to this subdivision is confidential data on individuals
as defined in section 13.02, subdivision 3, or protected nonpublic data as defined in section
13.02, subdivision 13. The commissioner may share with the attorney general, according
to section 13.05, subdivision 9, any not public data, as defined in section 13.02, subdivision
8a, held by the Department of Health to aid in the investigation and review of the transaction,
and the attorney general must maintain this data with the same classification according to
section 13.03, subdivision 4, paragraph (d).
new text end
new text begin Subd. 6. new text end
new text begin Supplemental authority of commissioner. new text end
new text begin
(a) Notwithstanding any law to
the contrary, the commissioner may use data or information submitted under this section,
section 62U.04, and sections 144.695 to 144.705 to conduct analyses of the aggregate impact
of health care transactions on access to or the cost of health care services, health care market
consolidation, and health care quality.
new text end
new text begin
(b) The commissioner shall issue periodic public reports on the number and types of
transactions subject to this section and on the aggregate impact of transactions on health
care cost, quality, and competition in Minnesota.
new text end
new text begin Subd. 7. new text end
new text begin Relation to other law. new text end
new text begin
(a) The powers and authority under this section are in
addition to, and do not affect or limit, all other rights, powers, and authority of the attorney
general or the commissioner under chapter 8, 309, 317A, 325D, 501B, or other law.
new text end
new text begin
(b) Nothing in this section shall suspend any obligation imposed under chapter 8, 309,
317A, 325D, 501B, or other law on the entities involved in a transaction.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment and
applies to transactions completed on or after that date. In determining whether a transaction
was completed on or after the effective date, any actions or series of actions necessary to
the completion of the transaction that occurred prior to the effective date must be considered.
new text end
Sec. 38.
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. 39.
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
(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; and
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
(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. 40.
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. 41.
new text begin
[144.645] SUPPORTING HEALTHY DEVELOPMENT OF BABIES 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 grant
program to support healthy development of babies. Grant proceeds must be used for
community-driven training and education on best practices for supporting healthy
development of babies during pregnancy and postpartum. The grant money must be used
to build capacity in, train, educate, or improve practices among individuals, from youth to
elders, serving families with members who are Black, Indigenous, or People of Color during
pregnancy and postpartum.
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. A nonprofit organization seeking a grant under this section
must apply to the commissioner at a time and in a manner specified by the commissioner.
The commissioner shall review each application to determine if the application is complete,
the nonprofit organization 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
Sec. 42.
new text begin
[144.6504] ALZHEIMER'S DISEASE AND DEMENTIA CARE TRAINING
PROGRAM.
new text end
new text begin
(a) The commissioner of health, in collaboration with interested stakeholders, shall
develop and provide a training program for community health workers on recognizing and
understanding Alzheimer's disease and dementia. The training program may be conducted
either virtually or in person and must, at a minimum, include instruction on:
new text end
new text begin
(1) recognizing the common warning signs of Alzheimer's disease and dementia;
new text end
new text begin
(2) understanding how Alzheimer's disease and dementia affect communication and
behavior;
new text end
new text begin
(3) recognizing potential safety risks for individuals living with dementia, including the
risks of wandering and elder abuse; and
new text end
new text begin
(4) identifying appropriate techniques to communicate with individuals living with
dementia and how to appropriately respond to dementia-related behaviors.
new text end
new text begin
(b) The commissioner shall work with the Minnesota State Colleges and University
System (MNSCU) to explore the possibility of including a training program that meets the
requirements of this section to the MNSCU-approved community health worker certification
program.
new text end
new text begin
(c) Notwithstanding paragraph (a), if a training program already exists that meets the
requirements of this section, the commissioner may approve the existing training program
or programs instead of developing a new program, and, in collaboration with interested
stakeholders, ensure that the approved training program or programs are available to all
community health workers.
new text end
Sec. 43.
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 towards 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. 44.
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. 45.
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+ people, and people 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 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 of 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 populations
of color, American Indian, LGBTQIA+, and those 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, American
Indians and those serving communities of color, American Indians; LGBTQIA+, 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. 46.
new text begin
[144.9981] CLIMATE RESILIENCY.
new text end
new text begin Subdivision 1. new text end
new text begin Climate resiliency program. 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, Tribal health, 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
new text begin Subd. 2. new text end
new text begin Grants authorized; allocation. new text end
new text begin
(a) The commissioner of health shall manage
a grant program for the purpose of climate resiliency planning. The commissioner shall
award grants through a request for proposals process to local public health, Tribal health,
soil and water conservation districts, or other local organizations for planning for the health
impacts of extreme weather events and developing adaptation actions. Priority shall be given
to organizations that serve communities that are disproportionately impacted by climate
change.
new text end
new text begin
(b) Grantees must use the funds to develop a plan or implement strategies that will reduce
the risk of health impacts from extreme weather events. The grant application must include:
new text end
new text begin
(1) a description of the plan or project for which the grant funds will be used;
new text end
new text begin
(2) a description of the pathway between the plan or project and its impacts on health;
new text end
new text begin
(3) a description of the objectives, a work plan, and a timeline for implementation; and
new text end
new text begin
(4) the community or group the grant proposes to focus on.
new text end
Sec. 47.
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 Definition. 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 related to or similar to 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), LGBTQ+, and
persons with 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. 48.
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 purposes of this section, the following definitions
apply.
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) "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
(e) "988" or "988 hotline" means the universal telephone number for the national suicide
prevention and mental health crisis hotline system within the United States operating through
the Suicide and Crisis Lifeline, or its successor, maintained by the assistant secretary for
mental health and substance use under section 520E-2 of the Public Health Service Act.
new text end
new text begin
(f) "988 administrator" means the administrator of the 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
(g) "988 contact" means a communication with the 988 national suicide prevention and
mental health crisis hotline system within the United States via modalities offered that may
include call, chat, or text.
new text end
new text begin
(h) "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 hotline; lifeline centers. new text end
new text begin
(a) The commissioner shall administer the
designation of and oversee a lifeline center or network of lifeline centers to answer 988
contacts from individuals accessing the Suicide and Crisis Lifeline from any location in
Minnesota 24 hours per day, seven days per week.
new text end
new text begin
(b) The designated lifeline center or centers must:
new text end
new text begin
(1) have an active agreement with the 988 administrator for participation within the
network and with the department;
new text end
new text begin
(2) meet the 988 administrator's requirements and best practice guidelines for operational
and clinical standards;
new text end
new text begin
(3) provide data, engage in reporting, and participate in evaluations and related quality
improvement activities as required by the 988 administrator and the department;
new text end
new text begin
(4) identify or adapt technology that is demonstrated to be interoperable across crisis
and emergency response systems used in the state for the purpose of crisis care coordination;
new text end
new text begin
(5) connect people to crisis response and outgoing services, including mobile crisis
teams, in accordance with guidelines established by the 988 administrator and the department
and in collaboration with the Department of Human Services;
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 emergency departments;
new text end
new text begin
(7) offer follow-up services to individuals accessing the lifeline center that are consistent
with guidelines established by the 988 administrator and the department; and
new text end
new text begin
(8) meet requirements set by the 988 administrator and the department for serving
high-risk and specialized populations and culturally or ethnically diverse populations.
new text end
new text begin
(c) The commissioner shall use the commissioner's rulemaking authority 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 Suicide and Crisis Lifeline, Veterans Crisis Line, and other SAMHSA-approved networks
to ensure consistency of public messaging about 988 services. The commissioner may
engage in activities to publicize and raise awareness about 988 services, or may provide
grants to other organizations for these purposes.
new text end
new text begin
(e) The commissioner shall provide an annual report to the legislature on usage of the
988 hotline, including answer rates, rates of abandoned calls, and referral rates to 911
emergency response and to mental health crisis teams. Notwithstanding section 144.05,
subdivision 7, the reports required under this paragraph do not expire.
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 prevention crisis 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 30 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 Biennial budget; annual financial report. new text end
new text begin
The commissioner must prepare a
biennial budget for maintaining the 988 system. By December 15 of each year, the
commissioner must submit a report to the legislature detailing the expenditures for
maintaining the 988 system, the 988 fees collected, the balance of the 988 fund, the
988-related administrative expenses, and the most recent forecast of revenues and
expenditures for the 988 special revenue account, including a separate projection of 988
fees from prepaid wireless customers and projections of year-end fund balances.
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. 49.
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. 50.
new text begin
[145.9011] FETAL AND INFANT DEATH STUDIES.
new text end
new text begin Subdivision 1. new text end
new text begin Access to data. new text end
new text begin
(a) For purposes of this section, the subject of the data
is defined as any of the following:
new text end
new text begin
(1) a live born infant that died within the first year of life;
new text end
new text begin
(2) a fetal death which meets the criteria required for reporting as defined in section
144.222; or
new text end
new text begin
(3) the biological mother of an infant as defined in clause (1) or of a fetal death as defined
in clause (2).
new text end
new text begin
(b) To conduct fetal and infant death studies, the commissioner of health must have
access to:
new text end
new text begin
(1) medical data as defined in section 13.384, subdivision 1, paragraph (b); medical
examiner data as defined in section 13.83, subdivision 1; and health records created,
maintained, or stored by providers as defined in section 144.291, subdivision 2, paragraph
(i), on the subject of the data;
new text end
new text begin
(2) data on health and social support services, including but not limited to family home
visiting programs and the women, infants, and children (WIC) program; prescription
monitoring programs data; and data on behavioral health services, on the subject of the data;
new text end
new text begin
(3) the name of a health care provider that provided prenatal, postpartum, pediatric, and
other health services to the subject of the data, which must be provided by a coroner or
medical examiner; and
new text end
new text begin
(4) Department of Human Services and other state agency data to identify and receive
information on the types and nature of other sources of care and social support received by
the subject of the data, and parents and guardians of the subject of the data, to assist with
evaluation of social service systems.
new text end
new text begin
(c) When necessary to conduct a fetal and infant death study, the commissioner must
have access to:
new text end
new text begin
(1) data described in this subdivision relevant to fetal and infant death studies from
before, during, and after pregnancy or birth for the subject of the data; and
new text end
new text begin
(2) law enforcement reports or incident reports related to the subject of the data and
must receive the reports when requested from law enforcement.
new text end
new text begin
(d) The commissioner does not have access to coroner or medical examiner data that
are part of an active investigation as described in section 13.83.
new text end
new text begin
(e) The commissioner must have access to all data described within this section without
the consent of the subject of the data and without the consent of the parent, other guardian,
or legal representative of the subject of the data. The commissioner has access to the data
in this subdivision to study fetal or infant deaths that occur on or after July 1, 2021.
new text end
new text begin
(f) The commissioner must make a good faith reasonable effort to notify the subject of
the data, parent, spouse, other guardian, or legal representative of the subject of the data
before collecting data on the subject of the data. For purposes of this paragraph, "reasonable
effort" means one notice is sent by certified mail to the last known address of the subject
of the data, parent, spouse, other guardian, or legal representative informing of the data
collection and offering a public health nurse support visit if desired.
new text end
new text begin Subd. 2. new text end
new text begin Management of records. new text end
new text begin
After the commissioner has collected all data about
the subject of a fetal or infant death study necessary to perform the study, the data extracted
from source records obtained under subdivision 2, other than data identifying the subject
of the data, must be transferred to separate records that must be maintained by the
commissioner. Notwithstanding section 138.17, after the data have been transferred, all
source records obtained under subdivision 2 that are possessed by the commissioner must
be destroyed.
new text end
new text begin Subd. 3. new text end
new text begin Classification of data. new text end
new text begin
(a) Data provided to the commissioner from source
records under subdivision 2, including identifying information on individual providers,
subjects of the data, their family, or guardians, and data derived by the commissioner under
subdivision 3 for the purpose of carrying out fetal or infant death studies, are classified as
confidential data on individuals or confidential data on decedents, as defined in sections
13.02, subdivision 3, and 13.10, subdivision 1, paragraph (a).
new text end
new text begin
(b) Data classified under subdivision 4, paragraph (a), must not be subject to discovery
or introduction into evidence in any administrative, civil, or criminal proceeding. Such
information otherwise available from an original source must not be immune from discovery
or barred from introduction into evidence merely because it was utilized by the commissioner
in carrying out fetal or infant death studies.
new text end
new text begin
(c) Summary data on fetal and infant death studies created by the commissioner, which
does not identify individual subjects of the data, their families, guardians, or individual
providers, must be public in accordance with section 13.05, subdivision 7.
new text end
new text begin
(d) Data provided by the commissioner of human services or other state agency to the
commissioner of health under this section retains the same classification as the data held
when retained by the commissioner of human services, as required under section 13.03,
subdivision 4, paragraph (c).
new text end
new text begin Subd. 4. new text end
new text begin Fetal and infant mortality reviews. new text end
new text begin
(a) The commissioner of health must
convene case review committees to conduct death study reviews, make recommendations,
and publicly share summary information, especially for and about racial and ethnic groups,
including American Indians and African Americans, that experience significantly disparate
rates of fetal and infant mortality.
new text end
new text begin
(b) The case review committees may include, but are not limited to, medical examiners
or coroners, representative from health care institutions that provide care to pregnant people
and infants, obstetric and pediatric practitioners, Medicaid representatives, state agency
women and infant program representatives, and individuals from the communities that
experience disparate rates of fetal and infant deaths, and other subject matter experts as
necessary.
new text end
new text begin
(c) The case review committees will review data from source records obtained under
subdivision 2, other than data identifying the subject, the subject's family, or guardians, or
the provider involved in the care of the subject.
new text end
new text begin
(d) A person attending a fetal and infant mortality review committee meeting must not
disclose what transpired at the meeting, except as necessary to carry out the purposes of the
review committee. The proceedings and records of the review committee are protected
nonpublic data as defined in section 13.02, subdivision 13. Discovery and introduction into
evidence in legal proceedings of case review committee proceedings and records, and
testimony in legal proceedings by review committee members and persons presenting
information to the review committee, must occur in compliance with the requirements in
section 256.01, subdivision 12, paragraph (e).
new text end
new text begin
(e) Every three years beginning December 1, 2024, the case review committees will
provide findings and recommendations to the Maternal and Child Health Advisory Task
Force and the commissioner from the committee's review of fetal and infant deaths and
provide specific recommendations designed to reduce population-based disparities in fetal
and infant deaths.
new text end
new text begin
(f) This paragraph governs case review committee member compensation and expense
reimbursement, notwithstanding any other law or policy to the contrary. Members of the
case review committee must be compensated by the commissioner of health for actual time
spent in work on case reviews at a per diem rate established by the commissioner of health
according to funding availability. Compensable time includes preparation for case reviews,
time spent on collaborative review, including subcommittee meetings, committee meetings,
and other preparation work for the committee review as identified by the commissioner of
health. Members must also be reimbursed for expenses in the same manner and amount as
provided in the Department of Management and Budget's commissioner's plan under section
43A.18, subdivision 2. To receive compensation or reimbursement, committee members
must invoice the Department of Health on an invoice form provided by the commissioner.
new text end
new text begin Subd. 5. new text end
new text begin Expiration. new text end
new text begin
Notwithstanding any other law or policy to the contrary, the fetal
and infant mortality review committee must not expire.
new text end
Sec. 51.
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. 52.
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. 53.
new text begin
[145.9275] SKIN-LIGHTENING PRODUCTS PUBLIC AWARENESS AND
EDUCATION GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Grant program. new text end
new text begin
The commissioner of health shall award grants through
a request for proposal process to community-based organizations that serve ethnic
communities and focus on public health outreach to Black and people of color communities
on the issues of colorism, skin-lightening products, and chemical exposures from these
products. Priority in awarding grants shall be given to organizations that have historically
provided services to ethnic communities on the skin-lightening and chemical exposure issue
for the past four years.
new text end
new text begin Subd. 2. new text end
new text begin Uses of grant funds. new text end
new text begin
Grant recipients must use grant funds awarded under this
section to conduct public awareness and education 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 these 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 from 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 exposure.
new text end
Sec. 54.
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. 55.
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 must 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. 56.
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. 57.
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 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. Grants must be awarded to support community
nonprofit organizations, Tribal governments, and community health boards. In accordance
with available funding, grants must be noncompetitively awarded to the eleven 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
new text begin Subd. 3. new text end
new text begin Technical assistance. new text end
new text begin
(a) The commissioner must provide grant recipients
receiving a grant under sections 145.9572 to 145.9576 with content expertise, technical
expertise, training, and advice on data-driven strategies.
new text end
new text begin
(b) For the purposes of carrying out the grant program under section 145.9573, including
for administrative purposes, the commissioner must 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) partnership development and capacity building;
new text end
new text begin
(2) Tribal support;
new text end
new text begin
(3) implementation support for specific infant health strategies;
new text end
new text begin
(4) communications by convening and sharing lessons learned; and
new text end
new text begin
(5) health equity.
new text end
Sec. 58.
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) ensure children and families are referred to and linked 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 community-based
organizations, community health boards, and Tribal Nations 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 must also be awarded to community-based organizations to train and
utilize cultural liaisons to help families navigate the screening and follow-up process in a
culturally and linguistically responsive manner. 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. 59.
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 special 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 must
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 must 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 must 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. 60.
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
The advisory council shall be organized and
administered under section 15.059, except that the council shall not expire under subdivision
6. The commissioner of health must convene meetings at least quarterly and must provide
meeting space and administrative support to the 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
The advisory council must submit a report annually by January
15 to the chairs and ranking minority members of the legislative committees with primary
jurisdiction over health policy and finance summarizing the work of the council over the
previous year and setting goals for the following year.
new text end
Sec. 61.
new text begin
[145.988] COMPREHENSIVE AND COLLABORATIVE 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
Comprehensive and Collaborative Resource and Referral System for Children to support a
comprehensive, collaborative resource and referral system for children from 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. 62.
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 Health 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 will 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. 63.
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. 64.
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. 65.
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. 66.
Minnesota Statutes 2022, section 256B.0625, subdivision 49, is amended to read:
Subd. 49.
Community health worker.
(a) Medical assistance covers the care
coordination and patient education services provided by a community health worker if the
community health worker has received a certificate from the Minnesota State Colleges and
Universities System approved community health worker curriculum.
(b) Community health workers must work under the supervision of a medical assistance
enrolled physician, registered nurse, advanced practice registered nurse, physician assistant,
mental health professional, or dentist, or work under the supervision of a certified public
health nurse operating under the direct authority of an enrolled unit of government.
new text begin
(c) Effective January 1, 2026, community health workers who are eligible for payment
under this subdivision who are providing care coordination or patient education services in
an adult day care, respite care, or in-home care setting must complete a training program
in Alzheimer's disease and dementia care that has been developed or approved by the
commissioner of health, in accordance with section 144.6504, to remain eligible for payment.
new text end
deleted text begin (c)deleted text end new text begin (d)new text end Care coordination and patient education services covered under this subdivision
include, but are not limited to, services relating to oral health and dental care.
Sec. 67.
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, 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. 68.
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. 69.
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. 70.
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. 71.
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. 72.
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. 73.
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. 74.
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. 75.
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. 76.
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. 77.
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. 78.
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. 79.
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. 80.
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 deleted text begin healthdeleted text end 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. 81. 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. 82. 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 the their
life are honored.
new text end
new text begin
(e) "POLST form" means a portable medical form used to communicate a physician'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. 83.
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. 84. 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 develop recommendations for the performance of
green burials to prevent environmental harm, including contamination of groundwater and
surface water, and to protect the health of workers performing green burials, 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; and
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.
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. 85. 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, 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 must provide notice on the department's website
about the changes in the law. The commissioner or the commissioner's 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. 86. 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;
new text end
new text begin
(4) spiritual and faith-based support; and
new text end
new text begin
(5) 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. 87. new text begin EMPLOYEE SAFETY AND SECURITY 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 must establish a competitive
grant program for workplace safety grants for eligible health care entities to increase the
employee safety or security. Each grant award must be for at least $5,000, but no more than
$100,000.
new text end
new text begin Subd. 2. new text end
new text begin Eligible applicants. new text end
new text begin
A health care entity located in this state is eligible to apply
for a grant. For purposes of this section, a health care entity includes but is not limited to
the following: health care systems, long-term care facilities, hospitals, nursing facilities,
medical clinics, dental clinics, community health clinics, and ambulance services.
new text end
new text begin Subd. 3. new text end
new text begin Applications. new text end
new text begin
An entity seeking a grant under this section must apply to the
commissioner in a form and manner prescribed by the commissioner. The grant applicant,
in its application, must include:
new text end
new text begin
(1) a proposed plan for how the grant funds will be used to improve employee safety or
security;
new text end
new text begin
(2) a description of the achievable objectives the applicant plans to achieve through the
use of the grant funds; and
new text end
new text begin
(3) a process for documenting and evaluating the results achieved through the use of the
grant funds.
new text end
new text begin Subd. 4. new text end
new text begin Eligible uses. new text end
new text begin
Grant funds must be used for the following purposes:
new text end
new text begin
(1) training for employees on self-defense;
new text end
new text begin
(2) training for employees on de-escalation methods;
new text end
new text begin
(3) creating and implementing a health care-based violence intervention programs
(HBVI); or
new text end
new text begin
(4) technology system improvements designed to improve employee safety or security.
new text end
new text begin Subd. 5. new text end
new text begin Grant allocations. new text end
new text begin
For grants awarded prior to January 1, 2025, the
commissioner must ensure that approximately 60 percent of awards are to health care entities
in the seven-county metropolitan area and 40 percent are to health care entities outside of
the seven-county metropolitan area. If funds remain on January 1, 2025, the commissioner
may award grants to health care entities regardless of where the entity is located.
new text end
new text begin Subd. 6. new text end
new text begin Report. new text end
new text begin
By January 15, 2026, the commissioner of health must report to the
legislative committees with jurisdiction over health policy and finance on the grants awarded
by this section. The report must include the following information:
new text end
new text begin
(1) the name of each grantee, the amount awarded to the grantee, and how the grantee
used the funds; and
new text end
new text begin
(2) the percentage of awards made to entities outside of the seven-county metropolitan
area.
new text end
Sec. 88. 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 workgroups 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, 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. 89. new text begin RULEMAKING AUTHORITY.
new text end
new text begin
The commissioner of health must adopt rules using the expedited rulemaking process
under Minnesota Statutes, section 14.389, to implement the installation of submerged closed
loop heat exchanger systems according to Minnesota Statutes, sections 103I.209 and
103I.210. The rules must incorporate, and are limited to, the provisions in those sections.
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. 90. new text begin REPORT; CLOSED LOOP HEAT EXCHANGER SYSTEM.
new text end
new text begin
By December 31, 2024, the commissioner of health must submit a report to the chairs
and ranking minority members of the legislative committees with jurisdiction over health
finance and policy. The report must include a recommendation on whether additional
requirements are necessary to ensure that the construction and operation of submerged
closed loop heat exchangers do not create the risk of material adverse impacts on the state's
groundwater caused by the chemical or biological composition of the circulating fluids by
operation of the well as part of the submerged closed loop heat exchanger. Unless specifically
authorized by subsequent act of the legislature, the commissioner must not adopt any rules
or requirements to implement the recommendations included in the report.
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. 91. 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 to them.
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 commissioner shall identify up to ten systems for which report submission
is required, and this requirement shall be included in the permit conditions. The information
shall be provided to the commissioner on a semiannual basis and the final semiannual
submission shall include information from the period from January 1, 2024, through July
1, 2024.
new text end
new text begin Subd. 4. new text end
new text begin Report requirements. new text end
new text begin
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 September 30, 2024. 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) date of the report;
new text end
new text begin
(2) a narrative description of system installation, operation, and status, including dates;
new text end
new text begin
(3) mean monthly temperature of the water entering the building;
new text end
new text begin
(4) mean monthly temperature of the water leaving the building;
new text end
new text begin
(5) 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
(6) 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, 2024.
new text end
Sec. 92. new text begin REPEALER.
new text end
new text begin
(a)
new text end
new text begin
Minnesota Statutes 2022, section 144.059, subdivision 10,
new text end
new text begin
is repealed.
new text end
new text begin
(b)
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.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
Paragraph (b) is effective July 1, 2024.
new text end
ARTICLE 5
MEDICAL EDUCATION AND RESEARCH COSTS
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.
(c) "Commissioner" means 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 settings 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 entities; deleted text begin and
deleted text end
new text begin
(3) includes training hours in settings outside of the hospital or clinic site, as applicable,
including but not limited to school, home, and community settings; and
new text end
deleted text begin (3)deleted text end new text begin (4)new text end 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 cost 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
(c) Funds distributed shall not be used to displace current funding appropriations from
federal or state sources.
(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 deleted text begin pediatricdeleted text end 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 144.1501, subdivision 3, is amended to read:
Subd. 3.
Eligibility.
(a) To be eligible to participate in the loan forgiveness program, an
individual must:
(1) be a medical or dental resident; new text begin be new text end a licensed pharmacist; or be enrolled in a training
or education program new text begin or obtaining required supervision hours new text end to become a dentist, dental
therapist, advanced dental therapist, mental health professional, alcohol and drug counselor,
pharmacist, public health nurse, midlevel practitioner, registered nurse, or a licensed practical
nurse. The commissioner may also consider applications submitted by graduates in eligible
professions who are licensed and in practice; and
(2) submit an application to the commissioner of health.
(b) An applicant selected to participate must sign a contract to agree to serve a minimum
three-year full-time service obligation according to subdivision 2, which shall begin no later
than March 31 following completion of required training, with the exception of a nurse,
who must agree to serve a minimum two-year full-time service obligation according to
subdivision 2, which shall begin no later than March 31 following completion of required
training.
Sec. 8.
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. 9.
new text begin
[144.1507] 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 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 shall 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. 10.
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. 11.
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 education, access, and workforce
goals.
new text end
new text begin
(b) The commissioner shall periodically evaluate the priorities in awarding innovations
grants under this section to ensure that the priorities meet the changing workforce needs of
the state.
new text end
Sec. 12.
new text begin
[144.88] MENTAL HEALTH AND SUBSTANCE USE DISORDER
EDUCATION CENTER.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The Mental Health and Substance Use Disorder Education
Center is established in the Department of Health. The purpose of the center is to increase
the number of professionals, practitioners, and peers working in mental health and substance
use disorder treatment; increase the diversity of professionals, practitioners, and peers
working in mental health and substance use disorder treatment; and facilitate a culturally
informed and responsive mental health and substance use disorder treatment workforce.
new text end
new text begin Subd. 2. new text end
new text begin Activities. new text end
new text begin
The Mental Health and Substance Use Disorder Education Center
must:
new text end
new text begin
(1) analyze the geographic and demographic availability of licensed professionals in the
field, identify gaps, and prioritize the need for additional licensed professionals by type,
location, and demographics;
new text end
new text begin
(2) create a program that exposes high school and college students to careers in the
mental health and substance use disorder treatment field;
new text end
new text begin
(3) create a website for individuals considering becoming a mental health provider that
clearly labels the steps necessary to achieve licensure and certification in the various mental
health fields and lists resources and links for more information;
new text end
new text begin
(4) create a job board for organizations seeking employees to provide mental health and
substance use disorder treatment, services, and supports;
new text end
new text begin
(5) track the number of students at the college and graduate level who are graduating
from programs that could facilitate a career as a mental health or substance use disorder
treatment practitioner or professional and work with the colleges and universities to support
the students in obtaining licensure;
new text end
new text begin
(6) identify barriers to licensure and make recommendations to address the barriers;
new text end
new text begin
(7) establish learning collaborative partnerships with mental health and substance use
disorder treatment providers, schools, criminal justice agencies, and others;
new text end
new text begin
(8) promote and expand loan forgiveness programs, funding for professionals to become
supervisors, funding to pay for supervision, and funding for pathways to licensure;
new text end
new text begin
(9) identify barriers to using loan forgiveness programs and develop recommendations
to address the barriers;
new text end
new text begin
(10) work to expand Medicaid graduate medical education to other mental health
professionals;
new text end
new text begin
(11) identify current sites for internships and practicums and assess the need for additional
sites;
new text end
new text begin
(12) develop training for other health care professionals to increase their knowledge
about mental health and substance use disorder treatment, including but not limited to
community health workers, pediatricians, primary care physicians, physician assistants, and
nurses; and
new text end
new text begin
(13) support training for integrated mental health and primary care in rural areas.
new text end
new text begin Subd. 3. new text end
new text begin Reports. new text end
new text begin
Beginning January 1, 2024, the commissioner of health shall submit
an annual report to the chairs and ranking minority members of the legislative committees
with jurisdiction over health finance and policy summarizing the center's activities and
progress in addressing the mental health and substance use disorder treatment workforce
shortage.
new text end
Sec. 13.
new text begin
[145.9272] FEDERALLY QUALIFIED HEALTH CENTERS
APPRENTICESHIP PROGRAM.
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) "Federally qualified health center" has the meaning given in section 145.9269,
subdivision 1.
new text end
new text begin
(c) "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 Subd. 2. new text end
new text begin Apprenticeship program. new text end
new text begin
The commissioner of health shall distribute a grant
to a nonprofit organization of community health centers for an apprenticeship program in
federally qualified health centers operating in Minnesota. Grant money must be used to
establish and fund ongoing costs for apprenticeship programs for medical assistants and
dental assistants at federally qualified health center service delivery sites in Minnesota. An
apprenticeship program funded under this section must be a 12-month program led by
certified medical assistants and licensed dental assistants. Trainees for an apprenticeship
program 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. 14.
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 for interns and clinical trainees, in an amount up
to $7,500 per intern or clinical trainee;
(2) to establish a program to provide supervision to multiple interns 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. 15.
new text begin
[245.4664] MENTAL HEALTH PROFESSIONAL SCHOLARSHIP 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) "Mental health professional" means an individual with a qualification specified in
section 245I.04, subdivision 2.
new text end
new text begin
(c) "Underrepresented community" has the meaning given in section 148E.010,
subdivision 20.
new text end
new text begin Subd. 2. new text end
new text begin Grant program established. new text end
new text begin
The mental health professional scholarship
program is established in the Department of Human Services to assist mental health providers
in funding employee scholarships for master's degree-level education programs in order to
create a pathway to becoming a mental health professional.
new text end
new text begin Subd. 3. new text end
new text begin Provision of grants. new text end
new text begin
The commissioner of human services shall award grants
to licensed or certified mental health providers who meet the criteria in subdivision 4 to
provide tuition reimbursement for master's degree-level programs and certain related costs
for individuals who have worked for the mental health provider for at least the past two
years in one or more of the following roles:
new text end
new text begin
(1) a mental health behavioral aide who meets a qualification in section 245I.04,
subdivision 16;
new text end
new text begin
(2) a mental health certified family peer specialist who meets the qualifications in section
245I.04, subdivision 12;
new text end
new text begin
(3) a mental health certified peer specialist who meets the qualifications in section
245I.04, subdivision 10;
new text end
new text begin
(4) a mental health practitioner who meets a qualification in section 245I.04, subdivision
4;
new text end
new text begin
(5) a mental health rehabilitation worker who meets the qualifications in section 245I.04,
subdivision 14;
new text end
new text begin
(6) an individual employed in a role in which the individual provides face-to-face client
services at a mental health center or certified community behavioral health center; or
new text end
new text begin
(7) a staff person who provides care or services to residents of a residential treatment
facility.
new text end
new text begin Subd. 4. new text end
new text begin Eligibility. new text end
new text begin
In order to be eligible for a grant under this section, a mental health
provider must:
new text end
new text begin
(1) primarily provide at least 25 percent of the provider'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 51c.303; or
new text end
new text begin
(2) primarily serve people from communities of color or underrepresented communities.
new text end
new text begin Subd. 5. new text end
new text begin Request for proposals. new text end
new text begin
The commissioner must publish a request for proposals
in the State Register specifying provider eligibility requirements, criteria for a qualifying
employee scholarship program, provider selection criteria, documentation required for
program participation, the maximum award amount, and methods of evaluation. The
commissioner must publish additional requests for proposals each year in which funding is
available for this purpose.
new text end
new text begin Subd. 6. new text end
new text begin Application requirements. new text end
new text begin
An eligible provider seeking a grant under this
section must submit an application to the commissioner. An application must contain a
complete description of the employee scholarship program being proposed by the applicant,
including the need for the mental health provider to enhance the education of its workforce,
the process the mental health provider will use to determine which employees will be eligible
for scholarships, any other money sources for scholarships, the amount of money sought
for the scholarship program, a proposed budget detailing how money will be spent, and
plans to retain eligible employees after completion of the education program.
new text end
new text begin Subd. 7. new text end
new text begin Selection process. new text end
new text begin
The commissioner shall determine a maximum award amount
for grants and shall select grant recipients based on the information provided in the grant
application, including the demonstrated need for the applicant provider to enhance the
education of its workforce, the proposed process to select employees for scholarships, the
applicant's proposed budget, and other criteria as determined by the commissioner. The
commissioner shall give preference to grant applicants who work in rural or culturally
specific organizations.
new text end
new text begin Subd. 8. new text end
new text begin Grant agreements. new text end
new text begin
Notwithstanding any law or rule to the contrary, grant
money awarded to a grant recipient in a grant agreement does not lapse until the grant
agreement expires.
new text end
new text begin Subd. 9. new text end
new text begin Allowable uses of grant money. new text end
new text begin
A mental health provider receiving a grant
under this section must use the grant money for one or more of the following:
new text end
new text begin
(1) to provide employees with tuition reimbursement for a master's degree-level program
in a discipline that will allow the employee to qualify as a mental health professional; or
new text end
new text begin
(2) for resources and supports, such as child care and transportation, that allow an
employee to attend a master's degree-level program specified in clause (1).
new text end
new text begin Subd. 10. new text end
new text begin Reporting requirements. new text end
new text begin
A mental health provider receiving a grant under
this section must submit an invoice for reimbursement and a report to the commissioner on
a schedule determined by the commissioner and using a form supplied by the commissioner.
