SF 4399

as introduced - 93rd Legislature (2023 - 2024) Posted on 03/22/2024 03:06pm

A bill for an act
relating to human services; establishing minimum wage protections for people
with disabilities; modifying person care assistance and community first services
and supports remote reassessment requirements; prioritizing technology in informed
choice for disability waiver services; clarifying form usage for community-based
waivered services; modernizing language in Deaf and Hard-of-Hearing Services
Act; making technical corrections to behavioral health language; amending
Minnesota Statutes 2022, sections 177.24, by adding a subdivision; 245D.10,
subdivision 1; 245F.02, subdivisions 17, 21; 245F.08, subdivision 3; 245F.15,
subdivision 7; 245G.04, by adding a subdivision; 252.44; 256B.0759, subdivision
4; 256B.0911, subdivision 24; 256B.4905, subdivision 12; 256C.21; 256C.23,
subdivisions 1a, 2, 2a, 2b, 2c, 6, 7, by adding a subdivision; 256C.233, subdivisions
1, 2; 256C.24, subdivisions 1, 2, 3; 256C.26; 256C.261; Minnesota Statutes 2023
Supplement, sections 245G.05, subdivision 3; 245G.09, subdivision 3; 254A.19,
subdivision 3; 254B.04, subdivision 6; 254B.05, subdivisions 1, 5; 254B.19,
subdivision 1; 256B.0759, subdivision 2; 256B.4906; 256B.4914, subdivision 4.

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

Section 1.

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

new text begin Subd. 6. new text end

new text begin Special certificate prohibition. new text end

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

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

Sec. 2.

Minnesota Statutes 2022, section 245D.10, subdivision 1, is amended to read:

Subdivision 1.

Policy and procedure requirements.

A license holder providing either
basic or intensive supports and services must establish, enforce, and maintain policies and
procedures as required in this chapter, chapter 245A, and other applicable state and federal
laws and regulations governing the provision of home and community-based services
licensed according to this chapter. new text begin A license holder must use forms provided by the
commissioner to report service suspensions and service terminations under subdivisions 3
and 3a.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 3.

Minnesota Statutes 2022, section 245F.02, subdivision 17, is amended to read:

Subd. 17.

Peer recovery support services.

"Peer recovery support services" means
deleted text begin mentoring and education, advocacy, and nonclinical recovery support provided by a recovery
peer deleted text end new text begin services provided according to section 245F.08, subdivision 3 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 245F.02, subdivision 21, is amended to read:

Subd. 21.

Recovery peer.

"Recovery peer" means a person who has progressed in the
person's own recovery from substance use disorder and is willing to serve as a peer to assist
others in their recovery new text begin and is qualified according to section 245F.15, subdivision 7 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 245F.08, subdivision 3, is amended to read:

Subd. 3.

Peer recovery support services.

deleted text begin (a) Peers in recovery serve as mentors or
recovery-support partners for individuals in recovery, and may provide encouragement,
self-disclosure of recovery experiences, transportation to appointments, assistance with
finding resources that will help locate housing, job search resources, and assistance finding
and participating in support groups.
deleted text end

deleted text begin (b) Peer recovery support services are provided by a recovery peer and must be supervised
by the responsible staff person.
deleted text end

new text begin Peer recovery support services must meet the requirements in section 245G.07,
subdivision 2, clause (8), and must be provided by a person who is qualified according to
the requirements in section 245F.15, subdivision 7.
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 245F.15, subdivision 7, is amended to read:

Subd. 7.

Recovery peer qualifications.

Recovery peers must:

deleted text begin (1) be at least 21 years of age and have a high school diploma or its equivalent;
deleted text end

deleted text begin (2) have a minimum of one year in recovery from substance use disorder;
deleted text end

deleted text begin (3) have completed a curriculum designated by the commissioner that teaches specific
skills and training in the domains of ethics and boundaries, advocacy, mentoring and
education, and recovery and wellness support; and
deleted text end

deleted text begin (4) receive supervision in areas specific to the domains of their role by qualified
supervisory staff.
deleted text end

new text begin (1) meet the qualifications in section 245I.04, subdivision 18; and
new text end

new text begin (2) provide services according to the scope of practice established in section 245I.04,
subdivision 19, under the supervision of an alcohol and drug counselor.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 7.

Minnesota Statutes 2022, section 245G.04, is amended by adding a subdivision to
read:

new text begin Subd. 3. new text end

new text begin Opioid educational material. new text end

new text begin (a) If a client is seeking treatment for opioid use
issues, the license holder must provide opioid educational material to the client on the day
of service initiation. The license holder must use the opioid educational material approved
by the commissioner that contains information on:
new text end

new text begin (1) risks for opioid use disorder and dependence;
new text end

new text begin (2) treatment options, including the use of a medication for opioid use disorder;
new text end

new text begin (3) the risk and recognition of opioid overdose; and
new text end

new text begin (4) the use, availability, and administration of an opiate antagonist to respond to opioid
overdose.
new text end

new text begin (b) If the client is identified as having opioid use issues at a later date, the required
educational material must be provided at that time.
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. 8.

Minnesota Statutes 2023 Supplement, section 245G.05, subdivision 3, is amended
to read:

Subd. 3.

Comprehensive assessment requirements.

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

(1) a diagnosis of a substance use disorder or a finding that the client does not meet the
criteria for a substance use disorder;

(2) a determination of whether the individual screens positive for co-occurring mental
health disorders using a screening tool approved by the commissioner pursuant to section
245.4863;

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

(4) a recommendation for the ASAM level of care identified in section 254B.19,
subdivision 1.

deleted text begin (b) If the individual is assessed for opioid use disorder, the program must provide
educational material to the client within 24 hours of service initiation on:
deleted text end

deleted text begin (1) risks for opioid use disorder and dependence;
deleted text end

deleted text begin (2) treatment options, including the use of a medication for opioid use disorder;
deleted text end

deleted text begin (3) the risk and recognition of opioid overdose; and
deleted text end

deleted text begin (4) the use, availability, and administration of an opiate antagonist to respond to opioid
overdose.
deleted text end

deleted text begin If the client is identified as having opioid use disorder at a later point, the required educational
material must be provided at that point. The license holder must use the educational materials
that are approved by the commissioner to comply with this requirement.
deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 9.

Minnesota Statutes 2023 Supplement, section 245G.09, subdivision 3, is amended
to read:

Subd. 3.

Contents.

Client records must contain the following:

(1) documentation that the client was given information on client rights and
responsibilities, grievance procedures, tuberculosis, and HIV, and that the client was provided
an orientation to the program abuse prevention plan required under section 245A.65,
subdivision 2, paragraph (a), clause (4). If the client has an opioid use disorder, the record
must contain documentation that the client was provided educational information according
to section deleted text begin 245G.05 deleted text end new text begin 245G.04 new text end , subdivision 3 deleted text begin , paragraph (b) deleted text end ;

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

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

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

(5) an individual treatment plan according to section 245G.06, subdivisions 1 and 1a;

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

(7) a summary at the time of service termination according to section 245G.06,
subdivision 4.

new text begin EFFECTIVE DATE. new text end

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

Sec. 10.

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

252.44 LEAD AGENCY BOARD RESPONSIBILITIES.

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

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

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

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

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

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

Sec. 11.

Minnesota Statutes 2023 Supplement, section 254A.19, subdivision 3, is amended
to read:

Subd. 3.

Comprehensive assessments.

new text begin (a) new text end An eligible vendor under section 254B.05
conducting a comprehensive assessment for an individual seeking treatment shall deleted text begin approve deleted text end new text begin
recommend new text end the nature, intensity level, and duration of treatment service if a need for services
is indicated, but the individual assessed can access any enrolled provider that is licensed to
provide the level of service authorized, including the provider or program that completed
the assessment. If an individual is enrolled in a prepaid health plan, the individual must
comply with any provider network requirements or limitations.

new text begin (b) When a comprehensive assessment is completed while the individual is in a substance
use disorder treatment program, the comprehensive assessment must meet the requirements
of section 245G.05.
new text end

new text begin (c) When a comprehensive assessment is completed for purposes of payment under
section 254B.05, subdivision 1, paragraphs (b), (c), or (h), or if the assessment is completed
prior to service initiation by a licensed substance use disorder treatment program licensed
under chapter 245G or applicable Tribal license, the assessor must:
new text end

new text begin (1) include all components under section 245G.05, subdivision 3;
new text end

new text begin (2) provide the assessment within five days of request or refer the individual to other
locations where they may access this service sooner;
new text end

new text begin (3) provide information on payment options for substance use disorder services when
the individual is uninsured or underinsured;
new text end

new text begin (4) provide the individual with a notice of privacy practices;
new text end

new text begin (5) provide a copy of the completed comprehensive assessment, upon request;
new text end

new text begin (6) provide resources and contact information for the level of care being recommended;
and
new text end

new text begin (7) provide an individual diagnosed with an opioid use disorder with educational material
approved by the commissioner that contains information on:
new text end

new text begin (i) risks for opioid use disorder and opioid dependence;
new text end

new text begin (ii) treatment options, including the use of a medication for opioid use disorder;
new text end

new text begin (iii) the risk and recognition of opioid overdose; and
new text end

new text begin (iv) the use, availability, and administration of an opiate antagonist to respond to opioid
overdose.
new text end

Sec. 12.