The report must include the amount spent on scholarships; the number of employees who
received scholarships; and, for each scholarship recipient, the recipient's name, current
position, amount awarded, educational institution attended, name of the educational program,
and expected or actual program completion date.
new text end
Sec. 16.
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 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.
(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
(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. 17.
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. 18.
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. 19. 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 LICENSING BOARDS
Section 1.
Minnesota Statutes 2022, section 144E.001, subdivision 1, is amended to read:
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.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 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. 4.
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 on a
contract basis to the two medical resource communication centers that were in operation in
the state prior to January 1, 2000.
new text end
Sec. 5.
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. 6.
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. 7.
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. 8.
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. 9.
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. 10.
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. 11.
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. 12.
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. 13.
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. 14.
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. 15.
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. 16.
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.
(c) "Distribute" means to deliver, other than by administering or dispensing.
(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.
(c) The central repository shall be subject to inspection by the board pursuant to section
151.06, subdivision 1.
(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. 17.
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. 18.
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. 19.
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.
(c) A dispenser is not required to submit this data for those controlled substance
prescriptions dispensed for:
(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. 20.
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. 21.
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. 22.
Minnesota Statutes 2022, section 152.126, subdivision 9, is amended to read:
Subd. 9.
Immunity from liabilitydeleted text begin ; no requirement to obtain informationdeleted text end .
(a) A
pharmacist, prescriber, or other dispenser making a report to the program in good faith under
this section is immune from any civil, criminal, or administrative liability, which might
otherwise be incurred or imposed as a result of the reportdeleted text begin , or on the basis that the pharmacist
or prescriber did or did not seek or obtain or use information from the programdeleted text end .
(b) new text begin Except as required by subdivision 6, paragraph (d), new text end nothing in this section shall
require a pharmacist, prescriber, or other dispenser to obtain information about a patient
from the program, and the pharmacist, prescriber, or other dispenser, if acting in good faith,
is immune from any civil, criminal, or administrative liability that might otherwise be
incurred or imposed for requesting, receiving, or using information from the program.
Sec. 23. new text begin LICENSED TRADITIONAL MIDWIVES; AUTHORITY TO PURCHASE
CERTAIN DRUGS.
new text end
new text begin
By November 15, 2023, the Minnesota Board of Medical Practice, in consultation with
the Advisory Council on Licensed Traditional Midwifery, must:
new text end
new text begin
(1) issue an administrative order to allow licensed traditional midwives to purchase
drugs listed in Minnesota Statutes, section 147D.09, paragraph (b); or
new text end
new text begin
(2) make recommendations to the chairs and ranking minority members of the legislative
committees with jurisdiction on health finance and policy on how to amend Minnesota
Statutes, section 147D.09, or other statutes to allow licensed traditional midwives to purchase
drugs listed in Minnesota Statutes, section 147D.09, paragraph (b).
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 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. 11f. 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.
(c) This subdivision applies to the following programs that must be licensed under
chapter 245A:
(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;
(12) independent living assistance for youth;
(13) detoxification programs;
(14) community residential settings; deleted text begin and
deleted text end
(15) intensive residential treatment services and residential crisis stabilization under
chapter 245Inew text begin ; and
new text end
new text begin (16) 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 9515.3110new 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
9.
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.
(c) All terms in this section shall have the definitions provided in section 245C.02.
(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
9.
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; and
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 9.
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,
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. The commissioner shall verify the information received
under this paragraph 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 number; 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
(c) The background study subject must also be informed that:
(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).
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.
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.
Sec. 14.
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. 15.
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.
Sec. 16.
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. 17.
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. 18.
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. 19.
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. 20.
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. 21.
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. 22.
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. 23.
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. 24.
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. 25.
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. 26.
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. 27.
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. 28.
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.033new 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
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 courtdeleted text end new text begin must be
paid directly to the commissioner and in the manner prescribed by the commissioner before
any maltreatment and state licensing agency checks under section 245C.033 may be
conductednew text end .
Sec. 29.
Minnesota Statutes 2022, section 245C.10, subdivision 16, is amended to read:
Subd. 16.
Providers of housing support services.
The commissioner shall recover the
cost of background studies initiated by providers of housing support 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. 30.
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. 31.
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. 32.
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. 33.
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. 34.
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. 35.
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
deleted text begin (i)deleted text end of the reason for the individual's disqualification;new text begin and
new text end
deleted text begin
(ii) that the individual's disqualification is set aside for that program or agency; and
deleted text end
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.
Sec. 36.
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
(i) obtain from the disqualified individual a copy of the individual's notice of
disqualification from the commissioner that explains the reason for disqualification; and
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.
Sec. 37.
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. 38.
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.
Sec. 39.
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.
Sec. 40.
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
(c) The identity of a disqualified individual and the reason for disqualification remain
private data when:
(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.
Sec. 41.
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
Sec. 42.
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. 43.
Minnesota Statutes 2022, section 245C.24, subdivision 2, is amended to read:
Subd. 2.
Permanent bar to set aside a disqualification.
(a) Except as provided in
paragraphs (b) to deleted text begin (f)deleted text end new text begin (g)new text end , the commissioner may not set aside the disqualification of any
individual disqualified pursuant to this chapter, regardless of how much time has passed,
if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
1.
(b) For an individual in the substance use disorder or corrections field who was
disqualified for a crime or conduct listed under section 245C.15, subdivision 1, and whose
disqualification was set aside prior to July 1, 2005, the commissioner must consider granting
a variance pursuant to section 245C.30 for the license holder for a program dealing primarily
with adults. A request for reconsideration evaluated under this paragraph must include a
letter of recommendation from the license holder that was subject to the prior set-aside
decision addressing the individual's quality of care to children or vulnerable adults and the
circumstances of the individual's departure from that service.
(c) If an individual who requires a background study for nonemergency medical
transportation services under section 245C.03, subdivision 12, was disqualified for a crime
or conduct listed under section 245C.15, subdivision 1, and if more than 40 years have
passed since the discharge of the sentence imposed, the commissioner may consider granting
a set-aside pursuant to section 245C.22. A request for reconsideration evaluated under this
paragraph must include a letter of recommendation from the employer. This paragraph does
not apply to a person disqualified based on a violation of sections 243.166; 609.185 to
609.205; 609.25; 609.342 to 609.3453; 609.352; 617.23, subdivision 2, clause (1), or 3,
clause (1); 617.246; or 617.247.
(d) When a licensed foster care provider adopts an individual who had received foster
care services from the provider for over six months, and the adopted individual is required
to receive a background study under section 245C.03, subdivision 1, paragraph (a), clause
(2) or (6), the commissioner may grant a variance to the license holder under section 245C.30
to permit the adopted individual with a permanent disqualification to remain affiliated with
the license holder under the conditions of the variance when the variance is recommended
by the county of responsibility for each of the remaining individuals in placement in the
home and the licensing agency for the home.
(e) For an individual 18 years of age or older affiliated with a licensed family foster
setting, the commissioner must not set aside or grant a variance for the disqualification of
any individual disqualified pursuant to this chapter, regardless of how much time has passed,
if the individual was disqualified for a crime or conduct listed in section 245C.15, subdivision
4a, paragraphs (a) and (b).
(f) In connection with a family foster setting license, the commissioner may grant a
variance to the disqualification for an individual who is under 18 years of age at the time
the background study is submitted.
new text begin
(g) The commissioner may set aside or grant a variance for any disqualification that is
based on conduct or a conviction in an individual's juvenile record.
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
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 study, 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 services todeleted text end new text begin Bureau
of Criminal Apprehensionnew text end 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 EFFECTIVE DATE. new text end
new text begin
Paragraph (a) is effective August 1, 2023, and paragraph (b) is
effective April 28, 2025.
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 under section 245.095, subdivision 4;
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 an entity that has a relationship with
an excluded provider or vendor, its owners, or controlling individuals, such that the individual
or entity would have knowledge of the excluded provider or vendor's business practices,
including but not limited to financial practices.
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, must
state with specificity the reasons the payment withhold is in error, and must include
documentation to support the request. Within 60 days from receipt of the request, the
commissioner must judiciously review allegations, facts, evidence available to the
commissioner as well as information submitted by the provider, vendor, individual, associated
individual, or associated entity to determine whether the payment withhold should remain
in place. The commissioner's decision on reconsideration regarding the payment withhold
is a final decision.
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.
new text begin
[245.7351] PURPOSE AND ESTABLISHMENT.
new text end
new text begin
The certified community behavioral health clinic model is an integrated payment and
service delivery model that uses evidence-based behavioral health practices to achieve better
outcomes for individuals experiencing behavioral health concerns while achieving sustainable
rates for providers and economic efficiencies for payors.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 4.
new text begin
[245.7352] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Scope. new text end
new text begin
The definitions in this section apply to sections 245.7351 to
245.7357.
new text end
new text begin Subd. 2. new text end
new text begin Care coordination. new text end
new text begin
"Care coordination" means the activities required to
coordinate care across settings and providers for the people served to ensure seamless
transitions across the full spectrum of health services. Care coordination includes: outreach
and engagement; documenting a plan of care for medical, behavioral health, and social
services and supports in the integrated treatment plan; assisting with obtaining appointments;
confirming appointments are kept; developing a crisis plan; tracking medication; and
implementing care coordination agreements with external providers. Care coordination may
include psychiatric consultation to primary care practitioners and mental health clinical care
consultation.
new text end
new text begin Subd. 3. new text end
new text begin Certified community behavioral health clinic or CCBHC. new text end
new text begin
"Certified
community behavioral health clinic" or "CCBHC" means a program or provider governed
under sections 245.7351 to 245.7357.
new text end
new text begin Subd. 4. new text end
new text begin Clinical responsibility. new text end
new text begin
"Clinical responsibility" means ensuring a designated
collaborating organization meets all clinical parameters required of the CCBHC.
new text end
new text begin Subd. 5. new text end
new text begin Commissioner. new text end
new text begin
"Commissioner" means the commissioner of human services.
new text end
new text begin Subd. 6. new text end
new text begin Comprehensive evaluation. new text end
new text begin
"Comprehensive evaluation" means a
person-centered, family-centered, trauma-informed evaluation completed for the purposes
of diagnosis, treatment planning, and determination of client eligibility for services approved
by a mental health professional.
new text end
new text begin Subd. 7. new text end
new text begin Designated collaborating organization. new text end
new text begin
"Designated collaborating
organization" means an entity with a formal agreement with a CCBHC to furnish CCBHC
services.
new text end
new text begin Subd. 8. new text end
new text begin Designated collaborating organization agreement. new text end
new text begin
"Designated collaborating
organization agreement" means a purchase of services agreement between a CCBHC and
a designated collaborating organization as evidenced by a contract, memorandum of
agreement, memorandum of understanding, or other such formal arrangement that describes
specific CCBHC services to be purchased and provided by a designated collaborating
organization on behalf of a CCBHC in accordance with federal and state requirements.
new text end
new text begin Subd. 9. new text end
new text begin Functional assessment. new text end
new text begin
"Functional assessment" means the assessment of a
client's current level of functioning relative to functioning that is appropriate for someone
the client's age.
new text end
new text begin Subd. 10. new text end
new text begin Financial responsibility. new text end
new text begin
"Financial responsibility" means the responsibility
for billing CCBHC services rendered under contract by a designated collaborating
organization.
new text end
new text begin Subd. 11. new text end
new text begin Initial evaluation. new text end
new text begin
"Initial evaluation" means an evaluation that is designed
to gather and document initial components of the comprehensive evaluation, allowing the
assessor to formulate a preliminary diagnosis and the client to begin services.
new text end
new text begin Subd. 12. new text end
new text begin Initial evaluation equivalents. new text end
new text begin
"Initial evaluation equivalents" means using
a process that is approved by the commissioner as an alternative to the initial evaluation.
new text end
new text begin Subd. 13. new text end
new text begin Integrated treatment plan. new text end
new text begin
"Integrated treatment plan" means a documented
plan of care that is person- and family-centered and formulated to respond to a client's needs
and goals. The integrated treatment plan must integrate prevention, medical needs, and
behavioral health needs and service delivery. The CCBHC must develop the integrated
treatment plan in collaboration with and receive endorsement from the client, the adult
client's family to the extent the client wishes and a child or youth client's family or caregivers,
and coordinate with staff or programs necessary to carry out the plan.
new text end
new text begin Subd. 14. new text end
new text begin Outpatient withdrawal management. new text end
new text begin
"Outpatient withdrawal management"
means a time-limited service delivered in an office setting, an outpatient behavioral health
clinic, or a person's home by staff providing medically supervised evaluation and
detoxification services to achieve safe and comfortable withdrawal from substances and
facilitate transition into ongoing treatment and recovery. Outpatient withdrawal management
services include assessment, withdrawal management, planning, medication prescribing
and management, trained observation of withdrawal symptoms, and supportive services.
new text end
new text begin Subd. 15. new text end
new text begin Preliminary screening and risk assessment. new text end
new text begin
"Preliminary screening and risk
assessment" means a screening and risk assessment that is completed at the first contact
with the prospective CCBHC service recipient and determines the acuity of recipient need.
new text end
new text begin Subd. 16. new text end
new text begin Preliminary treatment plan. new text end
new text begin
"Preliminary treatment plan" means an initial
plan of care that is written as a part of all initial evaluations, initial evaluation equivalents,
or comprehensive evaluations.
new text end
new text begin Subd. 17. new text end
new text begin Needs assessment. new text end
new text begin
"Needs assessment" means a systematic approach to
identifying community needs and determining program capacity to address the needs of the
population being served.
new text end
new text begin Subd. 18. new text end
new text begin State-sanctioned crisis services. new text end
new text begin
"State-sanctioned crisis services" means
adult and children's crisis response services conducted by an entity enrolled to provide crisis
services under section 256B.0624.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 5.
new text begin
[245.7353] APPLICABILITY.
new text end
new text begin Subdivision 1. new text end
new text begin Certification process. new text end
new text begin
(a) The commissioner must establish state
certification and recertification processes for certified community behavioral health clinics
that satisfy all federal and state requirements necessary for CCBHCs certified under sections
245.7351 to 245.7357 to be eligible for reimbursement under medical assistance, without
service area limits based on geographic area or region. The commissioner must consult with
CCBHC stakeholders before establishing and implementing changes in the certification or
recertification process and requirements.
new text end
new text begin
(b) The commissioner shall recertify a CCBHC provider entity every 36 months using
the provider entity's certification anniversary or December 31. The commissioner may
approve a recertification extension in the interest of sustaining services when a specific date
for recertification is identified.
new text end
new text begin
(c) The commissioner shall establish a process for decertification of a CCBHC provider
entity and shall require corrective action, medical assistance repayment, or decertification
of a provider entity that no longer meets the requirements in sections 245.7351 to 245.7357
or that fails to meet the clinical quality standards or administrative standards provided by
the commissioner in the application and certification processes.
new text end
new text begin
(d) The commissioner shall provide the following to CCBHC provider entities for the
certification, recertification, and decertification processes:
new text end
new text begin
(1) a structured listing of required provider entity certification criteria;
new text end
new text begin
(2) a formal written letter with a determination of certification, recertification, or
decertification, signed by the commissioner or the appropriate division director; and
new text end
new text begin
(3) a formal written communication outlining the process for necessary corrective action
and follow-up by the commissioner, if applicable, signed by the commissioner or the
appropriate division director.
new text end
new text begin Subd. 2. new text end
new text begin Certifications and licensures required. new text end
new text begin
In addition to all other requirements
contained in sections 245.7351 to 245.7357, a CCBHC must:
new text end
new text begin
(1) comply with the standards issued by the commissioner relating to CCBHC screenings,
assessments, and evaluations;
new text end
new text begin
(2) be certified as a mental health clinic under section 245I.20;
new text end
new text begin
(3) be licensed to provide substance use disorder treatment under chapter 245G;
new text end
new text begin
(4) be certified to provide children's therapeutic services and supports under section
256B.0943;
new text end
new text begin
(5) be certified to provide adult rehabilitative mental health services under section
256B.0623;
new text end
new text begin
(6) be enrolled to provide mental health crisis response services under section 256B.0624;
new text end
new text begin
(7) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;
new text end
new text begin
(8) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926;
new text end
new text begin
(9) comply with standards relating to peer services under sections 256B.0615, 256B.0616,
and 245G.07, subdivision 2, clause (8), as applicable when peer services are provided; and
new text end
new text begin
(10) directly employ, or through a formal arrangement utilize, a medically trained
behavioral health care provider with independent authority under state law to prescribe and
manage medications, including buprenorphine and other medications used to treat opioid
and alcohol use disorders.
new text end
new text begin Subd. 3. new text end
new text begin Variance authority. new text end
new text begin
When the standards listed in sections 245.7351 to 245.7357
or other applicable standards conflict or address similar issues in duplicative or incompatible
ways, the commissioner may grant variances to state requirements if the variances do not
conflict with federal requirements for services reimbursed under medical assistance. If
standards overlap, the commissioner may substitute all or a part of a licensure or certification
that is substantially the same as another licensure or certification. The commissioner must
consult with stakeholders as described in subdivision 1 before granting variances under this
subdivision. For the CCBHC that is certified but not approved for prospective payment
under section 256B.0625, subdivision 5m, the commissioner may grant a variance under
this paragraph if the variance does not increase the state share of costs.
new text end
new text begin Subd. 4. new text end
new text begin Notice and opportunity for correction. new text end
new text begin
If the commissioner finds that a
prospective or certified CCBHC has failed to comply with an applicable law or rule and
this failure does not imminently endanger health, safety, or rights of the persons served by
the program, the commissioner may issue a notice ordering a correction. The notice ordering
a correction must state the following in plain language:
new text end
new text begin
(1) the conditions that constitute a violation of the law or rule;
new text end
new text begin
(2) the specific law or rule violated; and
new text end
new text begin
(3) the time allowed to correct each violation.
new text end
new text begin Subd. 5. new text end
new text begin County letter of support. new text end
new text begin
A clinic that meets certification requirements for a
CCBHC under sections 245.7351 to 245.7357 is not subject to any state law or rule that
requires a county contract or other form of county approval as a condition for licensure or
enrollment as a medical assistance provider. The commissioner must require evidence from
the CCBHC that it has an ongoing relationship with the county or counties it serves to
facilitate access and continuity of care, especially for individuals who are uninsured or who
may go on and off medical assistance.
new text end
new text begin Subd. 6. new text end
new text begin Decertification, denial of certification, or recertification request. new text end
new text begin
(a) The
commissioner must establish a process for decertification and must require corrective action,
medical assistance repayment, or decertification of a CCBHC that no longer meets the
requirements in this section.
new text end
new text begin
(b) The commissioner must provide the following to providers for the certification,
recertification, and decertification process:
new text end
new text begin
(1) a structured listing of required provider certification criteria;
new text end
new text begin
(2) a formal written letter with a determination of certification, recertification, or
decertification, signed by the commissioner or the appropriate division director; and
new text end
new text begin
(3) a formal written communication outlining the process for necessary corrective action
and follow-up by the commissioner if applicable.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 6.
new text begin
[245.7354] MINIMUM STAFFING STANDARDS.
new text end
new text begin
(a) A CCBHC must meet minimum staffing requirements as identified in the certification
process.
new text end
new text begin
(b) A CCBHC must employ or contract for clinic staff who have backgrounds in diverse
disciplines, including licensed mental health professionals, licensed alcohol and drug
counselors, staff who are culturally and linguistically trained to meet the needs of the
population the clinic serves, and staff who are trained to make accommodations to meet the
needs of clients with disabilities.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 7.
new text begin
[245.7355] REQUIRED SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Generally. new text end
new text begin
CCBHCs must provide nine core services identified in
subdivisions 2 and 3.
new text end
new text begin Subd. 2. new text end
new text begin Required services to be provided directly. new text end
new text begin
Unless otherwise specified in
sections 245.7351 to 245.7357 and approved by the commissioner, a CCBHC must directly
provide the following:
new text end
new text begin
(1) ambulatory withdrawal management services ASAM level 1.0;
new text end
new text begin
(2) treatment planning;
new text end
new text begin
(3) screening, assessment, diagnosis, and risk assessment;
new text end
new text begin
(4) outpatient mental health treatment; and
new text end
new text begin
(5) substance use disorder treatment services for both adult and adolescent populations.
new text end
new text begin Subd. 3. new text end
new text begin Direct or contracted required services. new text end
new text begin
A CCBHC must provide the following
services directly or via formal relationships with designated collaborating organizations:
new text end
new text begin
(1) targeted case management;
new text end
new text begin
(2) outpatient primary care screening and monitoring;
new text end
new text begin
(3) community-based mental health care for veterans;
new text end
new text begin
(4) peer, family support, and counselor services;
new text end
new text begin
(5) psychiatric rehabilitation services; and
new text end
new text begin
(6) crisis services conducted by a state-sanctioned provider.
new text end
new text begin Subd. 4. new text end
new text begin Care coordination required. new text end
new text begin
A CCBHC must directly provide coordination
of care across settings and providers to ensure seamless transitions for individuals being
served across the full spectrum of health services, including acute, chronic, and behavioral
needs.
new text end
new text begin Subd. 5. new text end
new text begin Outreach and engagement required. new text end
new text begin
A CCBHC must provide outreach and
engagement services to the community, including promoting accessibility and culturally
and linguistically competent care, educating prospective CCBHC recipients about available
services, and connecting prospective CCBHC recipients with needed services.
new text end
new text begin Subd. 6. new text end
new text begin Initial evaluation; required elements. new text end
new text begin
(a) An initial evaluation must be
completed by a mental health professional or clinical trainee and must contain all data
elements listed in the commissioner's public clinical guidance.
new text end
new text begin
(b) The timing of initial evaluation administration must be determined based on results
of the preliminary screening and risk assessment. If a client is assessed to be experiencing
a crisis-level behavioral health need, care must follow the timelines established in the
CCBHC certification criteria published by the Substance Abuse and Mental Health Services
Administration and the commissioner's published clinical guidance.
new text end
new text begin
(c) Initial evaluation equivalents, as defined by the commissioner, may be completed to
satisfy the requirement for the initial evaluation under this subdivision.
new text end
new text begin
(d) The initial evaluation must include the following components:
new text end
new text begin
(e) For programs governed by sections 245.7351 to 245.7357, the CCBHC initial
evaluation requirements in this subdivision satisfy the requirements for:
new text end
new text begin
(1) a brief diagnostic assessment under section 245I.10, subdivision 5;
new text end
new text begin
(2) an individual family assessment summary under section 245.4881, subdivisions 3
and 4;
new text end
new text begin
(3) an individual assessment summary under section 245.4711, subdivisions 3 and 4;
new text end
new text begin
(4) a diagnostic assessment under Minnesota Rules, part 9520.0909, subpart 1;
new text end
new text begin
(5) a local agency determination based on a diagnostic assessment under Minnesota
Rules, part 9520.0910, subpart 1;
new text end
new text begin
(6) an individual family community support plan and an individual community support
plan under Minnesota Rules, part 9520.0914, subpart 2, items A and B;
new text end
new text begin
(7) an individual family community support plan under Minnesota Rules, part 9520.0918,
subparts 1 and 2; and
new text end
new text begin
(8) an individual community support plan under Minnesota Rules, part 9520.0919,
subparts 1 and 2.
new text end
new text begin Subd. 7. new text end
new text begin Comprehensive evaluation; required elements. new text end
new text begin
(a) All new CCBHC clients
must receive a comprehensive person-centered and family-centered diagnostic and treatment
planning evaluation to be completed within 60 calendar days following the preliminary
screening and risk assessment.
new text end
new text begin
(b) The comprehensive evaluation must be completed by a mental health professional
or clinical trainee and must contain all data elements listed in the commissioner's public
clinical guidance.
new text end
new text begin
(c) When a CCBHC client is engaged in substance use disorder services provided by
the CCBHC, the comprehensive evaluation must also be approved by an alcohol and drug
counselor.
new text end
new text begin
(d) A CCBHC comprehensive evaluation completed according to the standards in
subdivision 7 replaces the requirements for a comprehensive assessment in chapter 245G,
if the comprehensive evaluation includes a diagnosis of a substance use disorder or a finding
that the client does not meet the criteria for a substance use disorder.
new text end
new text begin
(e) A comprehensive evaluation must be updated at least annually for all adult clients
who continue to engage in behavioral health services, and:
new text end
new text begin
(1) when the client's presentation does not appear to align with the current diagnostic
formulation; or
new text end
new text begin
(2) when the client or mental health professional suspect the emergence of a new
diagnosis.
new text end
new text begin
(f) A comprehensive evaluation update must contain the following components:
new text end
new text begin
(1) a written update detailing all significant new or changed mental health symptoms,
as well as a description of how the new or changed symptoms are impacting functioning;
new text end
new text begin
(2) any diagnostic formulation updates, including rationale for new diagnoses as needed;
and
new text end
new text begin
(3) a rationale for removal of any existing diagnoses, as needed.
new text end
new text begin
(g) When completing a comprehensive evaluation 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. The comprehensive evaluation of children age five years and younger:
new text end
new text begin
(1) must include an initial session without the client present and may include treatment
to the parents or guardians along with inquiring about the child;
new text end
new text begin
(2) may consist of three to five separate encounters;
new text end
new text begin
(3) must incorporate the level of care assessment;
new text end
new text begin
(4) must be completed prior to recommending additional CCBHC services; and
new text end
new text begin
(5) must not contain scoring of the American Society of Addiction Medicine six
dimensions.
new text end
new text begin
(h) For programs governed by sections 245.7351 to 245.7357, the CCBHC comprehensive
evaluation requirements in this subdivision satisfy the requirements for:
new text end
new text begin
(1) a diagnostic assessment or crisis assessment under section 245I.10, subdivision 2,
paragraph (a);
new text end
new text begin
(2) a diagnostic assessment under section 245I.10, subdivisions 4 to 6;
new text end
new text begin
(3) an initial services plan under section 245G.04, subdivision 1;
new text end
new text begin
(4) a diagnostic assessment under section 245.4711, subdivision 2;
new text end
new text begin
(5) a diagnostic assessment under section 245.4881, subdivision 2;
new text end
new text begin
(6) a diagnostic assessment under Minnesota Rules, part 9520.0910, subpart 1;
new text end
new text begin
(7) a diagnostic assessment under Minnesota Rules, part 9520.0909, subpart 1; and
new text end
new text begin
(8) an individual family community support plan and an individual community support
plan under Minnesota Rules, part 9520.0914, subpart 2, items A and B.
new text end
new text begin Subd. 8. new text end
new text begin Integrated treatment plan; required elements. new text end
new text begin
(a) An integrated treatment
plan must be approved by a mental health professional as defined in section 245I.04,
subdivision 2.
new text end
new text begin
(b) An integrated treatment plan must be completed within 60 calendar days following
the completion of the preliminary screening and risk assessment.
new text end
new text begin
(c) An integrated treatment plan must use a person- and family-centered planning process
that includes the client, any family or client-identified natural supports, CCBHC service
providers, and care coordination staff.
new text end
new text begin
(d) An integrated treatment plan must be updated at least every six months or earlier
based on changes in the client's circumstances.
new text end
new text begin
(e) When a client is engaged in substance use disorder services at a CCBHC, the
integrated treatment plan must also be approved by an alcohol and drug counselor as defined
in section 245G.11, subdivision 5.
new text end
new text begin
(f) The treatment plan must integrate prevention, medical and behavioral health needs,
and service delivery and must be developed by the CCBHC in collaboration with and
endorsed by the client, the adult client's family to the extent the client wishes, or family or
caregivers of youth and children. The treatment plan must also be coordinated with staff or
programs necessary to carry out the plan.
new text end
new text begin
(g) The CCBHC integrated treatment plan requirements in this subdivision replace the
requirements for:
new text end
new text begin
(1) an individual treatment plan under section 245I.10, subdivisions 7 and 8;
new text end
new text begin
(2) an individual treatment plan under section 245G.06, subdivision 1; and
new text end
new text begin
(3) an individual treatment plan under section 245G.09, subdivision 3, clause (6).
new text end
new text begin
(h) The CCBHC functional assessment requirements replace the requirements for:
new text end
new text begin
(1) a functional assessment under section 256B.0623, subdivision 9;
new text end
new text begin
(2) a functional assessment under section 245.4711, subdivision 3; and
new text end
new text begin
(3) functional assessments under Minnesota Rules, part 9520.0914, subpart 2, items A
and B.
new text end
new text begin Subd. 9. new text end
new text begin Licensing and certification requirements. new text end
new text begin
The requirements for initial
evaluations under subdivision 6, comprehensive evaluations under subdivision 7, and
integrated treatment plans under subdivision 8 are part of the licensing requirements for
substance use disorder treatment programs licensed according to chapter 245G and
certification requirements for mental health clinics certified according to section 245I.20 if
the program or clinic is part of a CCBHC. The Department of Human Services licensing
division will review, inspect, and investigate for compliance with the requirements in
subdivisions 6 to 8.
new text end
Sec. 8.
new text begin
[245.7356] REQUIRED EVIDENCE-BASED SERVICES.
new text end
new text begin Subdivision 1. new text end
new text begin Generally. new text end
new text begin
A CCBHC must use evidence-based practices in all services.
Treatments must be provided in a manner appropriate for each client's phase of life and
development, specifically considering what is appropriate for children, adolescents,
transition-age youth, and older adults, as distinct groups for whom life stage and functioning
may affect treatment. Specifically, when treating children and adolescents, a CCHBC must
provide evidence-based services that are developmentally appropriate, youth guided, and
family and caregiver driven. When treating older adults, an individual client's desires and
functioning must be considered, and appropriate evidence-based treatments must be provided.
When treating individuals with developmental or other cognitive disabilities, level of
functioning must be considered, and appropriate evidence-based treatments must be provided.
The treatments referenced in this subdivision must be delivered by staff with specific training
in treating the segment of the population being served.
new text end
new text begin Subd. 2. new text end
new text begin Required evidence-based practices. new text end
new text begin
A CCBHC must use evidence-based
practices, including the use of cognitive behavioral therapy, motivational interviewing,
stages of change, and trauma treatment appropriate for populations being served.
new text end
new text begin Subd. 3. new text end
new text begin Issuance of and amendments to evidence-based practices requirements. new text end
new text begin
The
commissioner must issue a list of required evidence-based practices to be delivered by
CCBHCs and may also provide a list of recommended evidence-based practices. The
commissioner may update the list to reflect advances in outcomes research and medical
services for persons living with mental illnesses or substance use disorders. The commissioner
must take into consideration the adequacy of evidence to support the efficacy of the practice,
the quality of workforce available, and the current availability of the practice in the state.