Minnesota Statutes 2023 Supplement, section 254B.04, subdivision 6, is amended
to read:

Subd. 6.

Local agency to determine client financial eligibility.

(a) The local agency
shall determine a client's financial eligibility for the behavioral health fund according to
section 254B.04, subdivision 1a, with the income calculated prospectively for one year from
the date of deleted text begin comprehensive assessment deleted text end new text begin request new text end . The local agency shall pay for eligible clients
according to chapter 256G. The local agency shall enter the financial eligibility span within
ten calendar days of request. Client eligibility must be determined using forms prescribed
by the department. To determine a client's eligibility, the local agency must determine the
client's income, the size of the client's household, the availability of a third-party payment
source, and a responsible relative's ability to pay for the client's substance use disorder
treatment.

(b) A client who is a minor child must not be deemed to have income available to pay
for substance use disorder treatment, unless the minor child is responsible for payment under
section 144.347 for substance use disorder treatment services sought under section 144.343,
subdivision 1.

(c) The local agency must determine the client's household size as follows:

(1) if the client is a minor child, the household size includes the following persons living
in the same dwelling unit:

(i) the client;

(ii) the client's birth or adoptive parents; and

(iii) the client's siblings who are minors; and

(2) if the client is an adult, the household size includes the following persons living in
the same dwelling unit:

(i) the client;

(ii) the client's spouse;

(iii) the client's minor children; and

(iv) the client's spouse's minor children.

For purposes of this paragraph, household size includes a person listed in clauses (1) and
(2) who is in an out-of-home placement if a person listed in clause (1) or (2) is contributing
to the cost of care of the person in out-of-home placement.

(d) The local agency must determine the client's current prepaid health plan enrollment,
the availability of a third-party payment source, including the availability of total payment,
partial payment, and amount of co-payment.

(e) The local agency must provide the required eligibility information to the department
in the manner specified by the department.

(f) The local agency shall require the client and policyholder to conditionally assign to
the department the client and policyholder's rights and the rights of minor children to benefits
or services provided to the client if the department is required to collect from a third-party
pay source.

(g) The local agency must redetermine a client's eligibility for the behavioral health fund
every 12 months.

(h) A client, responsible relative, and policyholder must provide income or wage
verification, household size verification, and must make an assignment of third-party payment
rights under paragraph (f). If a client, responsible relative, or policyholder does not comply
with the provisions of this subdivision, the client is ineligible for behavioral health fund
payment for substance use disorder treatment, and the client and responsible relative must
be obligated to pay for the full cost of substance use disorder treatment services provided
to the client.

Sec. 13.

Minnesota Statutes 2023 Supplement, section 254B.05, subdivision 1, is amended
to read:

Subdivision 1.

Licensure new text begin or certification new text end required.

(a) Programs licensed by the
commissioner are eligible vendors. Hospitals may apply for and receive licenses to be
eligible vendors, notwithstanding the provisions of section 245A.03. American Indian
programs that provide substance use disorder treatment, extended care, transitional residence,
or outpatient treatment services, and are licensed by Tribal government are eligible vendors.

(b) A licensed professional in private practice as defined in section 245G.01, subdivision
17, who meets the requirements of section 245G.11, subdivisions 1 and 4, is an eligible
vendor of a comprehensive assessment and assessment summary provided according to
section 245G.05, and treatment services provided according to sections 245G.06 and
245G.07, subdivision 1, paragraphs (a), clauses (1) to (5), and (b); and subdivision 2, clauses
(1) to (6).

(c) A county is an eligible vendor for a comprehensive assessment and assessment
summary when provided by an individual who meets the staffing credentials of section
245G.11, subdivisions 1 and 5, and completed according to the requirements of section
245G.05. A county is an eligible vendor of care coordination services when provided by an
individual who meets the staffing credentials of section 245G.11, subdivisions 1 and 7, and
provided according to the requirements of section 245G.07, subdivision 1, paragraph (a),
clause (5). A county is an eligible vendor of peer recovery services when the services are
provided by an individual who meets the requirements of section 245G.11, subdivision 8.

(d) A recovery community organization that meets the requirements of clauses (1) to
(10) and meets deleted text begin membership deleted text end new text begin certification new text end or accreditation requirements of the Association
of Recovery Community Organizations, new text begin Alliance for Recovery Centered Organizations, new text end the
Council on Accreditation of Peer Recovery Support Services, or a Minnesota statewide
recovery community organization identified by the commissioner is an eligible vendor of
peer support services. Eligible vendors under this paragraph must:

(1) be nonprofit organizations;

(2) be led and governed by individuals in the recovery community, with more than 50
percent of the board of directors or advisory board members self-identifying as people in
personal recovery from substance use disorders;

(3) primarily focus on recovery from substance use disorders, with missions and visions
that support this primary focus;

(4) be grassroots and reflective of and engaged with the community served;

(5) be accountable to the recovery community through processes that promote the
involvement and engagement of, and consultation with, people in recovery and their families,
friends, and recovery allies;

(6) provide nonclinical peer recovery support services, including but not limited to
recovery support groups, recovery coaching, telephone recovery support, skill-building
groups, and harm-reduction activities;

(7) allow for and support opportunities for all paths toward recovery and refrain from
excluding anyone based on their chosen recovery path, which may include but is not limited
to harm reduction paths, faith-based paths, and nonfaith-based paths;

(8) be purposeful in meeting the diverse needs of Black, Indigenous, and people of color
communities, including board and staff development activities, organizational practices,
service offerings, advocacy efforts, and culturally informed outreach and service plans;

(9) be stewards of recovery-friendly language that is supportive of and promotes recovery
across diverse geographical and cultural contexts and reduces stigma; and

(10) maintain an employee and volunteer code of ethics and easily accessible grievance
procedures posted in physical spaces, on websites, or on program policies or forms.

(e) Recovery community organizations approved by the commissioner before June 30,
2023, shall retain their designation as recovery community organizations.

(f) A recovery community organization that is aggrieved by an accreditation or
membership determination and believes it meets the requirements under paragraph (d) may
appeal the determination under section 256.045, subdivision 3, paragraph (a), clause (15),
for reconsideration as an eligible vendor.

new text begin (g) All recovery community organizations must be certified or accredited by an entity
listed in paragraph (d) by January 1, 2025.
new text end

deleted text begin (g) deleted text end new text begin (h) new text end Detoxification programs licensed under Minnesota Rules, parts 9530.6510 to
9530.6590, are not eligible vendors. Programs that are not licensed as a residential or
nonresidential substance use disorder treatment or withdrawal management program by the
commissioner or by Tribal government or do not meet the requirements of subdivisions 1a
and 1b are not eligible vendors.

deleted text begin (h) deleted text end new text begin (i) new text end Hospitals, federally qualified health centers, and rural health clinics are eligible
vendors of a comprehensive assessment when the comprehensive assessment is completed
according to section 245G.05 and by an individual who meets the criteria of an alcohol and
drug counselor according to section 245G.11, subdivision 5. The alcohol and drug counselor
must be individually enrolled with the commissioner and reported on the claim as the
individual who provided the service.

Sec. 14.

Minnesota Statutes 2023 Supplement, section 254B.05, subdivision 5, is amended
to read:

Subd. 5.

Rate requirements.

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

(b) Eligible substance use disorder treatment services include:

(1) those licensed, as applicable, according to chapter 245G or applicable Tribal license
and provided according to the following ASAM levels of care:

(i) ASAM level 0.5 early intervention services provided according to section 254B.19,
subdivision 1, clause (1);

(ii) ASAM level 1.0 outpatient services provided according to section 254B.19,
subdivision 1, clause (2);

(iii) ASAM level 2.1 intensive outpatient services provided according to section 254B.19,
subdivision 1, clause (3);

(iv) ASAM level 2.5 partial hospitalization services provided according to section
254B.19, subdivision 1, clause (4);

(v) ASAM level 3.1 clinically managed low-intensity residential services provided
according to section 254B.19, subdivision 1, clause (5);

(vi) ASAM level 3.3 clinically managed population-specific high-intensity residential
services provided according to section 254B.19, subdivision 1, clause (6); and