At least 30 days before issuing the initial list and any revisions, the commissioner must
provide stakeholders with an opportunity to comment.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 9.
new text begin
[245.7357] DESIGNATED COLLABORATING ORGANIZATION.
new text end
new text begin Subdivision 1. new text end
new text begin Generally. new text end
new text begin
A CCBHC must directly provide a core set of services listed
in section 245.7355, subdivision 2, and may directly provide or contract for the remainder
of the services listed in section 245.7355, subdivision 3, with a designated collaborating
organization as defined in section 245.7351, subdivision 10, that has the required authority
to provide that service and that meets the criteria as a designated collaborating organization
under subdivision 2.
new text end
new text begin Subd. 2. new text end
new text begin Designated collaborating organization requirements. new text end
new text begin
(a) A CCBHC providing
CCBHC services via a designated collaborating organization agreement must:
new text end
new text begin
(1) have a formal agreement, as defined in section 245.7351, subdivision 11, with the
designated collaborating organization to furnish one or more of the allowable services listed
under section 245.7355, subdivision 3;
new text end
new text begin
(2) ensure that CCBHC services provided by a designated collaborating organization
must be provided in accordance with CCBHC service standards and provider requirements;
new text end
new text begin
(3) maintain responsibility for coordinating care and clinical and financial responsibility
for the services provided by a designated collaborating organization;
new text end
new text begin
(4) as applicable and necessary, ensure that a contracted designated collaborating
organization participates in CCBHC care coordination activities, including utilizing health
information technology to facilitate coordination and care transfers across organizations
and arranging access to data necessary for quality and financial operations and reporting;
new text end
new text begin
(5) ensure beneficiaries receiving CCBHC services at the designated collaborating
organization have access to the CCBHC grievance process;
new text end
new text begin
(6) submit all designated collaborating organization agreements for review and approval
by the commissioner prior to the designated collaborating organization furnishing CCBHC
services; and
new text end
new text begin
(7) meet any additional requirements issued by the commissioner.
new text end
new text begin
(b) Designated collaborating organization agreements must be submitted during the
certification process. Adding new designated collaborating organization relationships after
initial certification requires updates to the CCBHC certification. A CCBHC must update
designated collaborating organization information and the designated collaborating
organization agreement with the commissioner a minimum of 30 days prior to the execution
of a designated collaborating organization agreement. The commissioner must review and
approve or offer recommendations for designated collaborating organization agreement
modifications
new text end
new text begin
(c) Designated collaborating organizations furnishing services under an agreement with
CCBHCs must meet all standards established in sections 245.7351 to 245.7357 for the
service the designated collaborating organization is providing. CCBHCs maintain
responsibility for care coordination and are clinically and financially responsible for CCBHC
services provided by a designated collaborating organization.
new text end
new text begin
(d) Designated collaborating organization financial and payment processes must follow
those outlined in section 256B.0625, subdivision 5m, paragraph (c), clause (10).
new text end
new text begin Subd. 3. new text end
new text begin Designated collaborative organization agreements. new text end
new text begin
Designated collaborative
organization agreements must include:
new text end
new text begin
(1) the scope of CCBHC services to be furnished;
new text end
new text begin
(2) the payment methodology and rates for purchased services;
new text end
new text begin
(3) a requirement that the CCBHC maintains financial and clinical responsibility for
services provided by the designated collaborating organization;
new text end
new text begin
(4) a requirement that the CCBHC retains responsibility for care coordination;
new text end
new text begin
(5) a requirement that the designated collaborating organization must have the necessary
certifications, licenses, and enrollments to provide the services;
new text end
new text begin
(6) a requirement that the staff providing CCBHC services within the designated
collaborating organization must have the proper licensure for the services provided;
new text end
new text begin
(7) a requirement that the designated collaborating organization meets CCBHC cultural
competency and training requirements;
new text end
new text begin
(8) a requirement that the designated collaborating organization must follow all federal,
state, and CCBHC requirements for confidentiality and data privacy;
new text end
new text begin
(9) a requirement that the designated collaborating organization must follow the grievance
procedures of the CCBHC;
new text end
new text begin
(10) a requirement that the designated collaborating organization must follow the CCBHC
requirements for person- and family-centered, recovery-oriented care, being respectful of
the individual person's needs, preferences, and values, and ensuring involvement by the
person being served and self-direction of services received. Services for children and youth
must be family-centered, youth-guided, and developmentally appropriate;
new text end
new text begin
(11) a requirement that clients seeking services must have freedom of choice of providers;
new text end
new text begin
(12) a requirement that the designated collaborating organization must be part of the
CCBHCs health information technology system directly or through data integration;
new text end
new text begin
(13) a requirement that the designated collaborating organization must provide all clinical
and financial data necessary to support CCBHC required service and billing operations;
and
new text end
new text begin
(14) a requirement that the CCBHC and the designated collaborating organization have
safeguards in place to ensure that the designated collaborating organization does not receive
a duplicate payment for services that are included in the CCBHC's daily bundled rate.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 10.
Minnesota Statutes 2022, section 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 .
Sec. 11.
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. 12.
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. 13.
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, has nondisqualifying background study information, as
described in section 245C.05, subdivision 4, that reflects on the individual's 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. 14.
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. 15.
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. 16.
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 ordernew 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
by the applicant or license holder, 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. 17.
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. 18.
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; or
(5) revocation is required under section 245A.04, subdivision 7, paragraph (d).
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. 19.
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. 20.
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.
Sec. 21.
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.
Sec. 22.
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.
Sec. 23.
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.
Sec. 24.
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
Sec. 25.
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 , and 245.095, subdivision 4new text end .
Sec. 26.
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 sections 245.7351 to 245.7357, the license holder must comply
with the requirements in section 245.7355, subdivisions 6 to 9, as part of the licensing
requirements under this chapter.
new text end
Sec. 27.
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. 28.
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
Sec. 29.
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. 30.
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. 31.
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. 32.
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 hub,new 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. 33.
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. 34.
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. 35.
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 program is licensed according to this chapter and is part of a certified community
behavioral health clinic under sections 245.7351 to 245.7357, the license holder must comply
with the requirements in section 245.7355, subdivisions 6 to 9, as part of the licensing
requirements under this chapter.
new text end
Sec. 36.
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.
(c) The commissioner must act on an application within 90 working days of receiving
a completed application.
(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
service new 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. 37.
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. 38.
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. 39.
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. 40.
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. 41.
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) The commissioner shall disclose information to the commissioner of human services
to verify the income and tax identification information of:
new text end
new text begin
(1) an applicant under section 245A.04, subdivision 1;
new text end
new text begin
(2) an applicant under section 245I.20;
new text end
new text begin
(3) an applicant under section 245H.03;
new text end
new text begin
(4) a license holder; or
new text end
new text begin
(5) a certification holder.
new text end
Sec. 42. new text begin DIRECTION TO COMMISSIONER OF HUMAN SERVICES;
TRANSITION TO LICENSURE.
new text end
new text begin
(a) The commissioner of human services must transition the following mental health
services from certification under Minnesota Statutes, chapters 245 and 256B, to licensure
under Minnesota Statutes, chapter 245A, on or before January 1, 2026:
new text end
new text begin
(1) certified community behavioral health clinics;
new text end
new text begin
(2) adult rehabilitative mental health services;
new text end
new text begin
(3) mobile mental health crisis response services;
new text end
new text begin
(4) children's therapeutic services and supports; and
new text end
new text begin
(5) community mental health centers.
new text end
new text begin
(b) The transition to licensure under this section must be according to the Mental Health
Uniform Service Standards in Minnesota Statutes, chapter 245I.
new text end
new text begin
(c) No later than January 1, 2025, the commissioner must submit the proposed legislation
necessary to implement the transition in paragraphs (a) and (b) to the chairs and ranking
minority members of the legislative committees with jurisdiction over behavioral health
services.
new text end
new text begin
(d) The commissioner must consult with stakeholders to develop the legislation described
in paragraph (c).
new text end
ARTICLE 9
BEHAVIORAL HEALTH
Section 1.
new text begin
[245.0961] AFRICAN AMERICAN BEHAVIORAL HEALTH 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 an
African American Behavioral Health grant program to offer culturally specific,
comprehensive, trauma-informed, practice- and evidence-based, person- and family-centered
mental health and substance use disorder treatment services.
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, applicants
must be a nonprofit organization or a nongovernmental organization and must be a culturally
specific mental health service provider that is a licensed community mental health center
that specializes in services for African American children and families.
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 at a time and in a 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 offer culturally specific,
comprehensive, trauma-informed, practice- and evidence-based, person- and family-centered
mental health and substance use disorder services. Grant money may also be used for
supervision and training, and care coordination regardless of a client's ability to pay or place
of residence.
new text end
new text begin Subd. 5. 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. The report must include how many
clients were served with the grant money and, if grant money was used for supervision and
training, how many providers were supervised or trained using the grant money.
new text end
new text begin
(b) The commissioner must submit a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over behavioral health no later than six months
after receiving the report under paragraph (a). The report submitted by the commissioner
must include the information specified in paragraph (a).
new text end
Sec. 2.
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;
(5) mental health services for people from cultural and ethnic minorities, including
supervision of clinical trainees who are Black, indigenous, or people of color;
(6) children's mental health screening and follow-up diagnostic assessment and treatment;
(7) services to promote and develop the capacity of providers to use evidence-based
practices in providing children's mental health services;
(8) school-linked mental health services under section 245.4901;
(9) building evidence-based mental health intervention capacity for children birth to age
five;
(10) suicide prevention and counseling services that use text messaging statewide;
(11) mental health first aid training;
(12) 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;
(13) transition age services to develop or expand mental health treatment and supports
for adolescents and young adults 26 years of age or younger;
(14) early childhood mental health consultation;
(15) 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;
(16) psychiatric consultation for primary care practitioners; deleted text begin and
deleted text end
(17) providers to begin operations and meet program requirements when establishing a
new children's mental health programdeleted text begin . These may be start-up grantsdeleted text end new text begin , including start-up
grants; and
new text end
new text begin (18) evidence-informed interventions for youth and young adults who are at risk of
developing a mood disorder or are experiencing an emerging mood disorder, including
major depression and bipolar disorders, and a public awareness campaign on the signs and
symptoms of mood disorders in youth and young adultsnew text end .
(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 EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
new text end
Sec. 3.
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; and
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
(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 Program evaluation requirements. new text end
new text begin
(a) The commissioner must consult with
the commissioner of management and budget on program outcomes, evaluation metrics,
and progress indicators for the grant program under this section. The commissioner must
only implement program outcomes, evaluation metrics, and progress indicators that are
determined through and agreed upon during the consultation with the commissioner of
management and budget or stated in paragraph (b). The commissioner shall not implement
the grant program under this section until the consultation with the commissioner of
management and budget is completed. The commissioner must incorporate agreed-upon
program outcomes, evaluation metrics, and progress indicators into grant applications,
requests for proposals, and any reports to the legislature.
new text end
new text begin
(b) Grantees must provide regular data summaries to the commissioner for purposes of
evaluating the effectiveness of the grant program. The commissioner must use identified
culturally appropriate outcome measures 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 the 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;
new text end
new text begin
(7) led to an overall increase in culturally specific mental health and substance use
disorder service availability; and
new text end
new text begin
(8) led to changes indicated by other measures identified from consultation pursuant to
paragraph (a).
new text end
Sec. 4.
new text begin
[245.4904] EMERGING MOOD DISORDER GRANT PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Creation. new text end
new text begin
(a) The emerging mood disorder grant program is established
in the Department of Human Services to fund:
new text end
new text begin
(1) evidence-informed interventions for youth and young adults who are at risk of
developing a mood disorder or are experiencing an emerging mood disorder, including
major depression and bipolar disorders; and
new text end
new text begin
(2) a public awareness campaign on the signs and symptoms of mood disorders in youth
and young adults.
new text end
new text begin
(b) Emerging mood disorder services are eligible for children's mental health grants as
specified in section 245.4889, subdivision 1, paragraph (b), clause (18).
new text end
new text begin Subd. 2. new text end
new text begin Activities. new text end
new text begin
(a) All emerging mood disorder grant program recipients must:
new text end
new text begin
(1) provide intensive treatment and support to adolescents and young adults experiencing
or at risk of experiencing an emerging mood disorder. Intensive treatment and support
includes medication management, psychoeducation for the individual and the individual's
family, case management, employment support, education support, cognitive behavioral
approaches, social skills training, peer support, crisis planning, and stress management;
new text end
new text begin
(2) conduct outreach and provide training and guidance to mental health and health care
professionals, including postsecondary health clinicians, on early symptoms of mood
disorders, screening tools, and best practices;
new text end
new text begin
(3) ensure access for individuals to emerging mood disorder services under this section,
including ensuring access for individuals who live in rural areas; and
new text end
new text begin
(4) use all available funding streams.
new text end
new text begin
(b) Grant money may also be used to pay for housing or travel expenses for individuals
receiving services or to address other barriers preventing individuals and their families from
participating in emerging mood disorder services.
new text end
new text begin
(c) Grant money may be used by the grantee to evaluate the efficacy of providing
intensive services and supports to people with emerging mood disorders.
new text end
new text begin Subd. 3. new text end
new text begin Eligibility. new text end
new text begin
Program activities must be provided to youth and young adults with
early signs of an emerging mood disorder.
new text end
new text begin Subd. 4. new text end
new text begin Program evaluation requirements. new text end
new text begin
The commissioner must consult with the
commissioner of management and budget on program outcomes, evaluation metrics, and
progress indicators for the grant program under this section. The commissioner must only
implement program outcomes, evaluation metrics, and progress indicators that are determined
through and agreed upon during the consultation with the commissioner of management
and budget. The commissioner shall not implement the grant program under this section
until the consultation with the commissioner of management and budget is completed. The
commissioner must incorporate agreed-upon program outcomes, evaluation metrics, and
progress indicators into grant applications, requests for proposals, and any reports to the
legislature.
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. 5.
Minnesota Statutes 2022, section 245.735, subdivision 3, is amended to read:
Subd. 3.
Certified community behavioral health clinics.
(a) The commissioner deleted text begin shalldeleted text end new text begin
mustnew text end establish a state certification new text begin and recertification new text end process for certified community
behavioral health clinics (CCBHCs) that satisfy all federal requirements necessary for
CCBHCs certified under this section to be eligible for reimbursement under medical
assistance, without service area limits based on geographic area or region. The commissioner
shall consult with CCBHC stakeholders before establishing and implementing changes in
the certification new text begin or recertification new text end process and requirements. new text begin Any changes to the certification
or recertification process or requirements must be consistent with the most recently issued
CCBHC criteria published by the Substance Abuse and Mental Health Services
Administration (SAMHSA). The commissioner must allow a transition period for CCBHCs
to meet the revised SAMHSA criteria prior to July 1, 2024. The commissioner is authorized
to amend Minnesota's Medicaid state plan or the terms of the demonstration to comply with
federal requirements. new text end Entities that choose to be CCBHCs must:
(1) comply with state licensing requirements and other requirements issued by the
commissioner;
(2) employ or contract for clinic staff who have backgrounds in diverse disciplines,
including licensed mental health professionals and licensed alcohol and drug counselors,
and staff who are culturally and linguistically trained to meet the needs of the population
the clinic serves;
(3) ensure that clinic services are available and accessible to individuals and families of
all ages and genders and that crisis management services are available 24 hours per day;
(4) establish fees for clinic services for individuals who are not enrolled in medical
assistance using a sliding fee scale that ensures that services to patients are not denied or
limited due to an individual's inability to pay for services;
(5) comply with quality assurance reporting requirements and other reporting
requirements, including any required reporting of encounter data, clinical outcomes data,
and quality data;
(6) provide crisis mental health and substance use services, withdrawal management
services, emergency crisis intervention services, and stabilization services through existing
mobile crisis services; screening, assessment, and diagnosis services, including risk
assessments and level of care determinations; person- and family-centered treatment planning;
outpatient mental health and substance use services; targeted case management; psychiatric
rehabilitation services; peer support and counselor services and family support services;
and intensive community-based mental health services, including mental health services
for members of the armed forces and veterans. CCBHCs must directly provide the majority
of these services to enrollees, but may coordinate some services with another entity through
a collaboration or agreement, pursuant to paragraph (b);
(7) provide coordination of care across settings and providers to ensure seamless
transitions for individuals being served across the full spectrum of health services, including
acute, chronic, and behavioral needs. Care coordination may be accomplished through
partnerships or formal contracts with:
(i) counties, health plans, pharmacists, pharmacies, rural health clinics, federally qualified
health centers, inpatient psychiatric facilities, substance use and detoxification facilities, or
community-based mental health providers; and
(ii) other community services, supports, and providers, including schools, child welfare
agencies, juvenile and criminal justice agencies, Indian health services clinics, tribally
licensed health care and mental health facilities, urban Indian health clinics, Department of
Veterans Affairs medical centers, outpatient clinics, drop-in centers, acute care hospitals,
and hospital outpatient clinics;
(8) be certified as a mental health clinic under section 245I.20;
(9) comply with standards established by the commissioner relating to CCBHC
screenings, assessments, and evaluations;
(10) be licensed to provide substance use disorder treatment under chapter 245G;
(11) be certified to provide children's therapeutic services and supports under section
256B.0943;
(12) be certified to provide adult rehabilitative mental health services under section
256B.0623;
(13) be enrolled to provide mental health crisis response services under section
256B.0624;
(14) be enrolled to provide mental health targeted case management under section
256B.0625, subdivision 20;
(15) comply with standards relating to mental health case management in Minnesota
Rules, parts 9520.0900 to 9520.0926;
(16) provide services that comply with the evidence-based practices described in
paragraph (e); and
(17) comply with standards relating to peer services under sections 256B.0615,
256B.0616, and 245G.07, subdivision 2, clause (8), as applicable when peer services are
provided.
(b) new text begin As part of the state CCBHC certification and recertification process, the commissioner
must provide to entities applying for certification or requesting recertification (1) the standard
requirements of the community needs assessment, and (2) the staffing plan. The standard
requirements and the staffing plan must be consistent with the most recently issued CCBHC
criteria published by the SAMHSA.
new text end
new text begin (c) new text end If a certified CCBHC is unable to provide one or more of the services listed in
paragraph (a), clauses (6) to (17), the CCBHC may contract with another entity that has the
required authority to provide that service and that meets the following criteria as a designated
collaborating organization:
(1) the entity has a formal agreement with the CCBHC to furnish one or more of the
services under paragraph (a), clause (6);
(2) the entity provides assurances that it will provide services according to CCBHC
service standards and provider requirements;
(3) the entity agrees that the CCBHC is responsible for coordinating care and has clinical
and financial responsibility for the services that the entity provides under the agreement;
and
(4) the entity meets any additional requirements issued by the commissioner.
deleted text begin (c)deleted text end new text begin (d)new text end Notwithstanding any other law that requires a county contract or other form of
county approval for certain services listed in paragraph (a), clause (6), a clinic that otherwise
meets CCBHC requirements may receive the prospective payment under section 256B.0625,
subdivision 5m, for those services without a county contract or county approval. As part of
the certification process in paragraph (a), the commissioner shall require a letter of support
from the CCBHC's host county confirming that the CCBHC and the county or counties it
serves have an ongoing relationship to facilitate access and continuity of care, especially
for individuals who are uninsured or who may go on and off medical assistance.
deleted text begin (d)deleted text end new text begin (e)new text end When the standards listed in paragraph (a) or other applicable standards conflict
or address similar issues in duplicative or incompatible ways, the commissioner may grant
variances to state requirements if the variances do not conflict with federal requirements
for services reimbursed under medical assistance. If standards overlap, the commissioner
may substitute all or a part of a licensure or certification that is substantially the same as
another licensure or certification. The commissioner shall consult with stakeholders, as
described in subdivision 4, before granting variances under this provision. For the CCBHC
that is certified but not approved for prospective payment under section 256B.0625,
subdivision 5m, the commissioner may grant a variance under this paragraph if the variance
does not increase the state share of costs.
deleted text begin (e)deleted text end new text begin (f)new text end The commissioner shall issue a list of required evidence-based practices to be
delivered by CCBHCs, and may also provide a list of recommended evidence-based practices.
The commissioner may update the list to reflect advances in outcomes research and medical
services for persons living with mental illnesses or substance use disorders. The commissioner
shall take into consideration the adequacy of evidence to support the efficacy of the practice,
the quality of workforce available, and the current availability of the practice in the state.
At least 30 days before issuing the initial list and any revisions, the commissioner shall
provide stakeholders with an opportunity to comment.
deleted text begin (f)deleted text end new text begin (g)new text end The commissioner shall recertify CCBHCs at least every three years. The
commissioner shall establish a process for decertification and shall require corrective action,
medical assistance repayment, or decertification of a CCBHC that no longer meets the
requirements in this section or that fails to meet the standards provided by the commissioner
in the application and certification process.
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. 6.
Minnesota Statutes 2022, section 245.735, subdivision 6, is amended to read:
Subd. 6.
deleted text begin Demonstrationdeleted text end new text begin Section 223 Protecting Access to Medicare Actnew text end entities.
new text begin (a)
new text end The commissioner deleted text begin may operatedeleted text end new text begin must request federal approval to participate innew text end the
demonstration program established by section 223 of the Protecting Access to Medicare
Actnew text begin and,new text end if new text begin approved, must continue to participate in the demonstration program for as long
as new text end federal funding for the demonstration program remains available from the United States
Department of Health and Human Services. To the extent practicable, the commissioner
shall align the requirements of the demonstration program with the requirements under this
section for CCBHCs receiving medical assistance reimbursementnew text begin under the authority of the
state's Medicaid state plannew text end . A CCBHC may not apply to participate as a billing provider in
both the CCBHC federal demonstration and the benefit for CCBHCs under the medical
assistance program.
new text begin
(b) The commissioner must follow the payment guidance issued by the federal
government, including the payment of the CCBHC daily bundled rate for services rendered
by CCBHCs to individuals who are dually eligible for Medicare and medical assistance
when Medicare is the primary payer for the service. An entity that receives a CCBHC daily
bundled rate that overlaps with another federal Medicaid methodology is not eligible for
the CCBHC rate. Services provided by a CCBHC operating under authority of the state's
Medicaid state plan will not receive the prospective payment system rate for services rendered
by CCBHCs to individuals who are dually eligible for Medicare and medical assistance
when Medicare is the primary payer for the service. Payment for services rendered by
CCBHCs to individuals who have commercial insurance as primary and medical assistance
as secondary is subject to section 256B.37. Services provided by a CCBHC operating under
authority of the 223 demonstration or the state's Medicaid state plan will not receive the
prospective payment system rate for services rendered by CCBHCs to individuals who have
commercial insurance as primary and medical assistance as secondary.
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. 7.
Minnesota Statutes 2022, section 245.735, is amended by adding a subdivision to
read:
new text begin Subd. 7. new text end
new text begin Addition of CCBHCs to section 223 state demonstration programs. new text end
new text begin
(a) If
the commissioner's request to reenter the demonstration program under subdivision 6 is
approved, the commissioner must follow all federal guidance for the addition of CCBHCs
to section 223 state demonstration programs.
new text end
new text begin
(b) Prior to participating in the demonstration, a clinic must meet the demonstration
certification criteria and prospective payment system guidance in effect at that time and be
certified as a CCBHC in Minnesota. The SAMHSA attestation process for the CCBHC
expansion grants is not sufficient to constitute state certification. CCBHCs newly added to
the demonstration must participate in all aspects of the state demonstration program, including
but not limited to quality measurement and reporting, evaluation activities, and state CCBHC
demonstration program requirements such as use of state-specified evidence-based practices.
A newly added CCBHC must report on quality measures before its first full demonstration
year if it joined the demonstration program in the 2023 calendar year out of alignment with
the state's demonstration year cycle. A CCBHC may provide services in multiple locations
and in community-based settings subject to federal rules of the 223 demonstration authority
or Medicaid state plan authority. If a facility meets the definition of a satellite facility as
defined by the SAMHSA n and was established after April 1, 2014, the facility cannot
receive payment as a part of the demonstration program.
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. 8.
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. 9.
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. 10. 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. 11. 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. 12. new text begin MOBILE RESPONSE AND STABILIZATION SERVICES PILOT.
new text end
new text begin
The commissioner of human services shall establish a pilot to promote access to crisis
response services and reduce psychiatric hospitalizations and out-of-home placement services
for children, youth, and families. The pilot must incorporate a two-pronged approach to
provide an immediate, face-to-face response within 60 minutes of a crisis as well as extended,
longer-term supports for the family unit. The pilot must aim to help families respond to
children's behavioral health crises while bolstering resiliency and recovery within the family
unit. The pilot must include four sites, must include at least one rural site and one urban
site, and may include one or more Tribal behavioral health crisis providers. To qualify for
the pilot, a grantee must have a current mobile crisis certification in good standing under
Minnesota Statutes, section 256B.0624. The commissioner must 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
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
new text end
Sec. 13. 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
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
ARTICLE 10
ECONOMIC ASSISTANCE
Section 1.
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. 2.
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 is the cash portion
of the MFIP transitional standard for a single adult under section 256J.24, subdivision 5new 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 deleted text begin is 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 is the cash portion of the
MFIP transitional standard for a single adult under section 256J.24, subdivision 5new 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.
(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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective October 1, 2024.
new text end
Sec. 3.
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. 4.
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. 5.
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.
Sec. 6.
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. 7.
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. 8.
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. 9.
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. 10.
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. 11.
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. 12.
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 evaluation of the Minnesota family assets for independence initiative.
new text end
Sec. 13.
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. 14.
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. 15.
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. 16.
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 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 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 a person is a recipient of
housing support. If the SSI limit or benefit is reduced for a person due to events other than
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 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. 17.
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. 18.
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. 19.
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 it is due. The termination shall be effective on the first day of the month following
the month in which the report 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. 20.
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. 21.
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. 22.
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. 23.
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, or upon federal approval,
whichever is later. The commissioner of human services shall notify the revisor of statutes
when federal approval is obtained.
new text end
Sec. 24.
Minnesota Statutes 2022, section 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. 25.
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. 26.
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. 27.
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. 28.
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. 29.
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. 30.
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. 31.
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. 32.
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. 33.
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. 34.
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. 35.
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. 36.
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.
(c) Sanctions for noncompliance deleted text begin shall be imposed as follows:
deleted text end
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. 37.
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. 38.
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. 39.
Minnesota Statutes 2022, section 256J.95, subdivision 19, is amended to read:
Subd. 19.
DWP overpayments and underpayments.
DWP benefits are subject to
overpayments and underpayments. Anytime an overpayment or an underpayment is
determined for DWP, the correction shall be calculated using prospective budgeting.
Corrections shall be determined based on the policy in section deleted text begin 256J.34, subdivision 1,
paragraphs (a), (b), and (c)deleted text end new text begin 256P.09, subdivisions 1 to 4new text end . ATM errors must be recovered as
specified in section 256P.08, subdivision 7. Cross program recoupment of overpayments
cannot be assigned to or from DWP.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective March 1, 2025.
new text end
Sec. 40.
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
Sec. 41.
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. 42.
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 subdivision 4new 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.
Sec. 43.
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
Sec. 44.
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. 45.
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. 46.
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. 47.
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 and the addition of item (xvi) related to
retirement, survivors, and disability insurance payments is effective August 1, 2023.
new text end
Sec. 48.
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
Sec. 49.
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. 50.
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. 51.
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
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. 52.
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 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. 53.
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. 54.
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. 55.
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 assistance units that also receive 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. 56.
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. 57.
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. 58.
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 and assistance units that receive housing support
under chapter 256I 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 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. 59.
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 shall be subject to 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. 60.
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. 61.
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. 62. new text begin COUNTY WORKER TRAINING PROGRAM PILOT.
new text end
new text begin
(a) To the extent permitted under federal law, and subject to any necessary federal
approval, the commissioner of human services must permit Anoka, Dakota, St. Louis, and
Wright Counties to operate a 12-month pilot to provide the four-day mandated training
under Minnesota Statutes, section 256.01, subdivision 2, paragraph (a), clause (1), for the
MAXIS eligibility system and Supplemental Nutrition Assistance Program (SNAP) in-house.
Counties shall be permitted to provide their own training under this section starting 30 days
after receipt of necessary federal approval and only after receiving and agreeing to use the
commissioner's training materials.
new text end
new text begin
(b) The commissioner must provide oversight of the training program to ensure county
training is consistent with current curriculum. The commissioner shall determine what
oversight activities will be utilized. If there are changes in state or federal law governing
SNAP or changes are made to MAXIS, counties must not provide training until they have
received and agreed to use the updated curriculum provided by the commissioner.
new text end
new text begin
(c) Counties must comply with all applicable state and federal training requirements,
including but not limited to reporting requirements. In addition, no later than 120 days
following completion of the pilot, each county permitted to conduct their own training under
this section must report to the commissioner the following data:
new text end
new text begin
(1) the number of classes offered during the pilot period;
new text end
new text begin
(2) the number of workers trained during the pilot period; and
new text end
new text begin
(3) the number of county staff who provided training during the pilot period.
new text end
new text begin
(d) Nothing in this section shall prevent the commissioner from requiring the employees
of the counties participating in the pilot from receiving mandatory training provided by the
commissioner on subjects relating to data privacy and security awareness. Prior to receiving
any in-house training provided for in paragraph (a), any county employee must first receive
all training the commissioner requires pursuant to this section.
new text end
Sec. 63. 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, 53, 61, 62,
81, and 83; 256J.30, subdivisions 5, 7, and 8; 256J.33, subdivisions 3, 4, and 5; 256J.34,
subdivisions 1, 2, 3, and 4; and 256J.37, subdivision 10,
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 256.8799,
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 256J.425, subdivision 6,
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 March 1, 2025, except the repeal of
Minnesota Statutes 2022, sections 256J.08, subdivisions 53 and 62, and 256J.37, subdivision
10, is effective July 1, 2024. Paragraph (c) is effective May 1, 2026.
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.
new text begin
[245.0963] CONTINUUM OF CARE 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
grant program to maintain funding for shelters and services provided to individuals
experiencing homelessness.
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, applicants
must be a nonprofit organization or a county. An eligible applicant must have experience
providing continuum of care services to individuals experiencing homelessness and operating
a community-wide partnership committed to ending homelessness.
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
(a) Grant money must be used for:
new text end
new text begin
(1) maintaining funding for a 100-bed family shelter;
new text end
new text begin
(2) maintaining funding to provide shelter and services for single adults, including an
expanded shelter for women;
new text end
new text begin
(3) developing and operating a familiar faces pilot program for high-frequency unhoused
clients with intensive, 24-hours-a-day, seven-days-a-week staffing;
new text end
new text begin
(4) maintaining current day shelter programming; and
new text end
new text begin
(5) providing outreach, support services, single point of entry, infrastructure, and extreme
weather support.
new text end
new text begin
(b) A grantee may contract with eligible nonprofit organizations and local and Tribal
governmental agencies to provide the services listed under paragraph (a).
new text end
new text begin Subd. 5. new text end
new text begin Reporting. new text end
new text begin
(a) The grantee must submit a report to the commissioner in the
time and manner specified by the commissioner. The report must include how the grant
money was used and how many individuals were served.
new text end
new text begin
(b) The commissioner must submit a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over homelessness no later than six months
after receiving the report under paragraph (a). The report submitted by the commissioner
must include the information specified in paragraph (a).
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. 3.
new text begin
[245.0965] OLMSTED COUNTY HOMELESSNESS 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
grant program to fund and support shelters and services for persons experiencing
homelessness in Olmsted County.
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, applicants
must be a nonprofit organization or a county that provides shelter and services to persons
experiencing homelessness in Olmsted County. An eligible applicant must have experience
with services that house persons experiencing homelessness and aid transitions to permanent
stable housing.
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
(a) Eligible uses of grant money include:
new text end
new text begin
(1) operations and services to maintain daytime and overnight shelter;
new text end
new text begin
(2) recuperative care shelter;
new text end
new text begin
(3) housing-focused case management for persons experiencing homelessness;
new text end
new text begin
(4) shelter diversion services;
new text end
new text begin
(5) hotel and motel vouchers;
new text end
new text begin
(6) shelter for youth, including host homes;
new text end
new text begin
(7) transitional housing programs;
new text end
new text begin
(8) supportive staffing; and
new text end
new text begin
(9) outreach services.
new text end
new text begin
(b) The grantee may contract with eligible nonprofit organizations and local and Tribal
governmental agencies to provide the services specified under paragraph (a).
new text end
new text begin Subd. 5. new text end
new text begin Reporting. new text end
new text begin
(a) The grantee must submit a report to the commissioner in the
time and manner specified by the commissioner. The report must include the number of
persons experiencing homelessness that were served and what the grant money was used
for.
new text end
new text begin
(b) The commissioner must submit a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over homelessness no later than six months
after receiving the report under paragraph (a). The report submitted by the commissioner
must include the information specified in paragraph (a).
new text end
Sec. 4.
new text begin
[245.0966] HENNEPIN COUNTY HOMELESSNESS 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
grant program to maintain funding for shelters and services provided to individuals
experiencing homelessness in Hennepin County.
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, applicants
must be a nonprofit organization or a county that provides shelter and services to persons
experiencing homelessness in Hennepin County. An eligible applicant must have experience
with services that house persons experiencing homelessness and aid transitions to permanent,
stable housing.
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
(a) Grant money must be used for:
new text end
new text begin
(1) maintaining current shelter and homeless response programming;
new text end
new text begin
(2) maintaining shelter operations and services at Avivo Village, including the shelter
comprised of 100 private dwellings and the American Indian Community Development
Corporation Homeward Bound 50-bed shelter;
new text end
new text begin
(3) maintaining shelter operations and services at 24-hours-a-day, seven-days-a-week
shelters;
new text end
new text begin
(4) providing housing-focused case management; and
new text end
new text begin
(5) providing shelter diversion services.
new text end
new text begin
(b) A grantee may contract with eligible nonprofit organizations and local and Tribal
governmental agencies to provide the services listed under paragraph (a).
new text end
new text begin Subd. 5. new text end
new text begin Reporting. new text end
new text begin
(a) The grantee must submit a report to the commissioner in the
time and manner specified by the commissioner. The report must include how the grant
money was used and how many persons experiencing homelessness were served.
new text end
new text begin
(b) The commissioner must submit a report to the chairs and ranking minority members
of the legislative committees with jurisdiction over homelessness no later than six months
after receiving the report under paragraph (a). The report submitted by the commissioner
must include the information specified in paragraph (a).