(vii) ASAM level 3.5 clinically managed high-intensity residential services provided
according to section 254B.19, subdivision 1, clause (7);

(2) comprehensive assessments provided according to deleted text begin sections 245.4863, paragraph (a),
and 245G.05 deleted text end new text begin section 254A.19, subdivision 3 new text end ;

(3) treatment coordination services provided according to section 245G.07, subdivision
1, paragraph (a), clause (5);

(4) peer recovery support services provided according to section 245G.07, subdivision
2, clause (8);

(5) withdrawal management services provided according to chapter 245F;

(6) hospital-based treatment services that are licensed according to sections 245G.01 to
245G.17 or applicable Tribal license and licensed as a hospital under sections 144.50 to
144.56;

new text begin (7) substance use disorder treatment services with medications for opioid use disorder
provided in an opioid treatment program licensed according to sections 245G.01 to 245G.17
and 245G.22, or under an applicable Tribal license;
new text end

deleted text begin (7) deleted text end new text begin (8) new text end adolescent treatment programs that are licensed as outpatient treatment programs
according to sections 245G.01 to 245G.18 or as residential treatment programs according
to Minnesota Rules, parts 2960.0010 to 2960.0220, and 2960.0430 to 2960.0490, or
applicable Tribal license;

deleted text begin (8) deleted text end new text begin (9) new text end ASAM 3.5 clinically managed high-intensity residential services that are licensed
according to sections 245G.01 to 245G.17 and 245G.21 or applicable Tribal license, which
provide ASAM level of care 3.5 according to section 254B.19, subdivision 1, clause (7),
and are provided by a state-operated vendor or to clients who have been civilly committed
to the commissioner, present the most complex and difficult care needs, and are a potential
threat to the community; and

deleted text begin (9) deleted text end new text begin (10) new text end room and board facilities that meet the requirements of subdivision 1a.

(c) The commissioner shall establish higher rates for programs that meet the requirements
of paragraph (b) and one of the following additional requirements:

(1) programs that serve parents with their children if the program:

(i) provides on-site child care during the hours of treatment activity that:

(A) is licensed under chapter 245A as a child care center under Minnesota Rules, chapter
9503; or

(B) is licensed under chapter 245A and sections 245G.01 to 245G.19; or

(ii) arranges for off-site child care during hours of treatment activity at a facility that is
licensed under chapter 245A as:

(A) a child care center under Minnesota Rules, chapter 9503; or

(B) a family child care home under Minnesota Rules, chapter 9502;

(2) culturally specific or culturally responsive programs as defined in section 254B.01,
subdivision 4a;

(3) disability responsive programs as defined in section 254B.01, subdivision 4b;

(4) programs that offer medical services delivered by appropriately credentialed health
care staff in an amount equal to two hours per client per week if the medical needs of the
client and the nature and provision of any medical services provided are documented in the
client file; or

(5) programs that offer services to individuals with co-occurring mental health and
substance use disorder problems if:

(i) the program meets the co-occurring requirements in section 245G.20;

(ii) 25 percent of the counseling staff are licensed mental health professionals under
section 245I.04, subdivision 2, or are students or licensing candidates under the supervision
of a licensed alcohol and drug counselor supervisor and mental health professional under
section 245I.04, subdivision 2, except that no more than 50 percent of the mental health
staff may be students or licensing candidates with time documented to be directly related
to provisions of co-occurring services;

(iii) clients scoring positive on a standardized mental health screen receive a mental
health diagnostic assessment within ten days of admission;

(iv) the program has standards for multidisciplinary case review that include a monthly
review for each client that, at a minimum, includes a licensed mental health professional
and licensed alcohol and drug counselor, and their involvement in the review is documented;

(v) family education is offered that addresses mental health and substance use disorder
and the interaction between the two; and

(vi) co-occurring counseling staff shall receive eight hours of co-occurring disorder
training annually.

(d) In order to be eligible for a higher rate under paragraph (c), clause (1), a program
that provides arrangements for off-site child care must maintain current documentation at
the substance use disorder facility of the child care provider's current licensure to provide
child care services.

(e) Adolescent residential programs that meet the requirements of Minnesota Rules,
parts 2960.0430 to 2960.0490 and 2960.0580 to 2960.0690, are exempt from the requirements
in paragraph (c), clause (4), items (i) to (iv).

(f) Subject to federal approval, substance use disorder services that are otherwise covered
as direct face-to-face services may be provided via telehealth as defined in section 256B.0625,
subdivision 3b. The use of telehealth to deliver services must be medically appropriate to
the condition and needs of the person being served. Reimbursement shall be at the same
rates and under the same conditions that would otherwise apply to direct face-to-face services.

(g) For the purpose of reimbursement under this section, substance use disorder treatment
services provided in a group setting without a group participant maximum or maximum
client to staff ratio under chapter 245G shall not exceed a client to staff ratio of 48 to one.
At least one of the attending staff must meet the qualifications as established under this
chapter for the type of treatment service provided. A recovery peer may not be included as
part of the staff ratio.

(h) Payment for outpatient substance use disorder services that are licensed according
to sections 245G.01 to 245G.17 is limited to six hours per day or 30 hours per week unless
prior authorization of a greater number of hours is obtained from the commissioner.

(i) Payment for substance use disorder services under this section must start from the
day of service initiation, when the comprehensive assessment is completed within the
required timelines.

Sec. 15.

Minnesota Statutes 2023 Supplement, section 254B.19, subdivision 1, is amended
to read:

Subdivision 1.

Level of care requirements.

For each client assigned an ASAM level
of care, eligible vendors must implement the standards set by the ASAM for the respective
level of care. Additionally, vendors must meet the following requirements:

(1) For ASAM level 0.5 early intervention targeting individuals who are at risk of
developing a substance-related problem but may not have a diagnosed substance use disorder,
early intervention services may include individual or group counseling, treatment
coordination, peer recovery support, screening brief intervention, and referral to treatment
provided according to section 254A.03, subdivision 3, paragraph (c).

(2) For ASAM level 1.0 outpatient clients, adults must receive up to eight hours per
week of skilled treatment services and adolescents must receive up to five hours per week.
Services must be licensed according to section 245G.20 and meet requirements under section
256B.0759. Peer recovery and treatment coordination may be provided beyond the hourly
skilled treatment service hours allowable per week.

(3) For ASAM level 2.1 intensive outpatient clients, adults must receive nine to 19 hours
per week of skilled treatment services and adolescents must receive six or more hours per
week. Vendors must be licensed according to section 245G.20 and must meet requirements
under section 256B.0759. Peer recovery services and treatment coordination may be provided
beyond the hourly skilled treatment service hours allowable per week. If clinically indicated
on the client's treatment plan, this service may be provided in conjunction with room and
board according to section 254B.05, subdivision 1a.

(4) For ASAM level 2.5 partial hospitalization clients, adults must receive 20 hours or
more of skilled treatment services. Services must be licensed according to section 245G.20
and must meet requirements under section 256B.0759. Level 2.5 is for clients who need
daily monitoring in a structured setting, as directed by the individual treatment plan and in
accordance with the limitations in section 254B.05, subdivision 5, paragraph (h). If clinically
indicated on the client's treatment plan, this service may be provided in conjunction with
room and board according to section 254B.05, subdivision 1a.

(5) For ASAM level 3.1 clinically managed low-intensity residential clients, programs
must provide deleted text begin at least 5 deleted text end new text begin between nine and 19 new text end hours of skilled treatment services per week
according to each client's specific treatment schedule, as directed by the individual treatment
plan. Programs must be licensed according to section 245G.20 and must meet requirements
under section 256B.0759.

(6) For ASAM level 3.3 clinically managed population-specific high-intensity residential
clients, programs must be licensed according to section 245G.20 and must meet requirements
under section 256B.0759. Programs must have 24-hour staffing coverage. Programs must
be enrolled as a disability responsive program as described in section 254B.01, subdivision
4b, and must specialize in serving persons with a traumatic brain injury or a cognitive
impairment so significant, and the resulting level of impairment so great, that outpatient or
other levels of residential care would not be feasible or effective. Programs must provide,
at a minimum, daily skilled treatment services seven days a week according to each client's
specific treatment schedule, as directed by the individual treatment plan.

(7) For ASAM level 3.5 clinically managed high-intensity residential clients, services
must be licensed according to section 245G.20 and must meet requirements under section
256B.0759. Programs must have 24-hour staffing coverage and provide deleted text begin , at a minimum,
daily skilled treatment services seven days a deleted text end new text begin 20 or more hours of services per new text end week according
to each client's specific treatment schedule, as directed by the individual treatment plan.