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. 5.
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. People
who meet the disabling condition criteria established in paragraph (a) or (b) will not have
any countable income for the duration of eligibility under this paragraph.
new text end
Sec. 6.
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 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. 7.
new text begin
[256K.50] FAMILY SUPPORTIVE HOUSING.
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) "Family" means a nontemporary household unit that includes at least one child and
one parent or legal guardian.
new text end
new text begin
(c) "Family permanent supportive housing" means housing that:
new text end
new text begin
(1) is not time limited;
new text end
new text begin
(2) is affordable for those at or below 30 percent of the area median income;
new text end
new text begin
(3) offers specialized support services to residents tailored to the needs of children and
families; and
new text end
new text begin
(4) is available to families with multiple barriers to obtaining and maintaining housing,
including but not limited to those who are homeless or at risk of homelessness; those with
mental illness, substance use disorders, and other disabilities; and those referred by child
protection services.
new text end
new text begin
(d) "Resident" means a resident of family permanent supportive housing.
new text end
new text begin Subd. 2. new text end
new text begin Specialized family support services. new text end
new text begin
Specialized family support services are
nonmandatory, trauma-informed, and culturally appropriate services designed to help family
residents maintain secure, dignified housing and provide a safe, stable environment for
children. Services provided may include but are not limited to:
new text end
new text begin
(1) age-appropriate child-centric services for education and enrichment;
new text end
new text begin
(2) stabilization services such as:
new text end
new text begin
(i) educational assessments and referrals to educational programs;
new text end
new text begin
(ii) career planning, work skill training, job placement, and employment retention;
new text end
new text begin
(iii) budgeting and money management;
new text end
new text begin
(iv) referrals for counseling regarding violence and sexual exploitation;
new text end
new text begin
(v) referrals for medical or psychiatric services or substance use disorder treatment;
new text end
new text begin
(vi) parenting skills training;
new text end
new text begin
(vii) self-sufficiency support services or life skill training, including tenant education
and support to sustain housing; and
new text end
new text begin
(viii) aftercare and follow-up services; and
new text end
new text begin
(3) 24-hour-a-day, seven-days-a-week on-site staffing, including but not limited to front
desk and security.
new text end
new text begin Subd. 3. new text end
new text begin Funding. new text end
new text begin
Money appropriated for this section may be expended on programs
described under subdivision 2, technical assistance, and capacity building to meet the greatest
need on a statewide basis. The commissioner must provide outreach, technical assistance,
and program development support to increase capacity to new and existing service providers
to better meet needs statewide.
new text end
Sec. 8.
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. 9. 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, Minnesota supplemental aid, and food support under Minnesota
Statutes, chapter 256D;
new text end
new text begin
(3) housing support under Minnesota Statutes, chapter 256I;
new text end
new text begin
(4) the Minnesota family investment program and diversionary work program under
Minnesota Statutes, chapter 256J; and
new text end
new text begin
(5) economic assistance programs under Minnesota Statutes, chapter 256P.
new text end
new text begin
(b) The commissioner must not consider 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. 10. new text begin HOUSING STABILIZATION SERVICES INFLATIONARY
ADJUSTMENT.
new text end
new text begin
The commissioner of human services shall seek federal approval to apply biennial
inflationary updates to housing stabilization services rates based on the consumer price
index. Beginning January 1, 2024, the commissioner must update rates using the most
recently available data from the consumer price index.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024, or upon federal approval,
whichever is later. The commissioner shall notify the revisor of statutes when federal
approval is obtained.
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 .
(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 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.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
new text end
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 legislature 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) All employees transferred to the department remain in the same employment status,
bargaining unit, and civil service protection as the employees had before the transfer. All
collective bargaining agreements that cover any employee of the Departments of Human
Services, Education, Health, or Public Safety who is transferred to the Department of
Children, Youth, and Families remain in effect.
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 such 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.341] 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 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
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
[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. 23. 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. 24. new text begin DIRECTION TO COMMISSIONER; 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) quality of care;
new text end
new text begin
(2) geographic area;
new text end
new text begin
(3) type of child care provider and associated licensing standards;
new text end
new text begin
(4) age of child;
new text end
new text begin
(5) whether the early care and learning is inclusive, including caring for children with
disabilities alongside children without disabilities;
new text end
new text begin
(6) 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 provider's fixed costs, including rent and mortgage payments, property taxes, and
business-related insurance payments;
new text end
new text begin
(8) a provider's operating expenses, including expenses for training and substitutes; and
new text end
new text begin
(9) a 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 shall include:
new text end
new text begin
(1) recommendations for how the model could be used in conjunction with a child care
and early education professional wage scale to set 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 provider payment rates for child
care assistance.
new text end
Sec. 25. 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 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:
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. 26. 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. 27. 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
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
new text end
Sec. 28. 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, health, human services, and public safety related to the
responsibilities transferred under section 29; and
new text end
new text begin
(2) the commissioners of education, health, 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 29.
new text end
new text begin
(b) Data sharing authorized by this section includes only the data necessary to coordinate
department activities and services transferred under section 29.
new text end
new text begin
(c) Any data shared under this section retain their 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 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. 29. 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, Health, 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 reappropriated 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.
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, 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) the 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 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; and
new text end
new text begin
(2) grants-in-aid to youth intervention programs under Minnesota Statutes, section
299A.73.
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. 30. 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 across
agencies;
new text end
new text begin
(3) a description of efforts to secure needed federal approvals for the transfer of programs
and responsibilities;
new text end
new text begin
(4) engagement with leaders and staff of state agencies; Tribal governments; local service
providers, including but not limited to county agencies, Tribal organizations, and school
districts; families; and relevant stakeholders about the creation of the department and the
transfer of programs, responsibilities, and personnel to the department; and
new text end
new text begin
(5) plans and timelines related to the items referenced in clauses (1) to (4).
new text end
Sec. 31. 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 and with
nonpartisan legislative offices, 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
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
new text end
Sec. 32. new text begin REPEALER.
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 EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023.
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.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. 3.
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 shall 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 shall 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. 4.
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. 5.
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. 6.
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. 7.
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 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 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 unsafe. The deleted text begin 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 3deleted text end new text begin commissioner
shall introduce statewide criteria for unsafe care by April 28, 2025new text end .
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 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. 9.
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. 10.
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. 11.
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. 12.
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. 13.
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. 14.
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. 15.
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 jobs
skills training, career counseling, and job placement assistance necessary to begin a career
path in child care.
new text end
Sec. 16.
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 registered
with the Department of Labor and Industry under chapter 178, registered with the Office
of Apprenticeship within the United States Department of Labor, or registered with a
recognized state apprenticeship agency under Code of Federal Regulations, title 29, parts
29 and 30, and who 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) a public prekindergarten program under section 124D.13, 124D.135, 124D.15 to
124D.16, 125A.01 to 125A.05, or 125A.26 to 125A.48, or Laws 2017, First Special Session
chapter 5, article 8, section 9;
new text end
new text begin
(4) a Head Start program under sections 119A.50 to 119A.54; or
new text end
new text begin
(5) a certified, license-exempt child care center under chapter 245H.
new text end
new text begin
(d) "Mentor" means an early childhood registered apprenticeship program journeyworker
under section 178.011, subdivision 9, and 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 registered apprenticeship programs.
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 monthly meetings with a mentor;
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 Allowable uses. new text end
new text begin
Grant recipients may use grant money for personal expenses.
new text end
new text begin Subd. 6. 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. The training must be free of charge to mentors.
new text end
new text begin Subd. 7. new text end
new text begin Stipends for early childhood registered apprenticeship programs. new text end
new text begin
(a) An
early childhood registered apprenticeship program shall receive up to $5,000 for the first
apprentice and up to $2,500 for each additional apprentice employed under this section,
provided the early childhood registered apprenticeship program 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 program may not host more than three apprentices at one site in
a 12-month period.
new text end
Sec. 17.
new text begin
[119B.27] CHILD CARE RETENTION PROGRAM.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
A child care retention program is established to provide
eligible child care programs with payments to improve access to child care in Minnesota
and to strengthen the ability of child care programs to recruit and retain qualified early
educators to work in child care programs. The child care retention program shall be
administered by the commissioner of human services.
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 child
care retention 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, all providers receiving retention
payments under this section must:
new text end
new text begin
(1) complete an application developed by the commissioner for each payment period
for which the eligible program applies for funding;
new text end
new text begin
(2) 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 maximum allowed duration of vacations and holidays must be established by
the commissioner; and
new text end
new text begin
(3) submit data on child enrollment and attendance to the commissioner in the form and
manner prescribed by the commissioner.
new text end
new text begin
(b) Money received under this section must be expended by a provider no later than six
months after the date the payment was received.
new text end
new text begin
(c) Recipients must comply with all requirements listed in the application under this
section. Methods for demonstrating that requirements have been met shall be determined
by the commissioner.
new text end
new text begin
(d) Recipients must keep accurate and legible records of the following at the site where
services are delivered:
new text end
new text begin
(1) use of money;
new text end
new text begin
(2) attendance records. Daily attendance records must be completed every day 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 and picked up from the child care provider must be entered by the person
dropping off or picking up the child; and
new text end
new text begin
(3) staff employment, compensation, and benefits records. Employment, compensation,
and benefits records 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 retention payments, as required under
section 181.032, paragraphs (d) to (f); and any other records required to be maintained under
section 177.30.
new text end
new text begin
(e) The requirement to document compensation and benefits only applies to family child
care providers if retention payment money is used for employee compensation and benefits.
new text end
new text begin
(f) All records must be retained at the site where services are delivered for six years after
the date of receipt of payment and be made immediately available to the commissioner upon
request. Any records not provided to the commissioner at the date and time of the request
are deemed inadmissible if offered as evidence by a provider in any proceeding to contest
an overpayment or disqualification of the provider.
new text end
new text begin
(g) Recipients that fail to meet the requirements under this section are 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. 4. new text end
new text begin Providing payments. new text end
new text begin
(a) The commissioner shall provide retention payments
under this section to all eligible programs on a noncompetitive basis.
new text end
new text begin
(b) The commissioner shall award retention payments to all eligible programs. 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
(c) 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
(d) The amount awarded per full-time equivalent individual caring for children for each
payment type must be established by the commissioner.
new text end
new text begin
(e) Payments must be increased by ten percent for providers receiving payments through
the child care assistance programs under section 119B.03 or 119B.05 or early learning
scholarships under section 124D.165 or whose program is located in a child care access
equity area. Child care access equity areas are areas with low access to child care, high
poverty rates, high unemployment rates, low home ownership rates, and low median
household incomes. The commissioner must develop a method for establishing child care
access equity areas.
new text end
new text begin
(f) The commissioner shall make payments to eligible programs under this section in
the form, frequency, and manner established by the commissioner.
new text end
new text begin Subd. 5. new text end
new text begin Eligible uses of money. new text end
new text begin
(a) Recipients that are child care centers licensed under
Minnesota Rules, chapter 9503; certified license-exempt child care centers under chapter
245H; or Tribally licensed child care centers must use money provided 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. The increases in this paragraph must occur no less frequently than once per year.
new text end
new text begin
(b) Recipients that are family and group family child care homes licensed under
Minnesota Rules, chapter 9502, or are Tribally licensed family child care homes shall use
money provided under this section for one or more of the following uses:
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. 6. 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, may be 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) Payments must be used on one or more of the following eligible activities to meet
child care assistance program requirements under sections 119B.03 and 119B.05:
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. 7. new text end
new text begin Carryforward authority. new text end
new text begin
Money appropriated under this section are available
until expended.
new text end
new text begin Subd. 8. 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 the number of payments provided to recipients and outcomes of the retention payment
program since the last report. This subdivision expires January 31, 2033.
new text end
Sec. 18.
new text begin
[119B.28] SHARED SERVICES GRANTS.
new text end
new text begin
(a) The commissioner of human services shall establish a grant program to distribute
money for the planning, establishment, expansion, improvement, or operation of shared
services alliances to allow family child care providers to achieve economies of scale. The
commissioner must develop a process to fund organizations to operate shared services
alliances that includes application forms, timelines, and standards for renewal. For purposes
of this section, "shared services alliances" means networks of licensed family child care
providers that share services to reduce costs and achieve efficiencies.
new text end
new text begin
(b) Programs eligible to be a part of the shared services alliances supported through this
grant program include:
new text end
new text begin
(1) family child care or group family child care homes licensed under Minnesota Rules,
chapter 9502;
new text end
new text begin
(2) Tribally licensed family child care or group family child care; and
new text end
new text begin
(3) individuals in the process of starting a family child care or group family child care
home.
new text end
new text begin
(c) Eligible applicants include public entities and private for-profit and nonprofit
organizations.
new text end
new text begin
(d) Grantees shall use the grant money to deliver one or more of the following services:
new text end
new text begin
(1) pooling the 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 reporting for programs
such as 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 child care provider participants 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
(e) The commissioner must consult with the commissioner of management and budget
on program outcomes, evaluation metrics, and progress indicators for the grant program
under this section. The commissioner must only implement program outcomes, evaluation
metrics, and progress indicators that are determined through and agreed upon during the
consultation with the commissioner of management and budget. The commissioner shall
not implement the grant program under this section until the consultation with the
commissioner of management and budget is completed. The commissioner must incorporate
agreed upon program outcomes, evaluation metrics, and progress indicators into grant
applications, requests for proposals, and any reports to the legislature.
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. 19.
new text begin
[119B.29] CHILD CARE PROVIDER ACCESS TO TECHNOLOGY
GRANTS.
new text end
new text begin
(a) The commissioner of human services shall distribute money provided by this section
through grants to one or more organizations to offer grants or other supports to child care
providers for technology intended to improve the providers' business practices. The
commissioner must develop a process to fund organizations to provide technology supports
that includes application forms, timelines, reporting requirements, and standards for renewal.
new text end
new text begin
(b) Programs eligible to be supported through this grant program include:
new text end
new text begin
(1) child care centers licensed under Minnesota Rules, chapter 9503;
new text end
new text begin
(2) family or group family child care homes licensed under Minnesota Rules, chapter
9502; and
new text end
new text begin
(3) Tribally licensed centers, family child care, and group family child care.
new text end
new text begin
(c) Eligible applicants include public entities and private for-profit and nonprofit
organizations with the ability to develop technology products for child care business
management or offer training, technical assistance, coaching, or other supports for child
care providers to use technology products for child care business management.
new text end
new text begin
(d) Grantees shall use the grant money, either directly or through grants to 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; and
new text end
new text begin
(5) other services as determined by the commissioner.
new text end
Sec. 20.
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. 21.
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
119B
deleted text end
deleted text begin
and
deleted text end
deleted text begin
245E
deleted 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
245E
deleted 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. 22. new text begin DIRECTION TO COMMISSIONER; 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
commissioner of employment and economic development, the commissioner of education,
the Children's Cabinet, and relevant stakeholders, a child care and early education
professional wage scale that:
new text end
new text begin
(1) provides recommended wages that are equivalent to elementary school educators
with similar credentials and experience;
new text end
new text begin
(2) 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; and
new text end
new text begin
(3) 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 must submit a 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 for 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. 23. 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
Sec. 24. new text begin RECOGNIZING COMPARABLE COMPETENCIES TO ACHIEVE
COMPARABLE COMPENSATION TASK FORCE.
new text end
new text begin Subdivision 1. new text end
new text begin Membership. new text end
new text begin
(a) The Recognizing Comparable Competencies to Achieve
Comparable Compensation Task Force shall consist of the following 16 members, appointed
by the governor:
new text end
new text begin
(1) two individuals who are directors of a licensed child care center, one from greater
Minnesota and one from the seven-county metropolitan area;
new text end
new text begin
(2) two individuals who are license holders of family child care programs, one from
greater Minnesota and one from the seven-county metropolitan area;
new text end
new text begin
(3) four individuals who are early childhood educators, one who works in a licensed
child care center, one who works in a public-school-based early childhood program, one
who works in a Head Start program or a community education program, and one who works
in a licensed family child care setting;
new text end
new text begin
(4) one representative of a federally recognized Tribe who has expertise in the early care
and education system;
new text end
new text begin
(5) one representative from the Children's Cabinet;
new text end
new text begin
(6) two parents of children under five years of age, one parent whose child attends a
private early care and education program and one parent whose child attends a public
program. One parent under this clause must be from greater Minnesota, and the other parent
must be from the seven-county metropolitan area; and
new text end
new text begin
(7) four individuals who have expertise in early childhood workforce issues.
new text end
new text begin
(b) The governor must select a chair or cochairs for the task force from among the
members. The first task force meeting must be convened by the chair or cochairs and held
no later than September 1, 2023. Thereafter, the chair or cochairs shall convene the task
force at least monthly and may convene other meetings as necessary. The chair or cochairs
shall convene meetings in a manner to allow for access from diverse geographic locations
in Minnesota.
new text end
new text begin
(c) Compensation of task force members, filling of task force vacancies, and removal
of task force members are governed by Minnesota Statutes, section 15.059.
new text end
new text begin Subd. 2. new text end
new text begin Duties. new text end
new text begin
(a) The task force must develop a compensation framework for the
early childhood workforce that incorporates competencies and experiences, as well as
educational attainment.
new text end
new text begin
(b) In developing the compensation framework required under this subdivision, the task
force must:
new text end
new text begin
(1) identify competencies and experiences to incorporate into the framework, including
but not limited to multilingualism and previous work experience in a direct care setting;
and
new text end
new text begin
(2) propose mechanisms for including the compensation framework in the state's early
childhood programs and services.
new text end
new text begin Subd. 3. new text end
new text begin Administration. new text end
new text begin
(a) The commissioner of management and budget shall provide
staff and administrative services for the task force.
new text end
new text begin
(b) The task force expires upon submission of the final report required under subdivision
5, or January 30, 2025, whichever is earlier.
new text end
new text begin
(c) The task force is subject to Minnesota Statutes, chapter 13D.
new text end
new text begin Subd. 4. new text end
new text begin Required reports. new text end
new text begin
By December 1, 2024, the task force must submit its
preliminary findings to the governor and the chairs and ranking minority members of the
legislative committees with jurisdiction over early childhood programs. By January 15,
2025, the task force must submit the compensation framework and proposed mechanisms
for incorporating the framework into the state's early childhood programs and services to
the governor and the chairs and ranking minority members of the legislative committees
with jurisdiction over early childhood programs.
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, applicants
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.
Minnesota Statutes 2022, section 256N.26, subdivision 12, is amended to read:
Subd. 12.
Treatment of Supplemental Security Income.
deleted text begin If a child placed in foster
care receives benefits through Supplemental Security Income (SSI) at the time of foster
care placement or subsequent to placement in foster care, the financially responsible agency
may apply to be the payee for the child for the duration of the child's placement in foster
care.deleted text end If a child continues to be eligible for deleted text begin SSIdeleted text end new text begin Supplemental Security Income benefitsnew text end after
finalization of the adoption or transfer of permanent legal and physical custody and is
determined to be eligible for a payment under Northstar Care for Children, a permanent
caregiver may choose to receive payment from both programs simultaneously. The permanent
caregiver is responsible to report the amount of the payment to the Social Security
Administration and the deleted text begin SSIdeleted text end new text begin Supplemental Security Incomenew text end payment will be reduced as
required by the Social Security Administration.
Sec. 3.
new text begin
[256N.262] FOSTER CHILDREN BENEFITS TRUST.
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) "Beneficiary" means a current or former child in foster care who is or was entitled
to cash benefits.
new text end
new text begin
(c) "Cash benefits" means all sources of income a child in foster care is entitled to,
including death benefits; survivor benefits; crime victim impact payments; federal cash
benefits from programs administered by the Social Security Administration, including from
the Supplemental Security Income and the Retirement, Survivors, Disability Insurance
programs; and any other eligible income as determined by the Office of the Foster Youth
Ombudsperson.
new text end
new text begin Subd. 2. new text end
new text begin Establishment. new text end
new text begin
(a) The foster children benefits trust is established. The trust
must be funded by appropriations to the Office of the Foster Youth Ombudsperson to
compensate beneficiaries for cash benefits taken by a financially responsible agency to pay
for the beneficiaries' care. The trust must be managed to ensure the stability and growth of
the trust.
new text end
new text begin
(b) All assets of the trust are held in trust for the exclusive benefit of beneficiaries. Assets
must be held in a separate account in the state treasury to be known as the foster children
benefits trust account or in accounts with the third-party provider selected pursuant to
subdivision 9.
new text end
new text begin Subd. 3. new text end
new text begin Requirements of financially responsible agencies. new text end
new text begin
(a) A financially responsible
agency must assess whether each child the agency is responsible for is eligible to receive
any cash benefits as soon as the custody of the child is transferred to a child placing agency
or responsible social services agency pursuant to section 260C.201, subdivision 1, or custody
of the child is otherwise transferred to the state.
new text end
new text begin
(b) If a child placed in foster care is eligible to receive cash benefits, the financially
responsible agency must:
new text end
new text begin
(1) apply to be the payee for the child for the duration of the child's placement in foster
care;
new text end
new text begin
(2) at least monthly, transfer all cash benefits received on behalf of a beneficiary to the
Office of the Foster Youth Ombudsperson to be deposited in the trust;
new text end
new text begin
(3) at least annually, notify the Office of the Foster Youth Ombudsperson of all cash
benefits received for each beneficiary along with documentation identifying the beneficiary
and amounts received for the child;
new text end
new text begin
(4) notify each beneficiary 18 years of age or older that the beneficiary may be entitled
to disbursements pursuant to the foster children benefits trust and inform the child how to
contact the Office of the Foster Youth Ombudsperson about the trust; and
new text end
new text begin
(5) retain all documentation related to cash benefits received for a beneficiary for at least
five years after the agency is no longer the beneficiary's financially responsible agency.
new text end
new text begin
(c) The financially responsible agency is liable to a beneficiary for any benefit payment
that the agency receives as payee for a beneficiary that is not included in the documentation
sent to the Office of the Foster Youth Ombudsperson as required by this subdivision.
new text end
new text begin Subd. 4. new text end
new text begin Deposits. new text end
new text begin
The Office of the Foster Youth Ombudsperson must deposit an
amount equal to the cash benefits received by a financially responsible agency in a separate
account for each beneficiary.
new text end
new text begin Subd. 5. new text end
new text begin Ombudsperson's duties. new text end
new text begin
(a) The Office of the Foster Youth Ombudsperson
must keep a record of the amounts deposited pursuant to subdivision 4 and all disbursements
for each beneficiary's account.
new text end
new text begin
(b) Annually, the Office of the Foster Youth Ombudsperson must determine the annual
interest earnings of the trust, which include realized capital gains and losses.
new text end
new text begin
(c) The Office of the Foster Youth Ombudsperson must apportion any annual capital
gains earnings to the separate beneficiaries' accounts. The rate to be used in this
apportionment, computed to the last full quarter percent, must be determined by dividing
the capital gains earnings by the total invested assets of the trust.
new text end
new text begin
(d) For each beneficiary between the ages of 14 and 18, the Office of the Foster Youth
Ombudsperson must notify the beneficiary of the amount of cash benefits received on the
beneficiary's behalf in the prior calendar year and the tax implications of those benefits by
February 1 of each year.
new text end
new text begin
(e) Account owner data, account data, and data on beneficiaries of accounts are private
data on individuals or nonpublic data as defined in section 13.02.
new text end
new text begin Subd. 6. new text end
new text begin Account protections. new text end
new text begin
(a) Trust assets are not subject to claims by creditors of
the state, are not part of the general fund, and are not subject to appropriation by the state.
new text end
new text begin
(b) Trust assets may not be used as collateral, as a part of a structured settlement, or in
any way contracted to be paid to anyone who is not the beneficiary.
new text end
new text begin
(c) Trust assets are not subject to seizure or garnishment as assets or income of the
beneficiary.
new text end
new text begin Subd. 7. new text end
new text begin Reports. new text end
new text begin
(a) By December 1, 2024, the Office of the Foster Youth
Ombudsperson must submit a report to the legislative committees with jurisdiction over
human services on the potential tax and state and federal benefit impacts of the trust and
disbursements on beneficiaries and include recommendations on how best to minimize any
increased tax burden or benefit reduction due to the trust.
new text end
new text begin
(b) By December 1 of each year, the Office of the Foster Youth Ombudsperson must
submit a report to the legislative committees with jurisdiction over foster youth on the cost
of depositing into the trust pursuant to subdivision 4 and a projection for future costs.
new text end
new text begin Subd. 8. new text end
new text begin Disbursements. new text end
new text begin
(a) Once a beneficiary has reached 18 years of age, the Office
of the Foster Youth Ombudsperson must disburse $700 each month to the beneficiary until
the beneficiary's account is depleted. If the total amount remaining in a beneficiary's account
is less than $700, the Office of the Foster Youth Ombudsperson must disburse that total
amount remaining to the beneficiary.
new text end
new text begin
(b) With each disbursement, the Office of the Foster Youth Ombudsperson must include
information about the potential tax and benefits consequences of the disbursement.
new text end
new text begin
(c) On petition of a minor beneficiary who is 14 years of age or older, a court may order
the Office of the Foster Youth Ombudsperson to deliver or pay to the beneficiary or expend
for the beneficiary's benefit the amount of the beneficiary's trust account as the court
considers advisable for the use and benefit of the beneficiary.
new text end
new text begin Subd. 9. new text end
new text begin Administration. new text end
new text begin
The Office of the Foster Youth Ombudsperson must administer
the program pursuant to this section. The Office of the Foster Youth Ombudsperson may
contract with one or more third parties to carry out some or all of these administrative duties,
including managing the assets of the trust and ensuring that records are maintained.
new text end
new text begin Subd. 10. new text end
new text begin Repayment program. new text end
new text begin
(a) No later than January 1, 2025, the Office of the
Foster Youth Ombudsperson must identify every person for whom a financially responsible
agency received cash benefits as the person's representative payee between August 1, 2018,
and July 31, 2023, and the amount of money diverted to the financially responsible agency
during that time. The Office of the Foster Youth Ombudsperson must attempt to notify
every individual identified in this paragraph of the individual's potential eligibility for
repayment pursuant to this subdivision no later than July 1, 2025.
new text end
new text begin
(b) No later than January 1, 2026, the Office of the Foster Youth Ombudsperson must
begin accepting applications for individuals described in paragraph (a) to receive
compensation for cash benefits diverted to the individual's financially responsible agency
between August 1, 2018, and July 31, 2023. The Office of the Foster Youth Ombudsperson
must develop a system to process the applications and approve all applications that can
show that the applicant had cash benefits diverted to a financially responsible agency between
August 1, 2018, and July 31, 2023.
new text end
new text begin
(c) For every beneficiary already enrolled in the foster youth benefits trust that the Office
of the Foster Youth Ombudsperson determines had cash benefits diverted to a financially
responsible agency between August 1, 2018, and July 31, 2023, the Office of the Foster
Youth Ombudsperson must deposit an amount equal to the cash benefits diverted to a
financially responsible agency between August 1, 2018, and July 31, 2023, into the
beneficiary's trust account. The Office of the Foster Youth Ombudsperson must screen
beneficiaries for eligibility under this paragraph automatically without requiring an
application from the beneficiaries.
new text end
new text begin
(d) For every applicant under paragraph (b) who is not already enrolled in the foster
youth benefits trust, the Office of the Foster Youth Ombudsperson must directly award the
applicant an amount equal to the cash benefits diverted to a financially responsible agency
between August 1, 2018, and July 31, 2023.
new text end
new text begin
(e) No later than January 31, 2025, the Office of the Foster Youth Ombudsperson must
issue a report to the chairs and ranking minority members of the legislative committees with
jurisdiction over foster youth. The report must include:
new text end
new text begin
(1) the number of persons identified for whom a financially responsible agency received
cash benefits as the person's representative payee between August 1, 2018, and July 31,
2023; and
new text end
new text begin
(2) the Office of the Foster Youth Ombudsperson's plan for notifying eligible persons
described in paragraph (a).
new text end
new text begin Subd. 11. new text end
new text begin Rulemaking authority. new text end
new text begin
The Office of the Foster Youth Ombudsperson is
authorized, subject to the provisions of chapter 14, to make rules necessary to the operation
of the foster youth benefits trust and repayment program and to aid in performing its
administrative duties and ensuring an equitable result for beneficiaries and former foster
youths.
new text end
Sec. 4.
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.
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 Family First Prevention Services Act 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 Family First Prevention Services Act service
or program;
new text end
new text begin
(3) to implement or expand any existing Family First Prevention Services Act service
or programming; 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) Notwithstanding this subdivision, to the extent that money is available, no county
or Tribe shall be allocated less than:
new text end
new text begin
(1) $25,000 in calendar year 2024;
new text end
new text begin
(2) $50,000 in calendar year 2025; and
new text end
new text begin
(3) $75,000 in calendar year 2026 and each year thereafter.
new text end
new text begin
(c) 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
(d) 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. 5.
new text begin
[260.0141] FAMILY FIRST PREVENTION SERVICES ACT KINSHIP
NAVIGATOR 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
kinship navigator grant program 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 grant funds to assess and provide support to
meet kinship caregiver needs, provide connection to local and statewide resources, and
provide case management to assist with complex cases.
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 the 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.
Sec. 7.
Minnesota Statutes 2022, section 260C.007, subdivision 6, is amended to read:
Subd. 6.
Child in need of protection or services.
"Child in need of protection or
services" means a child who is in need of protection or services because the child:
(1) is abandoned or without parent, guardian, or custodian;
(2)(i) has been a victim of physical or sexual abuse as defined in section 260E.03,
subdivision 18 or 20, (ii) resides with or has resided with a victim of child abuse as defined
in subdivision 5 or domestic child abuse as defined in subdivision 13, (iii) resides with or
would reside with a perpetrator of domestic child abuse as defined in subdivision 13 or child
abuse as defined in subdivision 5 or 13, or (iv) is a victim of emotional maltreatment as
defined in subdivision 15;
(3) is without necessary food, clothing, shelter, education, or other required care for the
child's physical or mental health or morals because the child's parent, guardian, or custodian
is unable or unwilling to provide that care;
(4) is without the special care made necessary by a physical, mental, or emotional
condition because the child's parent, guardian, or custodian is unable or unwilling to provide
that carenew text begin . Parents of children reported to be in an emergency department or hospital setting
due to mental health or a disability who cannot be safely discharged to their family and are
unable to access necessary services must not be viewed as unable or unwilling to provide
care unless there are other factors presentnew text end ;
(5) is medically neglected, which includes, but is not limited to, the withholding of
medically indicated treatment from an infant with a disability with a life-threatening
condition. The term "withholding of medically indicated treatment" means the failure to
respond to the infant's life-threatening conditions by providing treatment, including
appropriate nutrition, hydration, and medication which, in the treating physician's, advanced
practice registered nurse's, or physician assistant's reasonable medical judgment, will be
most likely to be effective in ameliorating or correcting all conditions, except that the term
does not include the failure to provide treatment other than appropriate nutrition, hydration,
or medication to an infant when, in the treating physician's, advanced practice registered
nurse's, or physician assistant's reasonable medical judgment:
(i) the infant is chronically and irreversibly comatose;
(ii) the provision of the treatment would merely prolong dying, not be effective in
ameliorating or correcting all of the infant's life-threatening conditions, or otherwise be
futile in terms of the survival of the infant; or
(iii) the provision of the treatment would be virtually futile in terms of the survival of
the infant and the treatment itself under the circumstances would be inhumane;
(6) is one whose parent, guardian, or other custodian for good cause desires to be relieved
of the child's care and custody, including a child who entered foster care under a voluntary
placement agreement between the parent and the responsible social services agency under
section 260C.227;
(7) has been placed for adoption or care in violation of law;
(8) is without proper parental care because of the emotional, mental, or physical disability,
or state of immaturity of the child's parent, guardian, or other custodian;
(9) is one whose behavior, condition, or environment is such as to be injurious or
dangerous to the child or others. An injurious or dangerous environment may include, but
is not limited to, the exposure of a child to criminal activity in the child's home;
(10) is experiencing growth delays, which may be referred to as failure to thrive, that
have been diagnosed by a physician and are due to parental neglect;
(11) is a sexually exploited youth;
(12) has committed a delinquent act or a juvenile petty offense before becoming ten
years old;
(13) is a runaway;
(14) is a habitual truant;
(15) has been found incompetent to proceed or has been found not guilty by reason of
mental illness or mental deficiency in connection with a delinquency proceeding, a
certification under section 260B.125, an extended jurisdiction juvenile prosecution, or a
proceeding involving a juvenile petty offense; or
(16) has a parent whose parental rights to one or more other children were involuntarily
terminated or whose custodial rights to another child have been involuntarily transferred to
a relative and there is a case plan prepared by the responsible social services agency
documenting a compelling reason why filing the termination of parental rights petition under
section 260C.503, subdivision 2, is not in the best interests of the child.
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.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 deleted text begin serves at the pleasure of the
governor in the unclassified service,deleted text end 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. 10.
Minnesota Statutes 2022, section 260E.01, is amended to read:
260E.01 POLICY.
(a) 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 settings; and
(4) provide, when necessary, a safe temporary or permanent home environment for
maltreated children.
(b) In addition, it is the policy of this state to:
(1) require the reporting of maltreatment of children in the home, school, and community
settings;
(2) provide for deleted text begin thedeleted text end voluntary reporting of maltreatment of children;
(3) require an investigation when the report alleges sexual abuse or substantial child
endangermentnew text begin , except when the report alleges sex trafficking by a noncaregiver sex traffickernew text end ;
(4) provide a family assessment, if appropriate, when the report does not allege sexual
abuse or substantial child endangerment; deleted text begin and
deleted text end
(5) new text begin provide a noncaregiver sex trafficking assessment when the report alleges sex
trafficking by a noncaregiver sex trafficker; and
new text end
new text begin (6) new text end provide protective, family support, and family preservation services when needed
in appropriate cases.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2024.
new text end
Sec. 11.
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. 12.
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. 13.
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. 14.
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. 15.
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. 16.
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. 17.
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. 18.
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. 19.
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. 20.
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. 21.
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. 22.
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. 23.
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. 24.
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. 25.
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. 26.
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. 27.
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. 28.
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.
(c) The enrollment must remain in place while the party contests the 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. 29.
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. 30.
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. 31.
Minnesota Statutes 2022, section 518A.65, is amended to read:
518A.65 DRIVER'S LICENSE SUSPENSION.
(a)new text begin This paragraph is effective July 1, 2023.new text end 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 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 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 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 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) This paragraph is effective July 1, 2023.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 payment of child support or would have direct harmful effects on the obligor or joint
child that makes 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; and
new text end
new text begin
(11) other circumstances of the obligor indicate that a temporary condition exists for
which suspension of a driver's license for the nonpayment of child support is not appropriate.
When considering whether driver's license suspension is appropriate, the public authority
must assess: (i) whether suspension of the driver's license is likely to induce payment of
child support; and (ii) whether suspension of the 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 a 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 .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective July 1, 2023, unless otherwise specified.
new text end
Sec. 32.
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
ARTICLE 15
MISCELLANEOUS
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 Grant program reporting. new text end
new text begin
The commissioner must submit a report to the
chairs and ranking minority members of the legislative committees with jurisdiction over
health and human services by December 31, 2023, and by each December 31 thereafter on
the following information:
new text end
new text begin
(1) the number of grant programs administered by the commissioner that required a
full-time equivalent staff appropriation or administrative appropriation in order to implement;
new text end
new text begin
(2) the total amount of funds appropriated to the commissioner for full-time equivalent
staff or administration for all the grant programs; and
new text end
new text begin
(3) for each grant program administered by the commissioner:
new text end
new text begin
(i) the amount of funds appropriated to the commissioner for full-time equivalent staff
or administration to administer that particular grant program;
new text end
new text begin
(ii) the actual amount of funds that were spent on full-time equivalent staff or
administration to administer that particular grant program; and
new text end
new text begin
(iii) if there were funds appropriated that were not spent on full-time equivalent staff or
administration to administer that particular grant program, what the funds were actually
spent on.
new text end
Sec. 2. 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 the basic sliding fee program under Minnesota Statutes, section
119B.03.
new text end
new text begin
(c) The commissioner of human services shall allocate $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
(d) The commissioner of human services shall allocate $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
(e) The commissioner of human services shall allocate $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. 3. 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 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 reporting requirements 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, 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; and
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.
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
50 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; and
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.
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 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; and
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.
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; and
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.
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; and
new text end
new text begin
(3) completing necessary changes to comply with federal requirements.
new text end
Sec. 4. new text begin OUTCOMES AND EVALUATION CONSULTATION REQUIREMENTS.
new text end
new text begin
For any section in this act that includes program outcomes, evaluation metrics or
requirements, progress indicators, or other related measurements, any commissioner must
consult with the commissioner of management and budget to develop outcomes, metrics or
requirements, indicators, or other related measurements for each section in this act affected
by this section. The commissioner must only implement program outcomes, evaluation
metrics or requirements, progress indicators, or other related measurements that are
determined through and agreed upon during the consultation with the commissioner of
management and budget. The commissioner shall not implement any sections affected by
this section until the consultation with the commissioner of management and budget is
completed. The commissioner must incorporate agreed-upon program outcomes, evaluation
metrics, and progress indicators into grant applications, requests for proposals, and any
reports to the legislature.
new text end
Sec. 5. new text begin FINANCIAL REVIEW OF GRANT AND BUSINESS SUBSIDY
RECIPIENTS.
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 following terms have the
meanings given.
new text end
new text begin
(b) "Grant" means a grant or business subsidy funded by an appropriation in this act.
new text end
new text begin
(c) "Grantee" means a business entity as defined in Minnesota Statutes, section 5.001.
new text end
new text begin Subd. 2. new text end
new text begin Financial information required; determination of ability to perform. new text end
new text begin
Before
an agency awards a competitive, legislatively-named, single source, or sole source grant,
the agency must assess the risk that a grantee cannot or would not perform the required
duties. In making this assessment, the agency must review the following information:
new text end
new text begin
(1) the grantee's history of performing duties similar to those required by the grant,
whether the size of the grant requires the grantee to perform services at a significantly
increased scale, and whether the size of the grant will require significant changes to the
operation of the grantee's organization;
new text end
new text begin
(2) for a grantee that is a nonprofit organization, the grantee's Form 990 or Form 990-EZ
filed with the Internal Revenue Service in each of the prior three years. If the grantee has
not been in existence long enough or is not required to file Form 990 or Form 990-EZ, the
grantee must demonstrate to the grantor's satisfaction that the grantee is exempt and must
instead submit the grantee's most recent board-reviewed financial statements and
documentation of internal controls;
new text end
new text begin
(3) for a for-profit business, three years of federal and state tax returns, current financial
statements, certification that the business is not under bankruptcy proceedings, and disclosure
of any liens on its assets. If a business has not been in business long enough to have three
years of tax returns, the grantee must demonstrate to the grantor's satisfaction that the grantee
has appropriate internal financial controls;
new text end
new text begin
(4) evidence of registration and good standing with the secretary of state under Minnesota
Statutes, chapter 317A, or other applicable law;
new text end
new text begin
(5) if the grantee's total annual revenue exceeds $750,000, the grantee's most recent
financial audit performed by an independent third party in accordance with generally accepted
accounting principles; and
new text end
new text begin
(6) certification, provided by the grantee, that none of its principals have been convicted
of a financial crime.
new text end
new text begin Subd. 3. new text end
new text begin Additional measures for some grantees. new text end
new text begin
The agency may require additional
information and must provide enhanced oversight for grants that have not previously received
state or federal grants for similar amounts or similar duties and so have not yet demonstrated
the ability to perform the duties required under the grant on the scale required.
new text end
new text begin Subd. 4. new text end
new text begin Assistance from administration. new text end
new text begin
An agency without adequate resources or
experience to perform obligations under this section may contract with the commissioner
of administration to perform the agency's duties under this section.
new text end
new text begin Subd. 5. new text end
new text begin Agency authority to not award grant. new text end
new text begin
If an agency determines that there is
an appreciable risk that a grantee receiving a competitive, single source, or sole source grant
cannot or would not perform the required duties under the grant agreement, the agency must
notify the grantee and the commissioner of administration and give the grantee an opportunity
to respond to the agency's concerns. If the grantee does not satisfy the agency's concerns
within 45 days, the agency must not award the grant.
new text end
new text begin Subd. 6. new text end
new text begin Legislatively-named grantees. new text end
new text begin
If an agency determines that there is an
appreciable risk that a grantee receiving a legislatively-named grant cannot or would not
perform the required duties under the grant agreement, the agency must notify the grantee,
the commissioner of administration, and the chair and ranking minority members of Ways
and Means Committee in the house of representatives, the chairs and ranking minority
members of the Finance Committee in the senate, and the chairs and ranking minority
members of the committees in the house of representatives and the senate with primary
jurisdiction over the bill in which the money for the grant was appropriated. The agency
must give the grantee an opportunity to respond to the agency's concerns. If the grantee
does not satisfy the agency's concerns within 45 days, the agency must delay award of the
grant until adjournment of the next regular or special legislative session.
new text end
new text begin Subd. 7. new text end
new text begin Subgrants. new text end
new text begin
If a grantee will disburse the money received from the grant to
other organizations to perform duties required under the grant agreement, the agency must
be a party to agreements between the grantee and a subgrantee. Before entering agreements
for subgrants, the agency must perform the financial review required under this section with
respect to the subgrantees.
new text end
new text begin Subd. 8. new text end
new text begin Effect. new text end
new text begin
The requirements of this section are in addition to other requirements
imposed by law, the commissioner of administration under Minnesota Statutes, sections
16B.97 to 16B.98, or agency grant policy.
new text end
ARTICLE 16
HEALTH CARE AFFORDABILITY AND DELIVERY
Section 1.
new text begin
[62J.86] DEFINITIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
For the purposes of sections 62J.86 to 62J.92, the following
terms have the meanings given.
new text end
new text begin Subd. 2. new text end
new text begin Advisory council. new text end
new text begin
"Advisory council" means the Health Care Affordability
Advisory Council established under section 62J.88.
new text end
new text begin Subd. 3. new text end
new text begin Board. new text end
new text begin
"Board" means the Health Care Affordability Board established under
section 62J.87.
new text end
Sec. 2.
new text begin
[62J.87] HEALTH CARE AFFORDABILITY BOARD.
new text end
new text begin Subdivision 1. new text end
new text begin Membership. new text end
new text begin
(a) The Health Care Affordability Board consists of 13
members, appointed as follows:
new text end
new text begin
(1) five members appointed by the governor;
new text end
new text begin
(2) two members appointed by the majority leader of the senate;
new text end
new text begin
(3) two members appointed by the minority leader of the senate;
new text end
new text begin
(4) two members appointed by the speaker of the house; and
new text end
new text begin
(5) two members appointed by the minority leader of the house of representatives.
new text end
new text begin
(b) All appointed members must have knowledge and demonstrated expertise in one or
more of the following areas: health care finance, health economics, health care management
or administration at a senior level, health care consumer advocacy, representing the health
care workforce as a leader in a labor organization, purchasing health care insurance as a
health benefits administrator, delivery of primary care, health plan company administration,
public or population health, and addressing health disparities and structural inequities.
new text end
new text begin
(c) A member may not participate in board proceedings involving an organization,
activity, or transaction in which the member has either a direct or indirect financial interest,
other than as an individual consumer of health services.
new text end
new text begin
(d) The Legislative Coordinating Commission shall coordinate appointments under this
subdivision to ensure that board members are appointed by August 1, 2023, and that board
members as a whole meet all of the criteria related to the knowledge and expertise specified
in paragraph (b).
new text end
new text begin Subd. 2. new text end
new text begin Terms. new text end
new text begin
(a) Board appointees shall serve four-year terms. A board member shall
not serve more than three consecutive terms.
new text end
new text begin
(b) A board member may resign at any time by giving written notice to the board.
new text end
new text begin Subd. 3. new text end
new text begin Chair; other officers. new text end
new text begin
(a) The board shall elect a chair by a majority of the
members. The chair shall serve for two years.
new text end
new text begin
(b) The board shall elect a vice-chair and other officers from its membership as it deems
necessary.
new text end
new text begin Subd. 4. new text end
new text begin Staff; technical assistance; contracting. new text end
new text begin
(a) The board shall hire a full-time
executive director and other staff, who shall serve in the unclassified service. The executive
director must have significant knowledge and expertise in health economics and demonstrated
experience in health policy.
new text end
new text begin
(b) The attorney general shall provide legal services to the board.
new text end
new text begin
(c) The Health Economics Division within the Department of Health shall provide
technical assistance to the board in analyzing health care trends and costs and in setting
health care spending growth targets.
new text end
new text begin
(d) The board may employ or contract for professional and technical assistance, including
actuarial assistance, as the board deems necessary to perform the board's duties.
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 board may request that a state agency provide
the board with any publicly available information in a usable format as requested by the
board, at no cost to the board.
new text end
new text begin
(b) The board may request from a state agency unique or custom data sets, and the agency
may charge the board 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) Any information provided to the board by a state agency must be de-identified. For
purposes of this subdivision, "de-identification" means the process used to prevent the
identity of a person or business from being connected with the information and ensuring
all identifiable information has been removed.
new text end
new text begin
(d) Any data submitted to the board shall retain its original classification under the
Minnesota Data Practices Act in chapter 13.
new text end
new text begin Subd. 6. new text end
new text begin Compensation. new text end
new text begin
Board members shall not receive compensation but may receive
reimbursement for expenses as authorized under section 15.059, subdivision 3.
new text end
new text begin Subd. 7. new text end
new text begin Meetings. new text end
new text begin
(a) Meetings of the board are subject to chapter 13D. The board shall
meet publicly at least quarterly. The board may meet in closed session when reviewing
proprietary information as specified in section 62J.71, subdivision 4.
new text end
new text begin
(b) The board shall announce each public meeting at least two weeks prior to the
scheduled date of the meeting. Any materials for the meeting shall be made public at least
one week prior to the scheduled date of the meeting.
new text end
new text begin
(c) At each public meeting, the board shall provide the opportunity for comments from
the public, including the opportunity for written comments to be submitted to the board
prior to a decision by the board.
new text end
Sec. 3.
new text begin
[62J.88] HEALTH CARE AFFORDABILITY ADVISORY COUNCIL.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
The governor shall appoint a Health Care Affordability
Advisory Council to provide advice to the board on health care costs and access issues and
to represent the views of patients and other stakeholders. Members of the advisory council
shall be appointed based on their knowledge and demonstrated expertise in one or more of
the following areas: health care delivery, ensuring health care access for diverse populations,
public and population health, patient perspectives, health care cost trends and drivers, clinical
and health services research, innovation in health care delivery, and health care benefits
management.
new text end
new text begin Subd. 2. new text end
new text begin Duties; reports. new text end
new text begin
(a) The council shall provide technical recommendations to
the board on:
new text end
new text begin
(1) the identification of economic indicators and other metrics related to the development
and setting of health care spending growth targets;
new text end
new text begin
(2) data sources for measuring health care spending; and
new text end
new text begin
(3) measurement of the impact of health care spending growth targets on diverse
communities and populations, including but not limited to those communities and populations
adversely affected by health disparities.
new text end
new text begin
(b) The council shall report technical recommendations and a summary of its activities
to the board and the chairs and ranking minority members of the legislative committees
with primary jurisdiction over health care policy and finance at least annually, and shall
submit additional reports on its activities and recommendations to the board, as requested
by the board or at the discretion of the council.
new text end
new text begin Subd. 3. new text end
new text begin Terms. new text end
new text begin
(a) Advisory council members shall serve four-year terms.
new text end
new text begin
(b) Removal and vacancies of advisory council members shall be governed by section
15.059.
new text end
new text begin Subd. 4. new text end
new text begin Compensation. new text end
new text begin
Advisory council members may be compensated according to
section 15.059.
new text end
new text begin Subd. 5. new text end
new text begin Meetings. new text end
new text begin
The advisory council shall meet at least quarterly. Meetings of the
advisory council are subject to chapter 13D.
new text end
new text begin Subd. 6. new text end
new text begin Expiration. new text end
new text begin
Notwithstanding section 15.059, the advisory council shall not
expire.
new text end
Sec. 4.
new text begin
[62J.89] DUTIES OF THE BOARD.
new text end
new text begin Subdivision 1. new text end
new text begin General. new text end
new text begin
(a) The board shall monitor the administration and reform of
the health care delivery and payment systems in the state. The board shall:
new text end
new text begin
(1) set health care spending growth targets for the state, as specified under section 62J.90;
new text end
new text begin
(2) enhance the transparency of provider organizations;
new text end
new text begin
(3) monitor the adoption and effectiveness of alternative payment methodologies;
new text end
new text begin
(4) foster innovative health care delivery and payment models that lower health care
cost growth while improving the quality of patient care;
new text end
new text begin
(5) monitor and review the impact of changes within the health care marketplace; and
new text end
new text begin
(6) monitor patient access to necessary health care services.
new text end
new text begin
(b) The board shall establish goals to reduce health care disparities in racial and ethnic
communities and to ensure access to quality care for persons with disabilities or with chronic
or complex health conditions.
new text end
new text begin Subd. 2. new text end
new text begin Market trends. new text end
new text begin
The board shall monitor efforts to reform the health care
delivery and payment system in Minnesota to understand emerging trends in the commercial
health insurance market, including large self-insured employers and the state's public health
care programs, in order to identify opportunities for state action to achieve:
new text end
new text begin
(1) improved patient experience of care, including quality and satisfaction;
new text end
new text begin
(2) improved health of all populations, including a reduction in health disparities; and
new text end
new text begin
(3) a reduction in the growth of health care costs.
new text end
new text begin Subd. 3. new text end
new text begin Recommendations for reform. new text end
new text begin
The board shall make recommendations for
legislative policy, market, or any other reforms to:
new text end
new text begin
(1) lower the rate of growth in commercial health care costs and public health care
program spending in the state;
new text end
new text begin
(2) positively impact the state's rankings in the areas listed in this subdivision and
subdivision 2; and
new text end
new text begin
(3) improve the quality and value of care for all Minnesotans, and for specific populations
adversely affected by health inequities.
new text end
new text begin Subd. 4. new text end
new text begin Office of Patient Protection. new text end
new text begin
The board shall establish an Office of Patient
Protection, to be operational by January 1, 2025. The office shall assist consumers with
issues related to access and quality of health care, and advise the legislature on ways to
reduce consumer health care spending and improve consumer experiences by reducing
complexity for consumers.
new text end
Sec. 5.
new text begin
[62J.90] HEALTH CARE SPENDING GROWTH TARGETS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment and administration. new text end
new text begin
The board shall establish and
administer the health care spending growth target program to limit health care spending
growth in the state, and shall report regularly to the legislature and the public on progress
toward these targets.
new text end
new text begin Subd. 2. new text end
new text begin Methodology. new text end
new text begin
(a) The board shall develop a methodology to establish annual
health care spending growth targets and the economic indicators to be used in establishing
the initial and subsequent target levels.
new text end
new text begin
(b) The health care spending growth target must:
new text end
new text begin
(1) use a clear and operational definition of total state health care spending;
new text end
new text begin
(2) promote a predictable and sustainable rate of growth for total health care spending
as measured by an established economic indicator, such as the rate of increase of the state's
economy or of the personal income of residents of this state, or a combination;
new text end
new text begin
(3) define the health care markets and the entities to which the targets apply;
new text end
new text begin
(4) take into consideration the potential for variability in targets across public and private
payers;
new text end
new text begin
(5) account for the health status of patients; and
new text end
new text begin
(6) incorporate specific benchmarks related to health equity.
new text end
new text begin
(c) In developing, implementing, and evaluating the growth target program, the board
shall:
new text end
new text begin
(1) consider the incorporation of quality of care and primary care spending goals;
new text end
new text begin
(2) ensure that the program does not place a disproportionate burden on communities
most impacted by health disparities, the providers who primarily serve communities most
impacted by health disparities, or individuals who reside in rural areas or have high health
care needs;
new text end
new text begin
(3) explicitly consider payment models that help ensure financial sustainability of rural
health care delivery systems and the ability to provide population health;
new text end
new text begin
(4) allow setting growth targets that encourage an individual health care entity to serve
populations with greater health care risks by incorporating:
new text end
new text begin
(i) a risk factor adjustment reflecting the health status of the entity's patient mix; and
new text end
new text begin
(ii) an equity adjustment accounting for the social determinants of health and other
factors related to health equity for the entity's patient mix;
new text end
new text begin
(5) ensure that growth targets:
new text end
new text begin
(i) do not constrain the Minnesota health care workforce, including the need to provide
competitive wages and benefits;
new text end
new text begin
(ii) do not limit the use of collective bargaining or place a floor or ceiling on health care
workforce compensation; and
new text end
new text begin
(iii) promote workforce stability and maintain high-quality health care jobs; and
new text end
new text begin
(6) consult with the advisory council and other stakeholders.
new text end
new text begin Subd. 3. new text end
new text begin Data. new text end
new text begin
The board shall identify data to be used for tracking performance in
meeting the growth target and identify methods of data collection necessary for efficient
implementation by the board. In identifying data and methods, the board shall:
new text end
new text begin
(1) consider the availability, timeliness, quality, and usefulness of existing data, including
the data collected under section 62U.04;
new text end
new text begin
(2) assess the need for additional investments in data collection, data validation, or data
analysis capacity to support the board in performing its duties; and
new text end
new text begin
(3) minimize the reporting burden to the extent possible.
new text end
new text begin Subd. 4. new text end
new text begin Setting growth targets; related duties. new text end
new text begin
(a) The board, by June 15, 2024, and
by June 15 of each succeeding calendar year through June 15, 2028, shall establish annual
health care spending growth targets for the next calendar year consistent with the
requirements of this section. The board shall set annual health care spending growth targets
for the five-year period from January 1, 2025, through December 31, 2029.
new text end
new text begin
(b) The board shall periodically review all components of the health care spending
growth target program methodology, economic indicators, and other factors. The board may
revise the annual spending growth targets after a public hearing, as appropriate. If the board
revises a spending growth target, the board must provide public notice at least 60 days
before the start of the calendar year to which the revised growth target will apply.
new text end
new text begin
(c) The board, based on an analysis of drivers of health care spending and evidence from
public testimony, shall evaluate strategies and new policies, including the establishment of
accountability mechanisms, that are able to contribute to meeting growth targets and limiting
health care spending growth without increasing disparities in access to health care.
new text end
new text begin Subd. 5. new text end
new text begin Hearings. new text end
new text begin
At least annually, the board shall hold public hearings to present
findings from spending growth target monitoring. The board shall also regularly hold public
hearings to take testimony from stakeholders on health care spending growth, setting and
revising health care spending growth targets, the impact of spending growth and growth
targets on health care access and quality, and as needed to perform the duties assigned under
section 62J.89, subdivisions 1, 2, and 3.
new text end
Sec. 6.
new text begin
[62J.91] NOTICE TO HEALTH CARE ENTITIES.
new text end
new text begin Subdivision 1. new text end
new text begin Notice. new text end
new text begin
(a) The board shall provide notice to all health care entities that
have been identified by the board as exceeding the spending growth target for any given
year.
new text end
new text begin
(b) For purposes of this section, "health care entity" shall be defined by the board during
the development of the health care spending growth methodology. When developing this
methodology, the board shall consider a definition of health care entity that includes clinics,
hospitals, ambulatory surgical centers, physician organizations, accountable care
organizations, integrated provider and plan systems, and other entities defined by the board,
provided that physician organizations with a patient panel of 15,000 or fewer, or which
represent providers who collectively receive less than $25,000,000 in annual net patient
service revenue from health plan companies and other payers, shall be exempt.
new text end
new text begin Subd. 2. new text end
new text begin Performance improvement plans. new text end
new text begin
(a) The board shall establish and implement
procedures to assist health care entities to improve efficiency and reduce cost growth by
requiring some or all health care entities provided notice under subdivision 1 to file and
implement a performance improvement plan. The board shall provide written notice of this
requirement to health care entities.
new text end
new text begin
(b) Within 45 days of receiving a notice of the requirement to file a performance
improvement plan, a health care entity shall:
new text end
new text begin
(1) file a performance improvement plan with the board; or
new text end
new text begin
(2) file an application with the board to waive the requirement to file a performance
improvement plan or extend the timeline for filing a performance improvement plan.
new text end
new text begin
(c) The health care entity may file any documentation or supporting evidence with the
board to support the health care entity's application to waive or extend the timeline to file
a performance improvement plan. The board shall require the health care entity to submit
any other relevant information it deems necessary in considering the waiver or extension
application, provided that this information shall be made public at the discretion of the
board. The board may waive or delay the requirement for a health care entity to file a
performance improvement plan in response to a waiver or extension request in light of all
information received from the health care entity, based on a consideration of the following
factors:
new text end
new text begin
(1) the costs, price, and utilization trends of the health care entity over time, and any
demonstrated improvement in reducing per capita medical expenses adjusted by health
status;
new text end
new text begin
(2) any ongoing strategies or investments that the health care entity is implementing to
improve future long-term efficiency and reduce cost growth;
new text end
new text begin
(3) whether the factors that led to increased costs for the health care entity can reasonably
be considered to be unanticipated and outside of the control of the entity.
new text end
new text begin
These factors may
include but shall not be limited to age and other health status adjusted factors and other cost
inputs such as pharmaceutical expenses and medical device expenses;
new text end
new text begin
(4) the overall financial condition of the health care entity; and
new text end
new text begin
(5) any other factors the board considers relevant. If the board declines to waive or
extend the requirement for the health care entity to file a performance improvement plan,
the board shall provide written notice to the health care entity that its application for a waiver
or extension was denied and the health care entity shall file a performance improvement
plan.
new text end
new text begin
(d) A health care entity shall file a performance improvement plan with the board:
new text end
new text begin
(1) within 45 days of receipt of an initial notice;
new text end
new text begin
(2) if the health care entity has requested a waiver or extension, within 45 days of receipt
of a notice that such waiver or extension has been denied; or
new text end
new text begin
(3) if the health care entity is granted an extension, on the date given on the extension.
new text end
new text begin
The performance improvement plan shall identify the causes of the entity's cost growth and
shall include but not be limited to specific strategies, adjustments, and action steps the entity
proposes to implement to improve cost performance. The proposed performance improvement
plan shall include specific identifiable and measurable expected outcomes and a timetable
for implementation. The timetable for a performance improvement plan must not exceed
18 months.
new text end
new text begin
(e) The board shall approve any performance improvement plan that it determines is
reasonably likely to address the underlying cause of the entity's cost growth and has a
reasonable expectation for successful implementation. If the board determines that the
performance improvement plan is unacceptable or incomplete, the board may provide
consultation on the criteria that have not been met and may allow an additional time period
of up to 30 calendar days for resubmission. Upon approval of the proposed performance
improvement plan, the board shall notify the health care entity to begin immediate
implementation of the performance improvement plan. Public notice shall be provided by
the board on its website, identifying that the health care entity is implementing a performance
improvement plan. All health care entities implementing an approved performance
improvement plan shall be subject to additional reporting requirements and compliance
monitoring, as determined by the board. The board shall provide assistance to the health
care entity in the successful implementation of the performance improvement plan.
new text end
new text begin
(f) All health care entities shall in good faith work to implement the performance
improvement plan. At any point during the implementation of the performance improvement
plan, the health care entity may file amendments to the performance improvement plan,
subject to approval of the board. At the conclusion of the timetable established in the
performance improvement plan, the health care entity shall report to the board regarding
the outcome of the performance improvement plan. If the board determines the performance
improvement plan was not implemented successfully, the board shall:
new text end
new text begin
(1) extend the implementation timetable of the existing performance improvement plan;
new text end
new text begin
(2) approve amendments to the performance improvement plan as proposed by the health
care entity;
new text end
new text begin
(3) require the health care entity to submit a new performance improvement plan; or
new text end
new text begin
(4) waive or delay the requirement to file any additional performance improvement
plans.
new text end
new text begin
Upon the successful completion of the performance improvement plan, the board shall
remove the identity of the health care entity from the board's website. The board may assist
health care entities with implementing the performance improvement plans or otherwise
ensure compliance with this subdivision.
new text end
new text begin
(g) If the board determines that a health care entity has:
new text end
new text begin
(1) willfully neglected to file a performance improvement plan with the board within
45 days as required;
new text end
new text begin
(2) failed to file an acceptable performance improvement plan in good faith with the
board;
new text end
new text begin
(3) failed to implement the performance improvement plan in good faith; or
new text end
new text begin
(4) knowingly failed to provide information required by this subdivision to the board or
knowingly provided false information, the board may assess a civil penalty to the health
care entity of not more than $500,000. The board may only impose a civil penalty if the
board determines that the health care entity is unlikely to voluntarily comply with all
applicable provisions of this subdivision.
new text end
Sec. 7.
new text begin
[62J.92] REPORTING REQUIREMENTS.
new text end
new text begin Subdivision 1. new text end
new text begin General requirement. new text end
new text begin
(a) The board shall present the reports required
by this section to the chairs and ranking members of the legislative committees with primary
jurisdiction over health care finance and policy. The board shall also make these reports
available to the public on the board's website.
new text end
new text begin
(b) The board may contract with a third-party vendor for technical assistance in preparing
the reports.
new text end
new text begin Subd. 2. new text end
new text begin Progress reports. new text end
new text begin
The board shall submit written progress updates about the
development and implementation of the health care spending growth target program by
February 15, 2025, and February 15, 2026. The updates must include reporting on board
membership and activities, program design decisions, planned timelines for implementation
of the program, and the progress of implementation. The reports must include the
methodological details underlying program design decisions.
new text end
new text begin Subd. 3. new text end
new text begin Health care spending trends. new text end
new text begin
By December 15, 2025, and every December
15 thereafter, the board shall submit a report on health care spending trends and the health
care spending growth target program that includes:
new text end
new text begin
(1) spending growth in aggregate and for entities subject to health care spending growth
targets relative to established target levels;
new text end
new text begin
(2) findings from analyses of drivers of health care spending growth;
new text end
new text begin
(3) estimates of the impact of health care spending growth on Minnesota residents,
including for communities most impacted by health disparities, related to their access to
insurance and care, value of health care, and the ability to pursue other spending priorities;
new text end
new text begin
(4) the potential and observed impact of the health care growth targets on the financial
viability of the rural delivery system;
new text end
new text begin
(5) changes under consideration for revising the methodology to monitor or set growth
targets;
new text end
new text begin
(6) recommendations for initiatives to assist health care entities in meeting health care
spending growth targets, including broader and more transparent adoption of value-based
payment arrangements; and
new text end
new text begin
(7) the number of health care entities whose spending growth exceeded growth targets,
information on performance improvement plans and the extent to which the plans were
completed, and any civil penalties imposed on health care entities related to noncompliance
with performance improvement plans and related requirements.
new text end
Sec. 8.
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 shall 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. 9.
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 and 5 for the following
purposes:
(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; deleted text begin and
deleted text end
(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 patients, payers, or providers;
(iii) be updated by the commissioner, at least annually, with the most current data
available;
(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 context; and
(v) not lead to the collection of additional data elements beyond what is authorized under
this section as of June 30, 2015deleted text begin .deleted text end new text begin ; and
new text end
new text begin
(6) to provide technical assistance to the Health Care Affordability Board to implement
sections 62J.86 to 62J.92.
new text end
(b) The commissioner may publish the results of the authorized uses identified in
paragraph (a) 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 discerned.
(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.
(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.
(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).
Sec. 10.
new text begin
[62V.12] STATE-FUNDED COST-SHARING REDUCTIONS.
new text end
new text begin Subdivision 1. new text end
new text begin Establishment. new text end
new text begin
(a) The board must develop and administer a state-funded
cost-sharing reduction program for eligible persons who enroll in a silver level qualified
health plan through MNsure. The board must implement the cost-sharing reduction program
for plan years beginning on or after January 1, 2024.
new text end
new text begin
(b) For purposes of this section, an "eligible person" is an individual who meets the
eligibility criteria to receive a cost-sharing reduction under Code of Federal Regulations,
title 45, section 155.305(g).
new text end
new text begin Subd. 2. new text end
new text begin Reduction in cost-sharing. new text end
new text begin
(a) The cost-sharing reduction program must use
state funds to reduce enrollee cost-sharing by increasing the actuarial value of silver level
health plans for eligible persons beyond the 73 percent value established in Code of Federal
Regulations, title 45, section 156.420(a)(3)(ii), to an actuarial value of 87 percent.
new text end
new text begin
(b) Paragraph (a) applies beginning for plan year 2024 for eligible individuals expected
to have a household income above 200 percent of the federal poverty level but that does
not exceed 250 percent of the federal poverty level, for the benefit year for which coverage
is requested.
new text end
new text begin
(c) Beginning for plan year 2026, the cost-sharing reduction program applies for eligible
individuals expected to have a household income above 250 percent of the federal poverty
level but that does not exceed 300 percent of the federal poverty level, for the benefit year
for which coverage is requested. Under this paragraph, the cost-sharing reduction program
applies by increasing the actuarial value of silver level health plans for eligible persons to
the 73 percent actuarial value established in Code of Federal Regulations, title 45, section
156.420(a)(3)(ii).
new text end
new text begin Subd. 3. new text end
new text begin Administration. new text end
new text begin
The board, when administering the program, must:
new text end
new text begin
(1) allow eligible persons to enroll in a silver level health plan with a state-funded
cost-sharing reduction;
new text end
new text begin
(2) modify the MNsure shopping tool to display the total cost-sharing reduction benefit
available to individuals eligible under this section; and
new text end
new text begin
(3) reimburse health carriers on a quarterly basis for the cost to the health plan providing
the state-funded cost-sharing reductions.
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. 11.
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 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 about the easy enrollment health insurance outreach
program and the special enrollment period described in this subdivision to the general public.
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. 12.
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. 13.
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. 14.
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 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
(2) 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
(i) the child or the child's representative requests voluntary termination of eligibility;
new text end
new text begin
(ii) the child ceases to be a resident of this state;
new text end
new text begin
(iii) the child dies;
new text end
new text begin
(iv) the child attains the maximum age; or
new text end
new text begin
(v) 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, 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.
new text end
Sec. 15.
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
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 July 1, 2025, and applies to all medical
assistance benefit plans offered, issued, or renewed on or after that date.
new text end
Sec. 16.
Minnesota Statutes 2022, section 256L.04, subdivision 7a, is amended to read:
Subd. 7a.
Ineligibility.
Adults whose income is greater than the limits established under
this section may not enroll in the MinnesotaCare programnew text begin , except as provided in subdivision
15new text end .
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, or upon federal approval,
whichever is later, subject to certification under section 32. The commissioner of human
services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 17.
Minnesota Statutes 2022, section 256L.04, subdivision 10, is amended to read:
Subd. 10.
Citizenship requirements.
(a) Eligibility for MinnesotaCare is limited to
citizens or nationals of the United States and lawfully present noncitizens as defined in
Code of Federal Regulations, title 8, section 103.12. Undocumented noncitizensnew text begin , with the
exception of children under 19 years of age,new text end are ineligible for MinnesotaCare. 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 lawfully present and ineligible for medical assistance by reason of
immigration status and who have incomes equal to or less than 200 percent of federal poverty
guidelines.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2025.
new text end
Sec. 18.
Minnesota Statutes 2022, section 256L.04, is amended by adding a subdivision
to read:
new text begin Subd. 15. new text end
new text begin Persons eligible for public option. new text end
new text begin
(a) Families and individuals with income
above the maximum income eligibility limit specified in subdivision 1 or 7 but who meet
all other MinnesotaCare eligibility requirements are eligible for MinnesotaCare. All other
provisions of this chapter apply unless otherwise specified.
new text end
new text begin
(b) Families and individuals may enroll in MinnesotaCare under this subdivision only
during an annual open enrollment period or special enrollment period, as designated by
MNsure in compliance with Code of Federal Regulations, title 45, parts 155.410 and 155.420.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, or upon federal approval,
whichever is later, subject to certification under section 32. The commissioner of human
services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 19.
Minnesota Statutes 2022, section 256L.07, subdivision 1, is amended to read:
Subdivision 1.
General requirements.
Individuals enrolled in MinnesotaCare under
section 256L.04, subdivision 1, and individuals enrolled in MinnesotaCare under section
256L.04, subdivision 7, whose income increases above 200 percent of the federal poverty
guidelinesdeleted text begin ,deleted text end are no longer eligible for the program and deleted text begin shalldeleted text end new text begin mustnew text end be disenrolled by the
commissionernew text begin , unless the individuals continue MinnesotaCare enrollment through the public
option under section 256L.04, subdivision 15new text end . For persons disenrolled under this subdivision,
MinnesotaCare coverage terminates the last day of the calendar month in which the
commissioner sends advance notice according to Code of Federal Regulations, title 42,
section 431.211, that indicates the income of a family or individual exceeds program income
limits.
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2027, or upon federal approval,
whichever is later, subject to certification under section 32. The commissioner of human
services shall notify the revisor of statutes when federal approval is obtained.
new text end
Sec. 20.
Minnesota Statutes 2022, section 256L.15, subdivision 2, is amended to read:
Subd. 2.
Sliding fee scale; monthly individual or family income.
(a) The commissioner
shall establish a sliding fee scale to determine the percentage of monthly individual or family
income that households at different income levels must pay to obtain coverage through the
MinnesotaCare program. The sliding fee scale must be based on the enrollee's monthly
individual or family income.
deleted text begin
(b) Beginning January 1, 2014, MinnesotaCare enrollees shall pay premiums according
to the premium scale specified in paragraph (d).
deleted text end
deleted text begin (c)deleted text end new text begin (b)new text end Paragraph deleted text begin (b)deleted text end new text begin (a)new text end does not apply todeleted text begin :
deleted text end
deleted text begin (1)deleted text end children 20 years of age or youngerdeleted text begin ; and
deleted text end
deleted text begin (2) individuals with household incomes below 35 percent of the federal povertydeleted text end
deleted text begin guidelinesdeleted text end .
deleted text begin
(d) The following premium scale is established for each individual in the household who
is 21 years of age or older and enrolled in MinnesotaCare:
deleted text end
|
deleted text begin
Federal Poverty Guideline deleted text end deleted text begin Greater than or Equal to deleted text end |
deleted text begin
Less than deleted text end |
deleted text begin
Individual Premium deleted text end deleted text begin Amount deleted text end |
|
deleted text begin
35% deleted text end |
deleted text begin
55% deleted text end |
deleted text begin
$4 deleted text end |
|
deleted text begin
55% deleted text end |
deleted text begin
80% deleted text end |
deleted text begin
$6 deleted text end |
|
deleted text begin
80% deleted text end |
deleted text begin
90% deleted text end |
deleted text begin
$8 deleted text end |
|
deleted text begin
90% deleted text end |
deleted text begin
100% deleted text end |
deleted text begin
$10 deleted text end |
|
deleted text begin
100% deleted text end |
deleted text begin
110% deleted text end |
deleted text begin
$12 deleted text end |
|
deleted text begin
110% deleted text end |
deleted text begin
120% deleted text end |
deleted text begin
$14 deleted text end |
|
deleted text begin
120% deleted text end |
deleted text begin
130% deleted text end |
deleted text begin
$15 deleted text end |
|
deleted text begin
130% deleted text end |
deleted text begin
140% deleted text end |
deleted text begin
$16 deleted text end |
|
deleted text begin
140% deleted text end |
deleted text begin
150% deleted text end |
deleted text begin
$25 deleted text end |
|
deleted text begin
150% deleted text end |
deleted text begin
160% deleted text end |
deleted text begin
$37 deleted text end |
|
deleted text begin
160% deleted text end |
deleted text begin
170% deleted text end |
deleted text begin
$44 deleted text end |
|
deleted text begin
170% deleted text end |
deleted text begin
180% deleted text end |
deleted text begin
$52 deleted text end |
|
deleted text begin
180% deleted text end |
deleted text begin
190% deleted text end |
deleted text begin
$61 deleted text end |
|
deleted text begin
190% deleted text end |
deleted text begin
200% deleted text end |
deleted text begin
$71 deleted text end |
|
deleted text begin
200% deleted text end |
deleted text begin
$80 deleted text end |
deleted text begin (e)deleted text end new text begin (c)new text end Beginning January 1, deleted text begin 2021deleted text end new text begin 2024new text end , new text begin the commissioner shall continue to charge
premiums in accordance with the simplified premium scale established to comply with the
American Rescue Plan Act of 2021, in effect from January 1, 2021, through December 31,
2025, for families and individuals eligible under section 256L.04, subdivisions 1 and 7. new text end The
commissioner shall adjust the premium scale deleted text begin established under paragraph (d)deleted text end new text begin as needednew text end to
ensure that premiums do not exceed the amount that an individual would have been required
to pay if the individual was enrolled in an applicable benchmark plan in accordance with
the Code of Federal Regulations, title 42, section 600.505 (a)(1).
new text begin
(d) The commissioner shall establish a sliding premium scale for persons eligible through
the public option under section 256L.04, subdivision 15. Beginning January 1, 2027, persons
eligible through the public option shall pay premiums according to this premium scale.
Persons eligible through the public option who are 20 years of age or younger are exempt
from paying premiums.
new text end
new text begin EFFECTIVE DATE. new text end
new text begin
This section is effective January 1, 2024, and certification under
section 32 is not required, except that paragraph (d) is effective January 1, 2027, or upon
federal approval, whichever is later, subject to certification under section 32. 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 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. 22.
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. 23. 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 2023.
new text end
Sec. 24. new text begin RECOMMENDATIONS; OFFICE OF PATIENT PROTECTION.
new text end
new text begin
(a) The commissioners of human services, health, and commerce and the MNsure board
shall submit to the health care affordability board and the chairs and ranking minority
members of the legislative committees with primary jurisdiction over health and human
services finance and policy and commerce by January 15, 2024, a report on the organization
and duties of the Office of Patient Protection, to be established under Minnesota Statutes,
section 62J.89, subdivision 4. The report must include recommendations on how the office
shall:
new text end
new text begin
(1) coordinate or consolidate within the office existing state agency patient protection
activities, including but not limited to the activities of ombudsman offices and the MNsure
board;
new text end
new text begin
(2) enforce standards and procedures under Minnesota Statutes, chapter 62M, for
utilization review organizations;
new text end
new text begin
(3) work with private sector and state agency consumer assistance programs to assist
consumers with questions or concerns relating to public programs and private insurance
coverage;
new text end
new text begin
(4) establish and implement procedures to assist consumers aggrieved by restrictions on
patient choice, denials of services, and reductions in quality of care resulting from any final
action by a payer or provider; and
new text end
new text begin
(5) make health plan company quality of care and patient satisfaction information and
other information collected by the office readily accessible to consumers on the board's
website.
new text end
new text begin
(b) The commissioners and the MNsure board shall consult with stakeholders as they
develop the recommendations. The stakeholders consulted must include but are not limited
to organizations and individuals representing: underserved communities; persons with
disabilities; low-income Minnesotans; senior citizens; and public and private sector health
plan enrollees, including persons who purchase coverage through MNsure, health plan
companies, and public and private sector purchasers of health coverage.
new text end
new text begin
(c) The commissioners and the MNsure board may contract with a third party to develop
the report and recommendations.
new text end
Sec. 25. new text begin TRANSITION TO MINNESOTACARE PUBLIC OPTION.
new text end
new text begin
(a) The commissioner of human services must continue to administer MinnesotaCare
as a basic health program in accordance with Minnesota Statutes, section 256L.02,
subdivision 5, and must seek federal waivers, approvals, and law changes as required under
section 26.
new text end
new text begin
(b) The commissioner must present an implementation plan for the MinnesotaCare public
option under Minnesota Statutes, section 256L.04, subdivision 15, to the chairs and ranking
minority members of the legislative committees with jurisdiction over health care policy
and finance by December 15, 2024. The plan must include:
new text end
new text begin
(1) recommendations for any changes to the MinnesotaCare public option necessary to
continue federal basic health program funding or to receive other federal funding;
new text end
new text begin
(2) recommendations for ensuring sufficient provider participation in MinnesotaCare;
new text end
new text begin
(3) estimates of state costs related to the MinnesotaCare public option;
new text end
new text begin
(4) a description of the proposed premium scale for persons eligible through the public
option, including an analysis of the extent to which the proposed premium scale:
new text end
new text begin
(i) ensures affordable premiums for persons across the income spectrum enrolled under
the public option; and
new text end
new text begin
(ii) avoids premium cliffs for persons transitioning to and enrolled under the public
option; and
new text end
new text begin
(5) draft legislation that includes any additional policy and conforming changes necessary
to implement the MinnesotaCare public option and the implementation plan
recommendations.
new text end
new text begin
(c) The commissioner shall present to the chairs and ranking minority members of the
legislative committees with jurisdiction over health care policy and finance, by January 15,
2025, a report comparing service delivery and payment system models for delivering services
to MinnesotaCare enrollees eligible under Minnesota Statutes, section 256L.04, subdivisions
1, 7, and 15. The report must compare the current delivery model with at least two alternative
models. The alternative models must include a state-based model in which the state holds
the plan risk as the insurer and may contract with a third-party administrator for claims
processing and plan administration. The alternative models may include but are not limited
to:
new text end
new text begin
(1) expanding the use of integrated health partnerships under Minnesota Statutes, section
256B.0755;
new text end
new text begin
(2) delivering care under fee-for-service through a primary care case management system;
and
new text end
new text begin
(3) continuing to contract with managed care and county-based purchasing plans for
some or all enrollees under modified contracts.
new text end
new text begin
(d) The report must also include:
new text end
new text begin
(1) a description of how each model would address:
new text end
new text begin
(i) racial inequities in the delivery of health care and health care outcomes;
new text end
new text begin
(ii) geographic inequities in the delivery of health care;
new text end
new text begin
(iii) incentives for preventive care and other best practices; and
new text end
new text begin
(iv) reimbursement of providers for high-quality, value-based care at levels sufficient
to sustain or increase enrollee access to care;
new text end
new text begin
(2) a comparison of the projected cost of each model; and
new text end
new text begin
(3) an implementation timeline for each model that includes the earliest date by which
each model could be implemented if authorized during the 2025 legislative session.
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. 26. new text begin REQUEST FOR FEDERAL APPROVAL.
new text end
new text begin
(a) The commissioner of human services must seek all federal waivers, approvals, and
law changes necessary to implement a MinnesotaCare public option and any related changes
to state law, including but not limited to those waivers, approvals, and law changes necessary
to allow the state to:
new text end
new text begin
(1) continue receiving federal basic health program payments for basic health
program-eligible MinnesotaCare enrollees and to receive other federal funding for the
MinnesotaCare public option;
new text end
new text begin
(2) receive federal payments equal to the value of premium tax credits and cost-sharing
reductions that MinnesotaCare enrollees with household incomes greater than 200 percent
of the federal poverty guidelines would otherwise have received; and
new text end
new text begin
(3) receive federal payments equal to the value of emergency medical assistance that
would otherwise have been paid to the state for covered services provided to eligible
enrollees.
new text end
new text begin
(b) In implementing this section, the commissioner of human services must contract
with one or more independent entities to conduct an actuarial analysis of the implementation,
administration, and effects of the provisions of a MinnesotaCare public option and any
related changes to state law, including but not limited to benefits, costs, impacts on coverage,
and affordability to the state and eligible enrollees, impacts on the state's individual market,
and compliance with federal law, at a minimum as necessary to obtain any waivers, approvals,
and law changes sought under this section.
new text end
new text begin
(c) In implementing this section, the commissioner of human services must consult with
the commissioner of commerce and the Board of Directors of MNsure and may contract
for technical assistance.
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. 27. new text begin ANALYSIS OF BENEFITS AND COSTS OF A UNIVERSAL HEALTH
CARE SYSTEM.
new text end
new text begin Subdivision 1. new text end
new text begin Definitions. new text end
new text begin
(a) "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, chemical dependency treatment, prescription drugs, medical equipment and
supplies, long-term care, and home care, whether paid through premiums, co-pays and
deductibles, other out-of-pocket payments, or other funding from government, employers,
or other sources; and
new text end
new text begin
(2) the costs associated with administering, delivering, and paying for the care. The costs
of administering, delivering, and paying for the care includes all expenses by insurers,
providers, employers, individuals, and government to select, negotiate, purchase, and
administer insurance and care including but not limited to coverage for health care, dental,
long-term care, prescription drugs, 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
(b) "All necessary care" means the full range of services listed in the proposed Minnesota
Health Plan legislation, including medical, dental, vision and hearing, mental health, chemical
dependency treatment, reproductive and sexual health, prescription drugs, medical equipment
and supplies, long-term care, home care, and 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 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 under those
risk adjusted or nonrisk adjusted payment schemes by both providers and payors.
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. However, they 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 EFFECTIVE DATE. new text end
new text begin
This section is effective the day following final enactment.
new text end
Sec. 28. new text begin BENEFIT AND COST ANALYSIS OF A UNIVERSAL HEALTH REFORM
PROPOSAL.
new text end
new text begin Subdivision 1. new text end
new text begin Contract for analysis of proposal. new text end
new text begin
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 strive to produce estimates for all elements
in subdivision 3.
new text end
new text begin Subd. 2. new text end
new text begin Proposal. new text end
new text begin
The commissioner of health, with input from 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 2023 Senate File No. 2740;
House File No. 2798, if enacted, that would offer a universal health care plan designed to
meet a set of principles, including:
new text end
new text begin
(1) ensure all Minnesotans are covered;
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. 3. 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 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, long-term care, medical equipment or supplies, vision and hearing, or other health
services that are not covered, if any. The analysis must take into account the vast variety of
benefit designs in the commercial market and report the extent of coverage in each area;
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 shall be broken out by key necessary care areas, such as medical, dental, and mental
health. The analysis of total health care spending shall examine whether there are savings
or additional costs under the legislative proposal compared to the existing system due to:
new text end
new text begin
(i) changes in 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) changed prices on medical services and products, including pharmaceuticals, due to
price negotiations under the proposal;
new text end
new text begin
(iii) 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 capacity of
clinics, hospitals, and other appropriate care sites versus inappropriate emergency room
usage. The analysis shall break down capacity by geographic differences such as rural versus
metro, 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 areas such as reduced crime and out-of-home placement costs due to
mental health or chemical dependency coverage. Additional definition may further develop
hypotheses for other impacts that warrant analysis;
new text end
new text begin
(vi) job losses or gains within the health care system; specifically, 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
implementation of the resulting reduction of insurance and administrative burdens on
businesses; and
new text end
new text begin
(viii) impact on disparities in health care access and outcomes.
new text end
new text begin
(b) The contractor or contractors shall propose an iterative process for designing and
conducting the analysis. Steps shall be reviewed with and approved by the commissioner
of health and lead house and senate authors of the legislative proposal, and shall include
but not be limited to:
new text end
new text begin
(1) clarification of the specifics of the proposal. The analysis shall assume that the
provisions in the proposal are not preempted by federal law or that the federal government
gives a waiver to the preemptions;
new text end
new text begin
(2) additional data elements needed to accomplish goals of the analysis;
new text end
new text begin
(3) assumptions analysts are using in their analysis and the quality of the evidence behind
those assumptions;
new text end
new text begin
(4) timing of each stage of the project with agreed upon decision points;
new text end
new text begin
(5) approaches to address any services currently provided in the existing health care
system that may not be provided for within the Minnesota Health Plan as proposed; and
new text end
new text begin
(6) optional scenarios provided by contractor or contractors with minor alterations in
the proposed plan related to services covered or cost-sharing if those scenarios might be
helpful to the legislature.
new text end
new text begin
(c) The commissioner shall issue a final report by January 15, 2026, and may provide
interim reports and status updates to the governor and the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
policy and finance aligned with the iterative process defined above.
new text end
new text begin
(d) The contractor may offer a modeling tool as deliverable with a line-item cost provided.
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. 29. new text begin APPOINTMENTS AND INITIAL MEETING OF THE HEALTH CARE
AFFORDABILITY BOARD.
new text end
new text begin
Appointing authorities must make first appointments to the Health Care Affordability
Board under Minnesota Statutes, section 62J.87, by October 1, 2023. The governor must
designate one member to serve as an acting chair until the council selects a chair at its first
meeting. The acting chair must convene the first meeting by January 1, 2024.
new text end
Sec. 30. new text begin TERMS OF INITIAL APPOINTEES OF THE HEALTH CARE
AFFORDABILITY ADVISORY COUNCIL.
new text end
new text begin
Notwithstanding Minnesota Statutes, section 62J.88, subdivision 3, the initial appointed
members of the Health Care Affordability Advisory Council under Minnesota Statutes,
section 62J.88, shall serve staggered terms of two, three, and four years determined by lot
by the secretary of state.
new text end
Sec. 31. 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 July 1, 2025.
new text end
Sec. 32. new text begin CONTINGENT EFFECTIVE DATE.
new text end
new text begin
Sections 16, 18, and 19, and the specified portion of section 20, are effective January 1,
2027, or upon federal approval, whichever is later, but only if the commissioner of human
services certifies to the legislature the following:
new text end
new text begin
(1) that implementation of those sections will not result in substantial reduction in federal
basic health program funding for MinnesotaCare enrollees with incomes not exceeding 200
percent of the federal poverty guidelines;
new text end
new text begin
(2) premiums necessary to operationalize the program are deemed affordable in
accordance with applicable federal law;
new text end
new text begin
(3) the actuarial value of benefit does not fall below 94 percent and the benefit set is
equal to or greater than that historically available in MinnesotaCare;
new text end
new text begin
(4) the 1332 waiver was approved consistent, or without substantial deviation, from the
implementation plan;
new text end
new text begin
(5) the commissioner of commerce certifies that the public option would expand plan
options available for individuals purchasing coverage;
new text end
new text begin
(6) the state receives a substantially similar pass-through funding amount from the federal
government that would have otherwise gone to enrollees' advanced premium tax credits;
new text end
new text begin
(7) individuals currently served by the MinnesotaCare program are not disproportionately
or substantively negatively impacted in order to make the public option affordable or
implementable; and
new text end
new text begin
(8) individuals currently served by the Medical Assistance program are not
disproportionately or substantively negatively impacted in order to make the public option
affordable or implementable.
new text end
new text begin
The commissioner of human services shall notify the revisor of statutes when federal approval
is obtained.
new text end
ARTICLE 17
FORECAST ADJUSTMENTS
Section 1. new text begin HUMAN SERVICES FORECAST ADJUSTMENTS.
|
new text begin
The dollar amounts shown in the columns marked "Appropriations" are added to or, if
shown in parentheses, are subtracted from the appropriations in Laws 2021, First Special
Session chapter 7, article 15, and Laws 2021, First Special Session chapter 7, article 16,
from the general fund, or any other fund named, to the commissioner of human services for
the purposes specified in this article, to be available for the fiscal year indicated for each
purpose. The figure "2023" used in this article means that the appropriations listed are
available for the fiscal year ending June 30, 2023.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2023 new text end |
||||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
(1,459,845,000) new text end |
||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2023 new text end |
||
|
new text begin
General new text end |
new text begin
(1,235,088,000) new text end |
|
|
new text begin
Health Care Access new text end |
new text begin
(203,530,000) new text end |
|
|
new text begin
Federal TANF new text end |
new text begin
(21,227,000) new text end |
|
new text begin Subd. 2. new text end
new text begin
Forecasted Programs
|
|||||
|
new text begin
(a) Minnesota Family Investment Program (MFIP)/Diversionary Work Program (DWP) new text end |
|||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2023 new text end |
||
|
new text begin
General new text end |
new text begin
(99,000) new text end |
|
|
new text begin
Federal TANF new text end |
new text begin
(21,227,000) new text end |
|
|
new text begin
(b) MFIP Child Care Assistance new text end |
new text begin
(36,957,000) new text end |
|||||
|
new text begin
(c) General Assistance new text end |
new text begin
(1,632,000) new text end |
|||||
|
new text begin
(d) Minnesota Supplemental Aid new text end |
new text begin
783,000 new text end |
|||||
|
new text begin
(e) Housing Support new text end |
new text begin
180,000 new text end |
|||||
|
new text begin
(f) Northstar Care for Children new text end |
new text begin
(18,038,000) new text end |
|||||
|
new text begin
(g) MinnesotaCare new text end |
new text begin
(203,530,000) new text end |
|||||
new text begin
This appropriation is from the health care
access fund.
new text end
|
new text begin
(h) Medical Assistance new text end |
new text begin
(1,172,921,000) new text end |
|||||
|
new text begin
(i) Behavioral Health Fund new text end |
new text begin
(6,404,000) new text end |
|||||
Sec. 3. new text begin EFFECTIVE DATE.
new text end
new text begin
Sections 1 and 2 are effective the day following final enactment.
new text end
ARTICLE 18
APPROPRIATIONS
Section 1. new text begin HEALTH AND HUMAN SERVICES APPROPRIATIONS.
|
new text begin
The sums shown in the columns marked "Appropriations" are appropriated to the agencies
and for the purposes specified in this article. The appropriations are from the general fund,
or another named fund, and are available for the fiscal years indicated for each purpose.
The figures "2024" and "2025" used in this article mean that the appropriations listed under
them are available for the fiscal year ending June 30, 2024, or June 30, 2025, respectively.
"The first year" is fiscal year 2024. "The second year" is fiscal year 2025. "The biennium"
is fiscal years 2024 and 2025.
new text end
|
new text begin
APPROPRIATIONS new text end |
||||||
|
new text begin
Available for the Year new text end |
||||||
|
new text begin
Ending June 30 new text end |
||||||
|
new text begin
2024 new text end |
new text begin
2025 new text end |
|||||
Sec. 2. new text begin COMMISSIONER OF HUMAN
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
3,937,170,000 new text end |
new text begin
$ new text end |
new text begin
4,182,045,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2024 new text end |
new text begin
2025 new text end |
|
|
new text begin
General new text end |
new text begin
2,777,291,000 new text end |
new text begin
2,710,181,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,901,000 new text end |
new text begin
5,409,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
877,862,000 new text end |
new text begin
1,184,598,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
276,953,000 new text end |
new text begin
281,694,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
163,000 new text end |
new text begin
163,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
TANF Maintenance of Effort
|
||||||
new text begin
(a) Nonfederal expenditures. The
commissioner shall ensure that sufficient
qualified nonfederal expenditures are made
each year to meet the state's maintenance of
effort requirements of the TANF block grant
specified under Code of Federal Regulations,
title 45, section 263.1. In order to meet these
basic TANF maintenance of effort
requirements, the commissioner may report
as TANF maintenance of effort expenditures
only nonfederal money expended for allowable
activities listed in the following clauses:
new text end
new text begin
(1) MFIP cash, diversionary work program,
and food assistance benefits under Minnesota
Statutes, chapter 256J;
new text end
new text begin
(2) the child care assistance programs under
Minnesota Statutes, sections 119B.03 and
119B.05, and county child care administrative
costs under Minnesota Statutes, section
119B.15;
new text end
new text begin
(3) state and county MFIP administrative costs
under Minnesota Statutes, chapters 256J and
256K;
new text end
new text begin
(4) state, county, and Tribal MFIP
employment services under Minnesota
Statutes, chapters 256J and 256K;
new text end
new text begin
(5) expenditures made on behalf of legal
noncitizen MFIP recipients who qualify for
the MinnesotaCare program under Minnesota
Statutes, chapter 256L;
new text end
new text begin
(6) qualifying working family credit
expenditures under Minnesota Statutes, section
290.0671;
new text end
new text begin
(7) qualifying Minnesota education credit
expenditures under Minnesota Statutes, section
290.0674; and
new text end
new text begin
(8) qualifying Head Start expenditures under
Minnesota Statutes, section 119A.50.
new text end
new text begin
(b) Nonfederal expenditures; reporting. For
the activities listed in paragraph (a), clauses
(2) to (8), the commissioner must report only
expenditures that are excluded from the
definition of assistance under Code of Federal
Regulations, title 45, section 260.31.
new text end
new text begin
(c) Limitations; exceptions. The
commissioner must not claim an amount of
TANF maintenance of effort in excess of the
75 percent standard in Code of Federal
Regulations, title 45, section 263.1(a)(2),
except:
new text end
new text begin
(1) to the extent necessary to meet the 80
percent standard under Code of Federal
Regulations, title 45, section 263.1(a)(1), if it
is determined by the commissioner that the
state will not meet the TANF work
participation target rate for the current year;
new text end
new text begin
(2) to provide any additional amounts under
Code of Federal Regulations, title 45, section
264.5, that relate to replacement of TANF
funds due to the operation of TANF penalties;
and
new text end
new text begin
(3) to provide any additional amounts that may
contribute to avoiding or reducing TANF work
participation penalties through the operation
of the excess maintenance of effort provisions
of Code of Federal Regulations, title 45,
section 261.43(a)(2).
new text end
new text begin
(d) Supplemental expenditures. For the
purposes of paragraph (c), the commissioner
may supplement the maintenance of effort
claim with working family credit expenditures
or other qualified expenditures to the extent
such expenditures are otherwise available after
considering the expenditures allowed in this
subdivision.
new text end
new text begin
(e) Reduction of appropriations; exception.
The requirement in Minnesota Statutes, section
256.011, subdivision 3, that federal grants or
aids secured or obtained under that subdivision
be used to reduce any direct appropriations
provided by law does not apply if the grants
or aids are federal TANF funds.
new text end
new text begin
(f) IT appropriations generally. This
appropriation includes funds for information
technology projects, services, and support.
Notwithstanding Minnesota Statutes, section
16E.0466, funding for information technology
project costs must be incorporated into the
service level agreement and paid to Minnesota
IT Services by the Department of Human
Services under the rates and mechanism
specified in that agreement.
new text end
new text begin
(g) Receipts for systems project.
Appropriations and federal receipts for
information technology systems projects for
MAXIS, PRISM, MMIS, ISDS, METS, and
SSIS must be deposited in the state systems
account authorized in Minnesota Statutes,
section 256.014. Money appropriated for
information technology projects approved by
the chief information officer funded by the
legislature, and approved by the commissioner
of management and budget may be transferred
from one project to another and from
development to operations as the
commissioner of human services considers
necessary. Any unexpended balance in the
appropriation for these projects does not
cancel and is available for ongoing
development and operations.
new text end
new text begin
(h) Federal SNAP education and training
grants. Federal funds available during fiscal
years 2024 and 2025 for Supplemental
Nutrition Assistance Program Education and
Training and SNAP Quality Control
Performance Bonus grants are appropriated
to the commissioner of human services for the
purposes allowable under the terms of the
federal award. This paragraph is effective the
day following final enactment.
new text end
new text begin Subd. 3. new text end
new text begin
Central Office; Operations
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
255,556,000 new text end |
new text begin
242,971,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
4,776,000 new text end |
new text begin
5,284,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
9,347,000 new text end |
new text begin
11,244,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
1,090,000 new text end |
new text begin
1,194,000 new text end |
new text begin
(a) Administrative recovery; set-aside. The
commissioner may invoice local entities
through the SWIFT accounting system as an
alternative means to recover the actual cost of
administering the following provisions:
new text end
new text begin
(1) the statewide data management system
authorized in Minnesota Statutes, section
125A.744, subdivision 3;
new text end
new text begin
(2) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 245.495,
paragraph (b);
new text end
new text begin
(3) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 256B.0625,
subdivision 20, paragraph (k);
new text end
new text begin
(4) targeted case management under
Minnesota Statutes, section 256B.0924,
subdivision 6, paragraph (g);
new text end
new text begin
(5) residential services for children with severe
emotional disturbance under Minnesota
Statutes, section 256B.0945, subdivision 4,
paragraph (d); and
new text end
new text begin
(6) repayment of the special revenue
maximization account as provided under
Minnesota Statutes, section 256F.10,
subdivision 6, paragraph (b).
new text end
new text begin
(b) Transforming service delivery.
$8,225,000 in fiscal year 2024 and $7,411,000
in fiscal year 2025 are from the general fund
for transforming service delivery projects. The
base for this appropriation is $5,614,000 in
fiscal year 2026 and $5,614,000 in fiscal year
2027.
new text end
new text begin
(c) Integrated services for children and
families. $6,691,000 in fiscal year 2024 and
$4,053,000 in fiscal year 2025 are from the
general fund for integrated services for
children and families projects. The base for
this appropriation is $3,246,000 in fiscal year
2026 and $2,082,000 in fiscal year 2027.
new text end
new text begin
(d) Medicaid management information
system modernization. $7,636,000 in fiscal
year 2024 is for Medicaid management
information system modernization projects.
This is a onetime appropriation.
new text end
new text begin
(e) Provider licensing and reporting hub.
$5,986,000 in fiscal year 2024 and $2,834,000
in fiscal year 2025 are from the general fund
for provider licensing and reporting hub
projects. The base for this appropriation is
$2,607,000 in fiscal year 2026 and $2,249,000
in fiscal year 2027.
new text end
new text begin
(f) Improving the Minnesota eligibility
technology system functionality. $8,888,000
in fiscal year 2024 is from the general fund
for projects to improve the Minnesota
eligibility technology system functionality.
The base for this appropriation is $384,000 in
fiscal year 2026 and $384,000 in fiscal year
2027.
new text end
new text begin
(g) Base level adjustment. The general fund
base is $234,129,000 in fiscal year 2026 and
$233,067,000 in fiscal year 2027. The state
government special revenue base is $4,880,000
in fiscal year 2026 and $4,710,000 in fiscal
year 2027.
new text end
new text begin Subd. 4. new text end
new text begin
Central Office; Children and Families
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
38,943,000 new text end |
new text begin
36,803,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
2,582,000 new text end |
new text begin
2,582,000 new text end |
new text begin
(a) Quadrennial review of child support
guidelines. $64,000 in fiscal year 2024 and
$32,000 in fiscal year 2025 are from the
general fund for a quadrennial review of child
support guidelines.
new text end
new text begin
(b) Transfer. The commissioner must transfer
$64,000 in fiscal year 2024 and $32,000 in
fiscal year 2025 from the general fund to the
special revenue fund to be used for the
quadrennial review of child support guidelines.
new text end
new text begin
(c) Recognizing comparable competencies
to achieve comparable compensation task
force. $141,000 in fiscal year 2024 and
$165,000 in fiscal year 2025 are from the
general fund for the Recognizing Comparable
Competencies to Achieve Comparable
Compensation Task Force. This is a onetime
appropriation.
new text end
new text begin
(d) Child care and early education
professional wage scale. $637,000 in fiscal
year 2024 and $565,000 in fiscal year 2025
are from the general fund for developing a
wage scale for child care and early education
professionals. This is a onetime appropriation.
new text end
new text begin
(e) Cost estimation model for early care and
learning programs. $100,000 in fiscal year
2024 is from the general fund for developing
a cost estimation model for providing early
care and learning.
new text end
new text begin
(f) Integrated services for children and
families. $2,259,000 in fiscal year 2024 and
$2,542,000 in fiscal year 2025 are from the
general fund for integrated services for
children and families projects. The base for
this appropriation is $2,002,000 in fiscal year
2026 and $1,830,000 in fiscal year 2027.
new text end
new text begin
(g) Base level adjustment. The general fund
base is $35,606,000 in fiscal year 2026 and
$35,470,000 in fiscal year 2027.
new text end
new text begin Subd. 5. new text end
new text begin
Central Office; Health Care
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
30,477,000 new text end |
new text begin
32,949,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
28,168,000 new text end |
new text begin
28,168,000 new text end |
new text begin
(a) Medical assistance and MinnesotaCare
accessibility improvements. $1,350,000 in
fiscal year 2024 is from the general fund to
improve the accessibility of applications,
forms, and other consumer support resources
and services for medical assistance and
MinnesotaCare enrollees with limited English
proficiency.
new text end
new text begin
(b) Palliative care benefit study. $150,000
in fiscal year 2024 is from the general fund
for a study of the fiscal, medical, and social
impacts of implementing a palliative care
benefit in medical assistance and
MinnesotaCare. This is a onetime
appropriation. The commissioner must report
the results of the study to the chairs and
ranking minority members of the legislative
committees with jurisdiction over health care
by January 15, 2024.
new text end
new text begin
(c) Transforming service delivery. $155,000
in fiscal year 2024 and $180,000 in fiscal year
2025 are from the general fund for
transforming service delivery projects.
new text end
new text begin
(d) Improving the Minnesota eligibility
technology system functionality. $866,000
in fiscal year 2024 and $384,000 in fiscal year
2025 are from the general fund for improving
the Minnesota eligibility technology system
functionality.
new text end
new text begin
(e) Base level adjustment. The general fund
base is $42,202,000 in fiscal year 2026 and
$42,527,000 in fiscal year 2027.
new text end
new text begin Subd. 6. new text end
new text begin
Central Office; Aging and Disabilities
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
39,454,000 new text end |
new text begin
35,416,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
125,000 new text end |
new text begin
125,000 new text end |
new text begin
(a) Catholic Charities homeless elders
program. $728,000 in fiscal year 2024 and
$728,000 in fiscal year 2025 are for a grant to
Catholic Charities of St. Paul and Minneapolis
to operate its homeless elders program. This
is a onetime appropriation.
new text end
new text begin
(b) Integrated services for children and
families. $143,000 in fiscal year 2024 and
$165,000 in fiscal year 2025 are from the
general fund for integrated services for
children and families projects.
new text end
new text begin
(b) Base level adjustment. The general fund
base is $34,688,000 in fiscal year 2026 and
$34,688,000 in fiscal year 2027.
new text end
new text begin Subd. 7. new text end
new text begin
Central Office; Behavioral Health, Deaf
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
25,902,000 new text end |
new text begin
25,095,000 new text end |
|
new text begin
Lottery Prize new text end |
new text begin
163,000 new text end |
new text begin
163,000 new text end |
new text begin
(a) Homeless management system. $250,000
in fiscal year 2024 and $1,000,000 in fiscal
year 2025 are from the general fund for a
homeless management information system.
The base for this appropriation is $1,140,000
in fiscal year 2026 and $1,140,000 in fiscal
year 2027.
new text end
new text begin
(b) Base level adjustment. The general fund
base is $24,484,000 in fiscal year 2026 and
$24,085,000 in fiscal year 2027.
new text end
new text begin Subd. 8. new text end
new text begin
Forecasted Programs; MFIP/DWP
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
82,652,000 new text end |
new text begin
91,628,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
105,337,000 new text end |
new text begin
109,974,000 new text end |
new text begin Subd. 9. new text end
new text begin
Forecasted Programs; MFIP Child Care
|
new text begin
38,743,000 new text end |
new text begin
143,055,000 new text end |
||||
new text begin Subd. 10. new text end
new text begin
Forecasted Programs; General
|
new text begin
52,026,000 new text end |
new text begin
74,776,000 new text end |
||||
new text begin
Emergency general assistance. The amount
appropriated for emergency general assistance
is limited to no more than $6,729,812 in fiscal
year 2024 and $6,729,812 in fiscal year 2025.
Funds to counties shall be allocated by the
commissioner using the allocation method
under Minnesota Statutes, section 256D.06.
new text end
new text begin Subd. 11. new text end
new text begin
Forecasted Programs; Minnesota
|
new text begin
58,548,000 new text end |
new text begin
60,357,000 new text end |
||||
new text begin Subd. 12. new text end
new text begin
Forecasted Programs; Housing
|
new text begin
211,692,000 new text end |
new text begin
224,231,000 new text end |
||||
new text begin Subd. 13. new text end
new text begin
Forecasted Programs; Northstar Care
|
new text begin
113,912,000 new text end |
new text begin
124,546,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Forecasted Programs; MinnesotaCare
|
new text begin
89,323,000 new text end |
new text begin
57,124,000 new text end |
||||
new text begin
This appropriation is from the health care
access fund.
new text end
new text begin Subd. 15. new text end
new text begin
Forecasted Programs; Medical
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
1,220,215,000 new text end |
new text begin
944,121,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
747,559,000 new text end |
new text begin
1,084,597,000 new text end |
new text begin
The health care access fund base is
$878,419,000 in fiscal year 2026 and
$1,197,599,000 in fiscal year 2027.
new text end
new text begin Subd. 16. new text end
new text begin
Forecasted Programs; Alternative
|
new text begin
158,000 new text end |
new text begin
460,000 new text end |
||||
new text begin Subd. 17. new text end
new text begin
Forecasted Programs; Behavioral
|
new text begin
1,344,000 new text end |
new text begin
3,181,000 new text end |
||||
new text begin Subd. 18. new text end
new text begin
Grant Programs; Support Services
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
8,715,000 new text end |
new text begin
8,715,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
96,311,000 new text end |
new text begin
96,311,000 new text end |
new text begin Subd. 19. new text end
new text begin
Grant Programs; Basic Sliding Fee
|
new text begin
64,203,000 new text end |
new text begin
113,974,000 new text end |
||||
new text begin
The general fund base is $144,560,000 in
fiscal year 2026 and $142,007,000 in fiscal
year 2027.
new text end
new text begin Subd. 20. new text end
new text begin
Grant Programs; Child Care
|
new text begin
150,248,000 new text end |
new text begin
156,729,000 new text end |
||||
new text begin
(a) Child care provider retention payments.
$101,566,000 in fiscal year 2024 and
$141,598,000 in fiscal year 2025 are for the
child care provider retention program
payments under Minnesota Statutes, section
119B.27. The base for this appropriation is
$144,202,000 in fiscal year 2026 and
$144,202,000 in fiscal year 2027.
new text end
new text begin
(b) Transition grant program. $41,895,000
in fiscal year 2024 is for transition grants for
child care providers that intend to participate
in the child care retention program. This is a
onetime appropriation and is available until
June 30, 2025.
new text end
new text begin
(c) REETAIN grant program. $1,000,000
in fiscal year 2024 and $1,000,000 in fiscal
year 2025 are for the REETAIN grant program
under Minnesota Statutes, section 119B.195.
The general fund base for this appropriation
is $1,500,000 in fiscal year 2026 and
$1,500,000 in fiscal year 2027.
new text end
new text begin
(d) new text begin Child care workforce development
grants administration. new text end $1,300,000 in fiscal
year 2025 is for a grant to the statewide child
care resource and referral network to
administer child care workforce development
grants under Minnesota Statutes, section
119B.19, subdivision 7, clause (10).
new text end
new text begin
(e) new text begin Scholarship program.new text end $695,000 in fiscal
year 2025 is for a scholarship program for
early childhood and school-age educators
under Minnesota Statutes, section 119B.251.
new text end
new text begin
(f) new text begin Child care one-stop shop.new text end $2,920,000 in
fiscal year 2025 is for a grant to the statewide
child care resource and referral network to
administer the child care one-stop shop
regional assistance network under Minnesota
Statutes, section 119B.19, subdivision 7,
clause (9). The base for this appropriation is
$0 in fiscal year 2026 and $0 in fiscal year
2027.
new text end
new text begin
(g) new text begin Shared services grants.new text end $500,000 in fiscal
year 2024 and $500,000 in fiscal year 2025
are for shared services grants under Minnesota
Statutes, section 119B.28. The base for this
appropriation is $0 in fiscal year 2026 and $0
in fiscal year 2027.
new text end
new text begin
(h) new text begin Access to technology grants.new text end $300,000
in fiscal year 2024 and $300,000 in fiscal year
2025 are for child care provider access to
technology grants under Minnesota Statutes,
section 119B.29. The base for this
appropriation is $0 in fiscal year 2026 and $0
in fiscal year 2027.
new text end
new text begin
(i) new text begin Business training and consultation.new text end
$1,250,000 in fiscal year 2024 and $1,500,000
in fiscal year 2025 are for business training
and consultation under Minnesota Statutes,
section 119B.25, subdivision 3, paragraph (a),
clause (6).
new text end
new text begin
(j) Early childhood registered
apprenticeship grant program. $2,000,000
in fiscal year 2024 and $2,000,000 in fiscal
year 2025 are for the early childhood
registered apprenticeship grant program under
Minnesota Statutes, section 119B.252.
new text end
new text begin
(k) Family, friend, and neighbor grant
program. $3,179,000 in fiscal year 2024 and
$3,179,000 in fiscal year 2025 are for the
family, friend, and neighbor grant program
under Minnesota Statutes, section 119B.196.
new text end
new text begin
(l) Base level adjustment. The general fund
base is $156,113,000 in fiscal year 2026 and
$156,113,000 in fiscal year 2027.
new text end
new text begin Subd. 21. new text end
new text begin
Grant Programs; Child Support
|
new text begin
50,000 new text end |
new text begin
50,000 new text end |
||||
new text begin Subd. 22. new text end
new text begin
Grant Programs; Children's Services
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
75,524,000 new text end |
new text begin
85,181,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
140,000 new text end |
new text begin
140,000 new text end |
new text begin
(a) Mille Lacs Band of Ojibwe American
Indian child welfare initiative. $3,337,000
in fiscal year 2024 and $5,294,000 in fiscal
year 2025 are from the general fund for the
Mille Lacs Band of Ojibwe to join the
American Indian child welfare initiative. The
base for this appropriation is $7,893,000 in
fiscal year 2026 and $7,893,000 in fiscal year
2027.
new text end
new text begin
(b) Grants for kinship navigator services.
$764,000 in fiscal year 2024 and $764,000 in
fiscal year 2025 are from the general fund for
grants for kinship navigator services and
grants to Tribal Nations for kinship navigator
services. The base for this appropriation is
$750,000 in fiscal year 2026 and $750,000 in
fiscal year 2027.
new text end
new text begin
(c) Family First Prevention and Early
Intervention assessment response grants.
$6,100,000 in fiscal year 2024 and $9,800,000
in fiscal year 2025 are from the general fund
for family assessment response grants under
Minnesota Statutes, section 260.014.
new text end
new text begin
(d) Grants for evidence-based prevention
and early intervention services. $3,000,000
in fiscal year 2024 and $7,000,000 in fiscal
year 2025 are from the general fund for grants
to support evidence-based prevention and early
intervention services under Minnesota
Statutes, section 260.014. The base for this
appropriation is $10,000,000 in fiscal year
2026 and $10,000,000 in fiscal year 2027.
new text end
new text begin
(e) Grant to administer pool of qualified
individuals for assessments. $450,000 in
fiscal year 2024 and $450,000 in fiscal year
2025 are from the general fund for grants to
establish and manage a pool of state-funded
qualified individuals to conduct assessments
for out-of-home placement of a child in a
qualified residential treatment program.
new text end
new text begin
(f) Grants to counties to reduce foster care
caseloads. $3,000,000 in fiscal year 2024 and
$3,000,000 in fiscal year 2025 are from the
general fund for grants to counties and
American Indian child welfare initiative Tribes
to reduce extended foster care caseload sizes.
new text end
new text begin
(g) Quality parenting initiative grant
program. $100,000 in fiscal year 2024 and
$100,000 in fiscal year 2025 are from the
general fund for a grant to Quality Parenting
Initiative Minnesota under Minnesota Statutes,
section 245.0962.
new text end
new text begin
(h) Payments to counties to reimburse
revenue loss. $2,000,000 in fiscal year 2024
and $2,000,000 in fiscal year 2025 are for
payments to counties to reimburse the revenue
loss attributable to prohibiting counties, as the
financially responsible agency for a child
placed in foster care, from receiving
Supplemental Security Income on behalf of
the child placed in foster care during the time
the child is in foster care under Minnesota
Statutes, section 256N.26, subdivision 12.
new text end
new text begin
(h) Base level adjustment. The general fund
base is $91,001,000 in fiscal year 2026 and
$91,001,000 in fiscal year 2027.
new text end
new text begin Subd. 23. new text end
new text begin
Grant Programs; Children and
|
new text begin
62,356,000 new text end |
new text begin
62,356,000 new text end |
||||
new text begin Subd. 24. new text end
new text begin
Grant Programs; Children and
|
new text begin
70,823,000 new text end |
new text begin
74,829,000 new text end |
||||
new text begin
(a) Fraud prevention initiative start-up
grants. $400,000 in fiscal year 2024 is for
start-up grants to the Red Lake Nation, White
Earth Nation, and Mille Lacs Band of Ojibwe
to develop a fraud prevention program. This
is a onetime appropriation and is available
until June 30, 2025.
new text end
new text begin
(b) Grants to promote food security among
Tribal Nations and American Indian
communities. $1,851,000 in fiscal year 2024
and $1,851,000 in fiscal year 2025 are for
grants to support food security among Tribal
Nations and American Indian communities
under Minnesota Statutes, section 256E.341.
new text end
new text begin
(c) Minnesota food shelf program grants.
$2,827,000 in fiscal year 2024 and $2,827,000
in fiscal year 2025 are for the Minnesota food
shelf program under Minnesota Statutes,
section 256E.34.
new text end
new text begin
(d) Grant to CornerHouse children's
advocacy center. $315,000 in fiscal year 2024
and $315,000 in fiscal year 2025 are for a
grant to CornerHouse children's advocacy
center. The grant must be used to establish a
child maltreatment prevention program serving
rural, urban, and suburban communities across
the state and to expand response services in
Hennepin and Anoka Counties for children
who have experienced maltreatment. This
paragraph does not expire.
new text end
new text begin
(e) Hennepin County homelessness grant
program. $5,095,000 in fiscal year 2025 is
for a grant to Hennepin County under
Minnesota Statutes, section 245.0966. The
base for this appropriation is $10,191,000 in
fiscal year 2026 and $10,191,000 in fiscal year
2027.
new text end
new text begin
(f) Diaper distribution grant program.
$500,000 in fiscal year 2024 and $500,000 in
fiscal year 2025 are for the diaper distribution
grant program under Minnesota Statutes,
section 256E.38.
new text end
new text begin
(g) Prepared meals food relief. $1,250,000
in fiscal year 2024 and $1,250,000 in fiscal
year 2025 are for prepared meals food relief
grants under Minnesota Statutes, section
256E.341.
new text end
new text begin
(h) Family supportive housing. $4,000,000
in fiscal year 2024 and $4,000,000 in fiscal
year 2025 are for the grants under Minnesota
Statutes, section 256K.50.
new text end
new text begin
(i) Chosen family grants. $1,939,000 in fiscal
year 2024 is for grants to providers serving
homeless youth and youth at risk of
homelessness in Minnesota to establish or
expand services that formalize situations
where a caring adult whom a youth considers
chosen family allows the youth to stay at the
adult's residence to avoid being homeless. This
is a onetime appropriation and is available
until June 30, 2025.
new text end
new text begin
(j) Homeless youth cash stipend pilot
project. $3,000,000 in fiscal year 2024 and
$3,000,000 in fiscal year 2025 are for a grant
to Youthprise for the homeless youth cash
stipend pilot project. The grant must be used
to provide cash stipends to homeless youth,
provide cash incentives for stipend recipients
to participate in periodic surveys, provide
youth-designed optional services, and
complete a legislative report. The general fund
base for this appropriation is $3,000,000 in
fiscal year 2026, $3,000,000 in fiscal year
2027, and $0 in fiscal year 2028 and thereafter.
new text end
new text begin
(k) Olmsted County homelessness grant
program. $1,164,000 in fiscal year 2024 and
$1,164,000 in fiscal year 2025 are for a grant
to Olmsted County under Minnesota Statutes,
section 245.0965.
new text end
new text begin
(l) Continuum of care grant program.
$6,595,000 in fiscal year 2024 and $6,595,000
in fiscal year 2025 are for a grant to Ramsey
County for the Heading Home Ramsey
Continuum of Care under Minnesota Statutes,
section 245.0963. Of these amounts, ten
percent in fiscal year 2024 and ten percent in
fiscal year 2025 may be used by the grantee
for administrative expenses.
new text end
new text begin
(m) Base level adjustment. The general fund
base is $79,925,000 in fiscal year 2026 and
$79,925,000 in fiscal year 2027.
new text end
new text begin Subd. 25. new text end
new text begin
Grant Programs; Health Care Grants
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
7,311,000 new text end |
new text begin
7,311,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
3,465,000 new text end |
new text begin
3,465,000 new text end |
new text begin
(a) Grant to Indian Health Board of
Minneapolis. $2,500,000 in fiscal year 2024
and $2,500,000 in fiscal year 2025 are from
the general fund for a grant to the Indian
Health Board of Minneapolis to support
continued access to health care coverage
through medical assistance and
MinnesotaCare, improve access to quality
care, and increase vaccination rates among
urban American Indians. The general fund
base for this appropriation is $2,500,000 in
fiscal year 2026 and $0 in fiscal year 2027.
new text end
new text begin
(b) Base level adjustment. The general fund
base is $7,311,000 in fiscal year 2026 and
$4,811,000 in fiscal year 2027.
new text end
new text begin Subd. 26. new text end
new text begin
Grant Programs; Housing Support
|
new text begin
18,364,000 new text end |
new text begin
10,364,000 new text end |
||||
new text begin Subd. 27. new text end
new text begin
Grant Programs; Adult Mental Health
|
new text begin
108,545,000 new text end |
new text begin
114,407,000 new text end |
||||
new text begin
(a) Mobile crisis grants to Tribal Nations.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are for mobile crisis grants
under Minnesota Statutes section 245.4661,
subdivision 9, paragraph (b), clause (15), to
Tribal Nations.
new text end
new text begin
(b) Mental health provider supervision
grant program. $1,500,000 in fiscal year
2024 and $1,500,000 in fiscal year 2025 are
for the mental health provider supervision
grant program under Minnesota Statutes,
section 245.4663.
new text end
new text begin
(c) Mental health professional scholarship
grant program. $750,000 in fiscal year 2024
and $750,000 in fiscal year 2025 are for the
mental health professional scholarship grant
program under Minnesota Statutes, section
245.4664.
new text end
new text begin
(d) Minnesota State University, Mankato
community behavioral health center.
$750,000 in fiscal year 2024 and $750,000 in
fiscal year 2025 are for a grant to the Center
for Rural Behavioral Health at Minnesota State
University, Mankato to establish a community
behavioral health center and training clinic.
The community behavioral health center must
provide comprehensive, culturally specific,
trauma-informed, practice- and
evidence-based, person- and family-centered
mental health and substance use disorder
treatment services in Blue Earth County and
the surrounding region to individuals of all
ages, regardless of an individual's ability to
pay or place of residence. The community
behavioral health center and training clinic
must also provide training and workforce
development opportunities to students enrolled
in the university's training programs in the
fields of social work, counseling and student
personnel, alcohol and drug studies,
psychology, and nursing. Upon request, the
commissioner must make information
regarding the use of this grant funding
available to the chairs and ranking minority
members of the legislative committees with
jurisdiction over behavioral health. This is a
onetime appropriation.
new text end
new text begin
(e) Base level adjustment. The general fund
base is $123,797,000 in fiscal year 2026 and
$123,797,000 in fiscal year 2027.
new text end
new text begin Subd. 28. new text end
new text begin
Grant Programs; Child Mental Health
|
new text begin
39,180,000 new text end |
new text begin
35,326,000 new text end |
||||
new text begin
(a) Psychiatric residential treatment facility
start-up grants. $1,000,000 in fiscal year
2024 and $1,000,000 in fiscal year 2025 are
for psychiatric residential treatment facility
start-up grants under Minnesota Statutes,
section 256B.0941, subdivision 5.
new text end
new text begin
(b) Psychatric residential treatment
facilities specialization grants. $1,050,000
in fiscal year 2024 and $1,050,000 in fiscal
year 2025 are for psychiatric residential
treatment facilities specialization grants under
Minnesota Statutes, section 256B.0941,
subdivision 5.
new text end
new text begin
(c) Emerging mood disorder grants.
$1,250,000 in fiscal year 2024 and $1,250,000
in fiscal year 2025 are for emerging mood
disorder grants under Minnesota Statutes,
section 245.4904, for evidence-informed
interventions for youth and young adults who
are at higher risk of developing a mood
disorder or are already experiencing an
emerging mood disorder.
new text end
new text begin
(d) Implementation grants for mobile
response and stabilization services.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are for grants to implement
the mobile response and stabilization services
model to promote access to crisis response
services, reduce admissions to psychiatric
hospitals, and reduce out-of-home placement
services.
new text end
new text begin
(e) Grants for infant and early childhood
mental health consultations. $1,000,000 in
fiscal year 2024 and $1,000,000 in fiscal year
2025 are for grants under Minnesota Statutes,
section 245.4889, subdivision 1, paragraph
(b), clause (14), for infant and early childhood
mental health consultations throughout the
state, including Tribal Nations for expertise
in young children's development and early
childhood services.
new text end
new text begin
(f) African American Child Wellness
Institute. $1,000,000 in fiscal year 2024 and
$1,000,000 in fiscal year 2025 are for a grant
to the African American Child Wellness
Institute to provide culturally specific mental
health and substance use disorder services
under Minnesota Statutes, section 245.0961.
new text end
new text begin
(g) Headway Emotional Health Services.
$300,000 in fiscal year 2024 and $300,000 in
fiscal year 2025 are for a grant to Headway
Emotional Health Services for day treatment
transportation costs on nonschool days, student
nutrition, and student learning experiences
such as technology, arts, and outdoor activity.
This is a onetime appropriation.
new text end
new text begin
(h) Base level adjustment. The general fund
base is $35,026,000 in fiscal year 2026 and
$35,026,000 in fiscal year 2027.
new text end
new text begin Subd. 29. new text end
new text begin
Grant Programs; Chemical
|
new text begin
2,350,000 new text end |
new text begin
1,350,000 new text end |
||||
new text begin
Overdose prevention grants. $1,000,000 in
fiscal year 2024 is for a grant to the Steve
Rummler Hope Network for statewide
outreach, education, training, and distribution
of naloxone kits. Of this amount, 50 percent
of the money appropriated must be provided
to the Ka Joog nonprofit organization for
collaborative outreach in East African and
Somali communities in Minnesota. This is a
onetime appropriation and is available until
June 30, 2025.
new text end
new text begin Subd. 30. new text end
new text begin
Technical Activities
|
new text begin
71,493,000 new text end |
new text begin
71,493,000 new text end |
||||
new text begin
This appropriation is from the federal TANF
fund.
new text end
Sec. 3. new text begin COMMISSIONER OF HEALTH
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
442,138,000 new text end |
new text begin
$ new text end |
new text begin
423,582,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
2024 new text end |
new text begin
2025 new text end |
|
|
new text begin
General new text end |
new text begin
295,036,000 new text end |
new text begin
269,339,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
83,674,000 new text end |
new text begin
86,204,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
51,715,000 new text end |
new text begin
56,326,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Health Improvement
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
232,717,000 new text end |
new text begin
206,576,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
12,693,000 new text end |
new text begin
12,984,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
51,715,000 new text end |
new text begin
56,326,000 new text end |
|
new text begin
Federal TANF new text end |
new text begin
11,713,000 new text end |
new text begin
11,713,000 new text end |
new text begin
(a) Studies of telehealth expansion and
payment parity. $1,200,000 in fiscal year
2024 is from the general fund for studies of
telehealth expansion and payment parity. This
is a onetime appropriation and is available
until June 30, 2025.
new text end
new text begin
(b) Advancing equity through capacity
building and resource allocation grant
program. $500,000 in fiscal year 2024 and
$500,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 144.9821.
new text end
new text begin
(c) Community health workers. $971,000
in fiscal year 2024 and $971,000 in fiscal year
2025 are from the general fund for grants
under Minnesota Statutes, section 144.1462.
new text end
new text begin
(d) Community solutions for healthy child
development grants. $3,678,000 in fiscal year
2024 and $3,698,000 in fiscal year 2025 are
from the general fund for grants under
Minnesota Statutes, section 145.9257.
new text end
new text begin
(e) new text begin Cultural communications program.new text end
$1,724,000 in fiscal year 2024 and $1,724,000
in fiscal year 2025 are from the general fund
for the cultural communications program
established in Minnesota Statutes, section
144.0752.
new text end
new text begin
(f) Emergency preparedness and response.
$16,825,000 in fiscal year 2024 and
$16,662,000 in fiscal year 2025 are from the
general fund for public health emergency
preparedness and response, the sustainability
of the strategic stockpile, and COVID-19
pandemic response transition.
new text end
new text begin
(g) Family planning grants. $7,900,000 in
fiscal year 2024 and $7,900,000 in fiscal year
2025 are from the general fund for grants
under Minnesota Statutes, section 145.925.
new text end
new text begin
(h) Healthy Beginnings, Healthy Families.
$5,250,000 in fiscal year 2024 and $5,250,000
in fiscal year 2025 are from the general fund
for grants under Minnesota Statutes, section
145.9571.
new text end
new text begin
(i) Help Me Connect. $463,000 in fiscal year
2024 and $921,000 in fiscal year 2025 are
from the general fund for the Help Me
Connect program under Minnesota Statutes,
section 145.988.
new text end
new text begin
(j) Home visiting. $9,250,000 in fiscal year
2024 and $9,250,000 in fiscal year 2025 are
from the general fund to start up or expand
home visiting programs for priority
populations under Minnesota Statutes, section
145.87.
new text end
new text begin
(k) No Surprises Act enforcement.
$1,210,000 in fiscal year 2024 and $1,090,000
in fiscal year 2025 are from the general fund
for implementation of the federal No Surprises
Act under Minnesota Statutes, section
62Q.021, and a statewide provider directory.
The general fund base for this appropriation
is $855,000 in fiscal year 2026 and $855,000
in fiscal year 2027.
new text end
new text begin
(l) Office of African American Health.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are from the general fund
for grants under the authority of the Office of
African American Health under Minnesota
Statutes, section 144.0756.
new text end
new text begin
(m) Office of American Indian Health.
$1,000,000 in fiscal year 2024 and $1,000,000
in fiscal year 2025 are from the general fund
for grants under the authority of the Office of
American Indian Health under Minnesota
Statutes, section 144.0757.
new text end
new text begin
(n) Public health system transformation
grants. (1) $9,844,000 in fiscal year 2024 and
$9,844,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 145A.131, subdivision 1,
paragraph (f).
new text end
new text begin
(2) $535,000 in fiscal year 2024 and $535,000
in fiscal year 2025 are from the general fund
for grants under Minnesota Statutes, section
145A.14, subdivision 2, paragraph (b).
new text end
new text begin
(3) $321,000 in fiscal year 2024 and $321,000
in fiscal year 2025 are from the general fund
for grants under Minnesota Statutes, section
144.0759.
new text end
new text begin
(o) Health care workforce. (1) $1,154,000
in fiscal year 2024 and $3,117,000 in fiscal
year 2025 are from the health care access fund
for rural training tracks and rural clinicals
grants under Minnesota Statutes, section
144.1508. The base for this appropriation is
$4,502,000 in fiscal year 2026 and $4,502,000
in fiscal year 2027.
new text end
new text begin
(2) $323,000 in fiscal year 2024 and $323,000
in fiscal year 2025 are from the health care
access fund for immigrant international
medical graduate training grants under
Minnesota Statutes, section 144.1911.
new text end
new text begin
(3) $5,771,000 in fiscal year 2024 and
$5,147,000 in fiscal year 2025 are from the
health care access fund for site-based clinical
training grants under Minnesota Statutes,
section 144.1505. The base for this
appropriation is $4,426,000 in fiscal year 2026
and $4,426,000 in fiscal year 2027.
new text end
new text begin
(4) $1,000,000 in fiscal year 2024 and
$1,000,000 in fiscal year 2025 are from the
health care access fund for mental health
grants for health care professional grants. This
is a onetime appropriation and is available
until June 30, 2027.
new text end
new text begin
(5) $2,500,000 in fiscal year 2024 and
$2,500,000 in fiscal year 2025 are from the
health care access fund for health professionals
loan forgiveness under Minnesota Statutes,
section 144.1501, subdivision 1, paragraph
(h).
new text end
new text begin
(6) $708,000 in fiscal year 2024 and $708,000
in fiscal year 2025 are from the health care
access fund for primary care employee
recruitment education loan forgiveness under
Minnesota Statutes, section 144.1504.
new text end
new text begin
(7) $350,000 in fiscal year 2024 and $350,000
in fiscal year 2025 are from the health care
access fund for workforce research and data
analysis of shortages, maldistribution of health
care providers in Minnesota, and the factors
that influence decisions of health care
providers to practice in rural areas of
Minnesota.
new text end
new text begin
(p) School health. $800,000 in fiscal year
2024 and $800,000 in fiscal year 2025 are
from the general fund for grants under
Minnesota Statutes, section 145.903.
new text end
new text begin
(q) Long COVID. $3,146,000 in fiscal year
2024 and $3,146,000 in fiscal year 2025 are
from the general fund for grants and to
implement Minnesota Statutes, section
145.361.
new text end
new text begin
(r) Workplace violence prevention grants
for health care entities. $4,400,000 in fiscal
year 2024 is from the general fund for grants
to health care entities to improve employee
safety or security. This is a onetime
appropriation and is available until June 30,
2025.
new text end
new text begin
(s) Clinical dental education innovation
grants. $1,122,000 in fiscal year 2024 and
$1,122,000 in fiscal year 2025 are from the
general fund for clinical dental education
innovation grants under Minnesota Statutes,
section 144.1913.
new text end
new text begin
(t) Skin-lightening products public
awareness and education grant program.
$200,000 in fiscal year 2024 is from the
general fund for a grant to the Beautywell
Project under Minnesota Statutes, section
145.9275. This is a onetime appropriation.
new text end
new text begin
(u) Emmett Louis Till Victims Recovery
Program. $500,000 in fiscal year 2024 is from
the general fund for a grant to the Emmett
Louis Till Victims Recovery Program. The
commissioner must not use any of this
appropriation for administration. This is a
onetime appropriation and is available until
June 30, 2025.
new text end
new text begin
(v) Federally qualified health centers
apprenticeship program. $750,000 in fiscal
year 2024 and $750,000 in fiscal year 2025
are from the general fund for grants under
Minnesota Statutes, section 145.9272, and for
the study of the feasibility of establishing
additional federally qualified health centers
apprenticeship programs.
new text end
new text begin
(w) Alzheimer's public information
program. $80,000 in fiscal year 2024 and
$80,000 in fiscal year 2025 are from the
general fund for grants to community-based
organizations to co-create culturally specific
messages to targeted communities and to
promote public awareness materials online
through diverse media channels. This is a
onetime appropriation and is available until
June 30, 2027.
new text end
new text begin
(x) African American Babies Coalition
grant. $260,000 in fiscal year 2024 and
$260,000 in fiscal year 2025 are from the
general fund for a grant to the Amherst H.
Wilder Foundation for a grant under
Minnesota Statutes, section 144.645, for the
African American Babies Coalition initiative.
new text end
new text begin
(y) (1) Health professional loan forgiveness
account. $9,661,000 in fiscal year 2024 is
from the general fund for eligible mental
health professional loan forgiveness under
Minnesota Statutes, section 144.1501. This is
a onetime appropriation.
new text end
new text begin
(2) Transfer. The commissioner must transfer
$9,661,000 in fiscal year 2024 from the
general fund to the health professional loan
forgiveness account under Minnesota Statutes,
section 144.1501, subdivision 2.
new text end
new text begin
(z) new text begin Primary care residency expansion grant
program.new text end $400,000 in fiscal year 2024 and
$400,000 in fiscal year 2025 are from the
general fund for a psychiatry resident under
Minnesota Statutes, section 144.1506.
new text end
new text begin
(aa) new text begin Pediatric primary care mental health
training grant program. new text end $1,000,000 in fiscal
year 2024 and $1,000,000 in fiscal year 2025
are from the general fund for grants under
Minnesota Statutes, section 144.1507.
new text end
new text begin
(bb) new text begin Mental health cultural community
continuing education grant program.
new text end $500,000 in fiscal year 2024 and $500,000 in
fiscal year 2025 are from the general fund for
grants under Minnesota Statutes, section
144.1511.
new text end
new text begin
(cc) Labor trafficking services grant
program. $500,000 in fiscal year 2024 and
$500,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 144.3885.
new text end
new text begin
(dd) Alzheimer's disease and dementia care
training program. $449,000 in fiscal year
2025 and $449,000 in fiscal year 2026 are to
implement the Alzheimer's disease and
dementia care training program under
Minnesota Statutes, section 144.6504.
new text end
new text begin
(ee) Grant to Minnesota Alliance for
Volunteer Advancement. $138,000 in fiscal
year 2024 is from the general fund for a grant
to the Minnesota Alliance for Volunteer
Advancement to administer needs-based
volunteerism subgrants targeting
underresourced nonprofit organizations in
greater Minnesota to support selected
organizations' ongoing efforts to address and
minimize disparities in access to human
services through increased volunteerism.
Subgrant applicants must demonstrate that the
populations to be served by the subgrantee are
underserved or suffer from or are at risk of
homelessness, hunger, poverty, lack of access
to health care, or deficits in education. The
Minnesota Alliance for Volunteer
Advancement must give priority to
organizations that are serving the needs of
vulnerable populations. This is a onetime
appropriation and is available until June 30,
2025.
new text end
new text begin
(ff) new text begin Palliative Care Advisory Council.
new text end $40,000 in fiscal year 2024 and $40,000 in
fiscal year 2025 are from the general fund for
grants under Minnesota Statutes, section
144.059.
new text end
new text begin
(gg) Universal health care system study.
$1,815,000 in fiscal year 2024 and $580,000
in fiscal year 2025 are from the general fund
for an economic analysis of benefits and costs
of a universal health care system. The base for
this appropriation is $580,000 in fiscal year
2026 and $0 in fiscal year 2027.
new text end
new text begin
(hh) Study of the development of a statewide
registry for provider orders for
life-sustaining treatment. $365,000 in fiscal
year 2024 and $365,000 in fiscal year 2025
are from the general fund for a study of the
development of a statewide registry for
provider orders for life-sustaining treatment.
This is a onetime appropriation.
new text end
new text begin
(ii) 988 Suicide and crisis lifeline. $4,000,000
in fiscal year 2024 is from the general fund
for 988 national suicide prevention lifeline
grants under Minnesota Statutes, section
145.561. This is a onetime appropriation.
new text end
new text begin
(jj) Fetal and infant mortality case review
committee. $664,000 in fiscal year 2024 and
$875,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 145.9011.
new text end
new text begin
(kk) Equitable Health Care Task Force.
$779,000 in fiscal year 2024 and $749,000 in
fiscal year 2025 are from the general fund for
the Equitable Health Care Task Force. This is
a onetime appropriation.
new text end
new text begin
(ll) Medical education and research costs.
$300,000 in fiscal year 2024 and $300,000 in
fiscal year 2025 are from the general fund for
the medical education and research costs
program under Minnesota Statutes, section
62J.692.
new text end
new text begin
(mm) Special Guerilla Unit Veterans grant
program. $250,000 in fiscal year 2024 and
$250,000 in fiscal year 2025 are from the
general fund for a grant to the Special
Guerrilla Units Veterans and Families of the
United States of America under Minnesota
Statutes, section 144.0701.
new text end
new text begin
(nn) TANF Appropriations. (1) TANF funds
must be used as follows:
new text end
new text begin
(i) $3,579,000 in fiscal year 2024 and
$3,579,000 in fiscal year 2025 are from the
TANF fund for home visiting and nutritional
services listed under Minnesota Statutes,
section 145.882, subdivision 7, clauses (6) and
(7). Funds must be distributed to community
health boards according to Minnesota Statutes,
section 145A.131, subdivision 1;
new text end
new text begin
(ii) $2,000,000 in fiscal year 2024 and
$2,000,000 in fiscal year 2025 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
new text end
new text begin
(iii) $4,978,000 in fiscal year 2024 and
$4,978,000 in fiscal year 2025 are from the
TANF fund for the family home visiting grant
program under Minnesota Statutes, section
145A.17. $4,000,000 of the funding in fiscal
year 2024 and $4,000,000 in fiscal year 2025
must be distributed to community health
boards under Minnesota Statutes, section
145A.131, subdivision 1. $978,000 of the
funding in fiscal year 2024 and $978,000 in
fiscal year 2025 must be distributed to Tribal
governments under Minnesota Statutes, section
145A.14, subdivision 2a;
new text end
new text begin
(iv) $1,156,000 in fiscal year 2024 and
$1,156,000 in fiscal year 2025 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
new text end
new text begin
(v) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance as required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
new text end
new text begin
(2) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year does not cancel but is available in the
second year.
new text end
new text begin
(oo) Base level adjustments. The general
fund base is $204,079,000 in fiscal year 2026
and $203,440,000 in fiscal year 2027. The
state government special revenue fund base is
$12,853,000 in fiscal year 2026 and
$12,853,000 in fiscal year 2027. The health
care access fund base is $56,361,000 in fiscal
year 2026 and $55,761,000 in fiscal year 2027.
new text end
new text begin Subd. 3. new text end
new text begin
Health Protection
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
43,827,000 new text end |
new text begin
44,358,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
70,981,000 new text end |
new text begin
73,220,000 new text end |
new text begin
(a) Climate resiliency. $6,000,000 in fiscal
year 2024 and $6,000,000 in fiscal year 2025
are from the general fund for grants under
Minnesota Statutes, section 144.9981. The
base for this appropriation is $1,500,000 in
fiscal year 2026 and $1,500,000 in fiscal year
2027.
new text end
new text begin
(b) Homeless mortality study. $134,000 in
fiscal year 2024 and $149,000 in fiscal year
2025 are from the general fund for a homeless
mortality study. The general fund base for this
appropriation is $104,000 in fiscal year 2026
and $0 in fiscal year 2027.
new text end
new text begin
(c) Lead remediation in schools and child
care settings. $146,000 in fiscal year 2024
and $239,000 in fiscal year 2025 are from the
general fund for grants under Minnesota
Statutes, section 145.9272.
new text end
new text begin
(d) MinnesotaOne Health Antimicrobial
Stewardship Collaborative. $312,000 in
fiscal year 2024 and $312,000 in fiscal year
2025 are from the general fund for the
Minnesota One Health Antibiotic Stewardship
Collaborative under Minnesota Statutes,
section 144.0526.
new text end
new text begin
(e) Strengthening public drinking water
systems infrastructure. $4,420,000 in fiscal
year 2024 and $4,420,000 in fiscal year 2025
are from the general fund for grants under
Minnesota Statutes, section 144.3832. The
base for this appropriation is $1,580,000 in
fiscal year 2026 and $1,580,000 in fiscal year
2027.
new text end
new text begin
(f) HIV prevention health equity. $1,264,000
in fiscal year 2024 and $1,264,000 in fiscal
year 2025 are from the general fund for equity
in HIV prevention. This is a onetime
appropriation.
new text end
new text begin
(g) Green burials study and report. $79,000
in fiscal year 2024 is from the general fund
for a study and report on green burials. This
is a onetime appropriation.
new text end
new text begin
(h) Base level adjustments. The general fund
base is $34,020,000 in fiscal year 2026 and
$33,916,000 in fiscal year 2027.
new text end
new text begin Subd. 4. new text end
new text begin
Health Operations
|
new text begin
18,492,000 new text end |
new text begin
18,405,000 new text end |
||||
new text begin
Notwithstanding Minnesota Statutes, section
16E.21, subdivision 4, the amount transferred
to the information and telecommunications
account under Minnesota Statutes, section
16E.21, subdivision 2, for the business process
automation and external website
modernization projects approved by the
Legislative Advisory Commission on June 24,
2019, is available until June 30, 2024.
new text end
Sec. 4. new text begin HEALTH-RELATED BOARDS
|
||||||
new text begin Subdivision 1. new text end
new text begin
Total Appropriation
|
new text begin
$ new text end |
new text begin
32,160,000 new text end |
new text begin
$ new text end |
new text begin
32,166,000 new text end |
||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
1,222,000 new text end |
new text begin
468,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
30,862,000 new text end |
new text begin
31,660,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
76,000 new text end |
new text begin
38,000 new text end |
new text begin
The amounts that may be spent for each
purpose are specified in the following
subdivisions.
new text end
new text begin Subd. 2. new text end
new text begin
Board of Behavioral Health and
|
new text begin
1,022,000 new text end |
new text begin
1,044,000 new text end |
||||
new text begin Subd. 3. new text end
new text begin
Board of Chiropractic Examiners
|
new text begin
773,000 new text end |
new text begin
790,000 new text end |
||||
new text begin Subd. 4. new text end
new text begin
Board of Dentistry
|
new text begin
4,100,000 new text end |
new text begin
4,163,000 new text end |
||||
new text begin
(a) Administrative services unit; operating
costs. Of this appropriation, $1,936,000 in
fiscal year 2024 and $1,960,000 in fiscal year
2025 are for operating costs of the
administrative services unit. The
administrative services unit may receive and
expend reimbursements for services it
performs for other agencies.
new text end
new text begin
(b) Administrative services unit; volunteer
health care provider program. Of this
appropriation, $150,000 in fiscal year 2024
and $150,000 in fiscal year 2025 are to pay
for medical professional liability coverage
required under Minnesota Statutes, section
214.40.
new text end
new text begin
(c) Administrative services unit; retirement
costs. Of this appropriation, $237,000 in fiscal
year 2024 and $237,000 in fiscal year 2025
are for the administrative services unit to pay
for the retirement costs of health-related board
employees. This funding may be transferred
to the health board incurring retirement costs.
Any board that has an unexpended balance for
an amount transferred under this paragraph
shall transfer the unexpended amount to the
administrative services unit. If the amount
appropriated in the first year of the biennium
is not sufficient, the amount from the second
year of the biennium is available.
new text end
new text begin
(d) Administrative services unit; contested
cases and other legal proceedings. Of this
appropriation, $200,000 in fiscal year 2024
and $200,000 in fiscal year 2025 are for costs
of contested case hearings and other
unanticipated costs of legal proceedings
involving health-related boards under this
section. Upon certification by a health-related
board to the administrative services unit that
unanticipated costs for legal proceedings will
be incurred and that available appropriations
are insufficient to pay for the unanticipated
costs for that board, the administrative services
unit is authorized to transfer money from this
appropriation to the board for payment of costs
for contested case hearings and other
unanticipated costs of legal proceedings with
the approval of the commissioner of
management and budget. The commissioner
of management and budget must require any
board that has an unexpended balance or an
amount transferred under this paragraph to
transfer the unexpended amount to the
administrative services unit to be deposited in
the state government special revenue fund.
new text end
new text begin Subd. 5. new text end
new text begin
Board of Dietetics and Nutrition
|
new text begin
213,000 new text end |
new text begin
217,000 new text end |
||||
new text begin Subd. 6. new text end
new text begin
Board of Executives for Long-term
|
new text begin
705,000 new text end |
new text begin
736,000 new text end |
||||
new text begin Subd. 7. new text end
new text begin
Board of Marriage and Family Therapy
|
new text begin
443,000 new text end |
new text begin
456,000 new text end |
||||
new text begin Subd. 8. new text end
new text begin
Board of Medical Practice
|
new text begin
5,779,000 new text end |
new text begin
5,971,000 new text end |
||||
new text begin Subd. 9. new text end
new text begin
Board of Nursing
|
new text begin
6,039,000 new text end |
new text begin
6,275,000 new text end |
||||
new text begin Subd. 10. new text end
new text begin
Board of Occupational Therapy
|
new text begin
480,000 new text end |
new text begin
480,000 new text end |
||||
new text begin Subd. 11. new text end
new text begin
Board of Optometry
|
new text begin
270,000 new text end |
new text begin
280,000 new text end |
||||
new text begin Subd. 12. new text end
new text begin
Board of Pharmacy
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
1,222,000 new text end |
new text begin
468,000 new text end |
|
new text begin
State Government Special Revenue new text end |
new text begin
5,328,000 new text end |
new text begin
5,309,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
76,000 new text end |
new text begin
38,000 new text end |
new text begin
(a) Prescription monitoring program.
$754,000 in fiscal year 2024 is from the
general fund for the Minnesota prescription
monitoring program under Minnesota Statutes,
section 152.126. This is a onetime
appropriation and is available until June 30,
2025.
new text end
new text begin
(b) Medication repository program.
$450,000 in fiscal year 2024 and $450,000 in
fiscal year 2025 are from the general fund for
a contract under Minnesota Statutes, section
151.555.
new text end
new text begin
(c) Base level adjustment. The state
government special revenue fund base is
$5,159,000 in fiscal year 2026 and $5,159,000
in fiscal year 2027. The health care access
fund base is $0 in fiscal year 2026 and $0 in
fiscal year 2027.
new text end
new text begin Subd. 13. new text end
new text begin
Board of Physical Therapy
|
new text begin
678,000 new text end |
new text begin
694,000 new text end |
||||
new text begin Subd. 14. new text end
new text begin
Board of Podiatric Medicine
|
new text begin
253,000 new text end |
new text begin
257,000 new text end |
||||
new text begin Subd. 15. new text end
new text begin
Board of Psychology
|
new text begin
2,618,000 new text end |
new text begin
2,734,000 new text end |
||||
new text begin
Health professionals service program. This
appropriation includes $1,234,000 in fiscal
year 2024 and $1,324,000 in fiscal year 2025
for the health professional services program.
new text end
new text begin Subd. 16. new text end
new text begin
Board of Social Work
|
new text begin
1,779,000 new text end |
new text begin
1,839,000 new text end |
||||
new text begin Subd. 17. new text end
new text begin
Board of Veterinary Medicine
|
new text begin
382,000 new text end |
new text begin
415,000 new text end |
||||
new text begin
Base adjustment. The state government
special revenue fund base is $461,000 in fiscal
year 2026 and $461,000 in fiscal year 2027.
new text end
Sec. 5. new text begin EMERGENCY MEDICAL SERVICES
|
new text begin
$ new text end |
new text begin
6,800,000 new text end |
new text begin
$ new text end |
new text begin
6,176,000 new text end |
||
new text begin
(a) Cooper/Sams volunteer ambulance
program. $950,000 in fiscal year 2024 and
$950,000 in fiscal year 2025 are for the
Cooper/Sams volunteer ambulance program
under Minnesota Statutes, section 144E.40.
new text end
new text begin
(1) Of this amount, $861,000 in fiscal year
2024 and $861,000 in fiscal year 2025 are for
the ambulance service personnel longevity
award and incentive program under Minnesota
Statutes, section 144E.40.
new text end
new text begin
(2) Of this amount, $89,000 in fiscal year 2024
and $89,000 in fiscal year 2025 are for
operations of the ambulance service personnel
longevity award and incentive program under
Minnesota Statutes, section 144E.40.
new text end
new text begin
(b) Operations. $2,421,000 in fiscal year 2024
and $2,480,000 in fiscal year 2025 are for
board operations.
new text end
new text begin
(c) Emergency medical services fund.
$1,385,000 in fiscal year 2024 and $1,385,000
in fiscal year 2025 are for distribution to
regional emergency medical services systems
for the purposes specified in Minnesota
Statutes, section 144E.50. Notwithstanding
Minnesota Statutes, section 144E.50,
subdivision 5, in each year the board must
distribute this appropriation equally among
the eight emergency medical services systems
designated by the board.
new text end
new text begin
(d) Ambulance training grants. $361,000 in
fiscal year 2024 and $361,000 in fiscal year
2025 are for training grants under Minnesota
Statutes, section 144E.35.
new text end
new text begin
(e) Medical resource communication center
grants. $1,633,000 in fiscal year 2024 and
$970,000 in fiscal year 2025 are for medical
resource communication center grants under
Minnesota Statutes, section 144E.53.
new text end
Sec. 6. new text begin OMBUDSPERSON FOR FAMILIES
|
new text begin
$ new text end |
new text begin
759,000 new text end |
new text begin
$ new text end |
new text begin
776,000 new text end |
||
Sec. 7. new text begin OMBUDSPERSON FOR AMERICAN
|
new text begin
$ new text end |
new text begin
336,000 new text end |
new text begin
$ new text end |
new text begin
340,000 new text end |
||
Sec. 8. new text begin OFFICE OF THE FOSTER YOUTH
|
new text begin
$ new text end |
new text begin
742,000 new text end |
new text begin
$ new text end |
new text begin
759,000 new text end |
||
Sec. 9. new text begin MNSURE
|
||||||
|
new text begin
Appropriations by Fund new text end |
||
|
new text begin
General new text end |
new text begin
27,447,000 new text end |
new text begin
45,526,000 new text end |
|
new text begin
Health Care Access new text end |
new text begin
2,270,000 new text end |
new text begin
1,470,000 new text end |
new text begin
(a) Technology Modernization. $11,025,000
in fiscal year 2024 and $10,726,000 in fiscal
year 2025 are from the general fund to
establish a single end-to-end information
technology system with seamless, real-time
interoperability between qualified health plan
eligibility and enrollment services. The base
for this appropriation is $3,521,000 in fiscal
year 2026 and $0 in fiscal year 2027.
new text end
new text begin
(b) Easy Enrollment. $70,000 in fiscal year
2024 and $70,000 in fiscal year 2025 are from
the general fund to implement easy enrollment.
new text end
new text begin
(c) Transfer. The Board of Directors of
MNsure must transfer $11,095,000 in fiscal
year 2024 and $14,996,000 in fiscal year 2025
from the general fund to the enterprise account
under Minnesota Statutes, section 62V.07. The
base for this transfer is $3,591,000 in fiscal
year 2026 and $70,000 in fiscal year 2027.
new text end
new text begin
(d) Minnesota insulin safety net public
awareness campaign. $800,000 in fiscal year
2024 is from the health care access fund for a
public awareness campaign for the insulin
safety net program under Minnesota Statutes,
section 151.74. This is a onetime appropriation
and is available until June 30, 2025.
new text end
new text begin
(e) Cost-sharing reduction program.
$15,000,000 in fiscal year 2024 and
$30,000,000 in fiscal year 2025 are from the
general fund to implement the cost-sharing
reduction program under Minnesota Statutes,
section 62V.12.
new text end
new text begin
(f) Base level adjustment. The general fund
base is $34,121,000 in fiscal year 2026 and
$30,600,000 in fiscal year 2027.
new text end
Sec. 10. new text begin RARE DISEASE ADVISORY
|
new text begin
$ new text end |
new text begin
654,000 new text end |
new text begin
$ new text end |
new text begin
602,000 new text end |
||
Sec. 11. new text begin COMMISSIONER OF REVENUE
|
new text begin
$ new text end |
new text begin
40,000 new text end |
new text begin
$ new text end |
new text begin
4,000 new text end |
||
new text begin
Easy enrollment. $40,000 in fiscal year 2024
and $4,000 in fiscal year 2025 are for the
administrative costs associated with the easy
enrollment program.
new text end
Sec. 12. new text begin COMMISSIONER OF
|
new text begin
$ new text end |
new text begin
12,613,000 new text end |
new text begin
$ new text end |
new text begin
2,516,000 new text end |
||
new text begin
(a) Outcomes and evaluation consultation.
$450,000 in fiscal year 2024 and $450,000 in
fiscal year 2025 are for outcomes and
evaluation consultation requirements.
new text end
new text begin
(b) Department of Children, Youth, and
Families. $11,931,000 in fiscal year 2024 and
$2,066,000 in fiscal year 2025 are to establish
the Department of Children, Youth, and
Families. This is a onetime appropriation.
new text end
new text begin
(c) Impact evaluation. $232,000 in fiscal year
2024 is for the Keeping Nurses at the Bedside
Act impact evaluation. This is a onetime
appropriation.
new text end
new text begin
(d) Base adjustment. The general fund base
is $450,000 in fiscal year 2026 and $450,000
in fiscal year 2027.
new text end
Sec. 13. new text begin COMMISSIONER OF CHILDREN,
|
new text begin
$ new text end |
new text begin
823,000 new text end |
new text begin
$ new text end |
new text begin
3,521,000 new text end |
||
Sec. 14. new text begin COMMISSIONER OF COMMERCE
|
new text begin
$ new text end |
new text begin
42,000 new text end |
new text begin
$ new text end |
new text begin
51,000 new text end |
||
new text begin
(a) Heath Care Affordability Board
Requirements. $42,000 in fiscal year 2024
and $17,000 in fiscal year 2025 are for
responsibilities related to the Health Care
Affordability Board.
new text end
new text begin
(b) Defrayal of costs for mandated coverage
of biomarker testing. $17,000 in fiscal year
2025 is for administrative costs to implement
mandated coverage of biomarker testing to
diagnose, treat, manage, and monitor illness
or disease. The base for this appropriation is
$2,611,000 in fiscal year 2026 and $2,611,000
in fiscal year 2027. The base includes
$2,594,000 in fiscal year 2026 and $2,594,000
in fiscal year 2027 for defrayal of costs for
mandated coverage of biomarker testing to
diagnose, treat, manage, and monitor illness
or disease.
new text end
new text begin
(c) Consultation for coverage of services
provided by pharmacists. $17,000 in fiscal
year 2025 is for consultation with health plan
companies, pharmacies, and pharmacy benefit
managers to develop guidance and implement
equal coverage for services provided by
pharmacists. This is a onetime appropriation.
new text end
new text begin
(d) Base adjustment. The general fund base
is $2,628,000 in fiscal year 2026 and
$2,628,000 in fiscal year 2027.
new text end
Sec. 15. new text begin HEALTH CARE AFFORDABILITY
|
new text begin
$ new text end |
new text begin
1,336,000 new text end |
new text begin
$ new text end |
new text begin
1,727,000 new text end |
||
new text begin
Base adjustment. The general fund base is
$1,793,000 in fiscal year 2026 and $1,790,000
in fiscal year 2027.
new text end
Sec. 16.
Laws 2021, First Special Session chapter 7, article 16, section 2, subdivision 32,
as amended by Laws 2022, chapter 98, article 15, section 7, subdivision 32, is amended to
read:
Subd. 32.Grant Programs; Child Mental Health
|
30,167,000 |
30,182,000 |
||||
(a) Children's Residential Facilities.
$1,964,000 in fiscal year 2022 and $1,979,000
in fiscal year 2023 are to reimburse counties
and Tribal governments for a portion of the
costs of treatment in children's residential
facilities. The commissioner shall distribute
the appropriation to counties and Tribal
governments proportionally based on a
methodology developed by the commissioner.
The deleted text begin fiscal year 2022 appropriation is available
until June 30, 2023deleted text end new text begin base for this appropriation
is $0 in fiscal year 2025new text end .
(b) Base Level Adjustment. The general fund
base is $29,580,000 in fiscal year 2024 and
deleted text begin $27,705,000deleted text end new text begin $25,726,000new text end in fiscal year 2025.
Sec. 17.
Laws 2021, First Special Session chapter 7, article 16, section 3, subdivision 2,
as amended by Laws 2022, chapter 98, article 1, section 68, is amended to read:
Subd. 2.Health Improvement
|
||||||
| Appropriations by Fund |
||
| General |
123,714,000 |
deleted text begin
124,000,000
deleted text end
new text begin
122,800,000 new text end |
| State Government Special Revenue |
11,967,000 |
11,290,000 |
| Health Care Access |
37,512,000 |
36,832,000 |
| Federal TANF |
11,713,000 |
11,713,000 |
(a) TANF Appropriations. (1) $3,579,000 in
fiscal year 2022 and $3,579,000 in fiscal year
2023 are from the TANF fund for home
visiting and nutritional services listed under
Minnesota Statutes, section 145.882,
subdivision 7, clauses (6) and (7). Funds must
be distributed to community health boards
according to Minnesota Statutes, section
145A.131, subdivision 1;
(2) $2,000,000 in fiscal year 2022 and
$2,000,000 in fiscal year 2023 are from the
TANF fund for decreasing racial and ethnic
disparities in infant mortality rates under
Minnesota Statutes, section 145.928,
subdivision 7;
(3) $4,978,000 in fiscal year 2022 and
$4,978,000 in fiscal year 2023 are from the
TANF fund for the family home visiting grant
program according to Minnesota Statutes,
section 145A.17. $4,000,000 of the funding
in each fiscal year must be distributed to
community health boards according to
Minnesota Statutes, section 145A.131,
subdivision 1. $978,000 of the funding in each
fiscal year must be distributed to tribal
governments according to Minnesota Statutes,
section 145A.14, subdivision 2a;
(4) $1,156,000 in fiscal year 2022 and
$1,156,000 in fiscal year 2023 are from the
TANF fund for family planning grants under
Minnesota Statutes, section 145.925; and
(5) the commissioner may use up to 6.23
percent of the funds appropriated from the
TANF fund each fiscal year to conduct the
ongoing evaluations required under Minnesota
Statutes, section 145A.17, subdivision 7, and
training and technical assistance as required
under Minnesota Statutes, section 145A.17,
subdivisions 4 and 5.
(b) TANF Carryforward. Any unexpended
balance of the TANF appropriation in the first
year of the biennium does not cancel but is
available for the second year.
(c) Tribal Public Health Grants. $500,000
in fiscal year 2022 and $500,000 in fiscal year
2023 are from the general fund for Tribal
public health grants under Minnesota Statutes,
section 145A.14, for public health
infrastructure projects as defined by the Tribal
government.
(d) Public Health Infrastructure Funds.
$6,000,000 in fiscal year 2022 and $6,000,000
in fiscal year 2023 are from the general fund
for public health infrastructure funds to
distribute to community health boards and
Tribal governments to support their ability to
meet national public health standards.
(e) Public Health System Assessment and
Oversight. $1,500,000 in fiscal year 2022 and
$1,500,000 in fiscal year 2023 are from the
general fund for the commissioner to assess
the capacity of the public health system to
meet national public health standards and
oversee public health system improvement
efforts.
(f) Health Professional Education Loan
Forgiveness. Notwithstanding the priorities
and distribution requirements under Minnesota
Statutes, section 144.1501, $3,000,000 in
fiscal year 2022 and $3,000,000 in fiscal year
2023 are from the general fund for loan
forgiveness under article 3, section 43, for
individuals who are eligible alcohol and drug
counselors, eligible medical residents, or
eligible mental health professionals, as defined
in article 3, section 43. The general fund base
for this appropriation is $2,625,000 in fiscal
year 2024 and $0 in fiscal year 2025. The
health care access fund base for this
appropriation is $875,000 in fiscal year 2024,
$3,500,000 in fiscal year 2025, and $0 in fiscal
year 2026. The general fund amounts in this
paragraph are available until March 31, 2024.
This paragraph expires on April 1, 2024.
(g) Mental Health Cultural Community
Continuing Education Grant Program.
$500,000 in fiscal year 2022 and $500,000 in
fiscal year 2023 are from the general fund for
the mental health cultural community
continuing education grant program. This is
a onetime appropriation
(h) Birth Records; Homeless Youth. $72,000
in fiscal year 2022 and $32,000 in fiscal year
2023 are from the state government special
revenue fund for administration and issuance
of certified birth records and statements of no
vital record found to homeless youth under
Minnesota Statutes, section 144.2255.
(i) Supporting Healthy Development of
Babies During Pregnancy and Postpartum.
$260,000 in fiscal year 2022 and $260,000 in
fiscal year 2023 are from the general fund for
a grant to the Amherst H. Wilder Foundation
for the African American Babies Coalition
initiative for community-driven training and
education on best practices to support healthy
development of babies during pregnancy and
postpartum. Grant funds must be used to build
capacity in, train, educate, or improve
practices among individuals, from youth to
elders, serving families with members who
are Black, indigenous, or people of color,
during pregnancy and postpartum. This is a
onetime appropriation and is available until
June 30, 2023.
(j) Dignity in Pregnancy and Childbirth.
$494,000 in fiscal year 2022 and $200,000 in
fiscal year 2023 are from the general fund for
purposes of Minnesota Statutes, section
144.1461. Of this appropriation: (1) $294,000
in fiscal year 2022 is for a grant to the
University of Minnesota School of Public
Health's Center for Antiracism Research for
Health Equity, to develop a model curriculum
on anti-racism and implicit bias for use by
hospitals with obstetric care and birth centers
to provide continuing education to staff caring
for pregnant or postpartum women. The model
curriculum must be evidence-based and must
meet the criteria in Minnesota Statutes, section
144.1461, subdivision 2, paragraph (a); and
(2) $200,000 in fiscal year 2022 and $200,000
in fiscal year 2023 are for purposes of
Minnesota Statutes, section 144.1461,
subdivision 3.
(k) Congenital Cytomegalovirus (CMV). (1)
$196,000 in fiscal year 2022 and $196,000 in
fiscal year 2023 are from the general fund for
outreach and education on congenital
cytomegalovirus (CMV) under Minnesota
Statutes, section 144.064.
(2) Contingent on the Advisory Committee on
Heritable and Congenital Disorders
recommending and the commissioner of health
approving inclusion of CMV in the newborn
screening panel in accordance with Minnesota
Statutes, section 144.065, subdivision 3,
paragraph (d), $656,000 in fiscal year 2023 is
from the state government special revenue
fund for follow-up services.
(l) Nonnarcotic Pain Management and
Wellness. $649,000 in fiscal year 2022 is from
the general fund for nonnarcotic pain
management and wellness in accordance with
Laws 2019, chapter 63, article 3, section 1,
paragraph (n).
(m) Base Level Adjustments. The general
fund base is $121,201,000 in fiscal year 2024
and $116,344,000 in fiscal year 2025, of which
$750,000 in fiscal year 2024 and $750,000 in
fiscal year 2025 are for fetal alcohol spectrum
disorders prevention grants under Minnesota
Statutes, section 145.267. The health care
access fund base is $38,385,000 in fiscal year
2024 and $40,644,000 in fiscal year 2025.
Sec. 18. new text begin TRANSFERS.
new text end
new text begin Subdivision 1. new text end
new text begin Grants. new text end
new text begin
The commissioner of human services, with the approval of the
commissioner of management and budget, may transfer unencumbered appropriation balances
for the biennium ending June 30, 2025, within fiscal years among the MFIP; general
assistance; medical assistance; MinnesotaCare; MFIP child care assistance under Minnesota
Statutes, section 119B.05; Minnesota supplemental aid program; group residential housing
program; the entitlement portion of Northstar Care for Children under Minnesota Statutes,
chapter 256N; and the entitlement portion of the behavioral health fund between fiscal years
of the biennium. The commissioner shall inform the chairs and ranking minority members
of the legislative committees with jurisdiction over health and human services quarterly
about transfers made under this subdivision.
new text end
new text begin Subd. 2. new text end
new text begin Administration. new text end
new text begin
Positions, salary money, and nonsalary administrative money
may be transferred within the Department of Human Services and the Department of Health
as the commissioners consider necessary, with the advance approval of the commissioner
of management and budget. The commissioners shall inform the chairs and ranking minority
members of the legislative committees with jurisdiction over health and human services
finance quarterly about transfers made under this section.
new text end
Sec. 19. new text begin INDIRECT COSTS NOT TO FUND PROGRAMS.
new text end
new text begin
The commissioner of health shall not use indirect cost allocations to pay for the
operational costs of any program for which they are responsible.
new text end
Sec. 20. new text begin EXPIRATION OF UNCODIFIED LANGUAGE.
new text end
new text begin
All uncodified language contained in this article expires on June 30, 2025, unless a
different expiration date is explicit.
new text end