(8) For ASAM level withdrawal management 3.2 clinically managed clients, withdrawal
management must be provided according to chapter 245F.

(9) For ASAM level withdrawal management 3.7 medically monitored clients, withdrawal
management must be provided according to chapter 245F.

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 has been obtained.
new text end

Sec. 16.

Minnesota Statutes 2023 Supplement, section 256B.0759, subdivision 2, is
amended to read:

Subd. 2.

Provider participation.

(a) Programs licensed by the Department of Human
Services as nonresidential substance use disorder treatment programs that receive payment
under this chapter must enroll as demonstration project providers and meet the requirements
of subdivision 3 by January 1, 2025. Programs that do not meet the requirements of this
paragraph are ineligible for payment for services provided under section 256B.0625.

(b) Programs licensed by the Department of Human Services as residential treatment
programs according to section 245G.21 that receive payment under this chapter must enroll
as demonstration project providers and meet the requirements of subdivision 3 by January
1, 2024. Programs that do not meet the requirements of this paragraph are ineligible for
payment for services provided under section 256B.0625.

(c) Programs licensed by the Department of Human Services as residential treatment
programs according to section 245G.21 that receive payment under this chapter deleted text begin and deleted text end new text begin , new text end are
licensed as a hospital under sections 144.50 to 144.581 deleted text begin must deleted text end new text begin , and provide only ASAM 3.7
medically monitored inpatient level of care are not required to new text end enroll as demonstration
project providers deleted text begin and meet the requirements of subdivision 3 by January 1, 2025 deleted text end . new text begin Programs
meeting these criteria must submit evidence of providing the required level of care to the
commissioner to be exempt from enrolling in the demonstration.
new text end

(d) Programs licensed by the Department of Human Services as withdrawal management
programs according to chapter 245F that receive payment under this chapter must enroll as
demonstration project providers and meet the requirements of subdivision 3 by January 1,
2024. Programs that do not meet the requirements of this paragraph are ineligible for payment
for services provided under section 256B.0625.

(e) Out-of-state residential substance use disorder treatment programs that receive
payment under this chapter must enroll as demonstration project providers and meet the
requirements of subdivision 3 by January 1, 2024. Programs that do not meet the requirements
of this paragraph are ineligible for payment for services provided under section 256B.0625.

(f) Tribally licensed programs may elect to participate in the demonstration project and
meet the requirements of subdivision 3. The Department of Human Services must consult
with Tribal Nations to discuss participation in the substance use disorder demonstration
project.

(g) The commissioner shall allow providers enrolled in the demonstration project before
July 1, 2021, to receive applicable rate enhancements authorized under subdivision 4 for
all services provided on or after the date of enrollment, except that the commissioner shall
allow a provider to receive applicable rate enhancements authorized under subdivision 4
for services provided on or after July 22, 2020, to fee-for-service enrollees, and on or after
January 1, 2021, to managed care enrollees, if the provider meets all of the following
requirements:

(1) the provider attests that during the time period for which the provider is seeking the
rate enhancement, the provider took meaningful steps in their plan approved by the
commissioner to meet the demonstration project requirements in subdivision 3; and

(2) the provider submits attestation and evidence, including all information requested
by the commissioner, of meeting the requirements of subdivision 3 to the commissioner in
a format required by the commissioner.

(h) The commissioner may recoup any rate enhancements paid under paragraph (g) to
a provider that does not meet the requirements of subdivision 3 by July 1, 2021.

Sec. 17.

Minnesota Statutes 2022, section 256B.0759, subdivision 4, is amended to read:

Subd. 4.

Provider payment rates.

(a) Payment rates for participating providers must
be increased for services provided to medical assistance enrollees. To receive a rate increase,
participating providers must meet demonstration project requirements and provide evidence
of formal referral arrangements with providers delivering step-up or step-down levels of
care. Providers that have enrolled in the demonstration project but have not met the provider
standards under subdivision 3 as of July 1, 2022, are not eligible for a rate increase under
this subdivision until the date that the provider meets the provider standards in subdivision
3. Services provided from July 1, 2022, to the date that the provider meets the provider
standards under subdivision 3 shall be reimbursed at rates according to section 254B.05,
subdivision 5, paragraph (b). Rate increases paid under this subdivision to a provider for
services provided between July 1, 2021, and July 1, 2022, are not subject to recoupment
when the provider is taking meaningful steps to meet demonstration project requirements
that are not otherwise required by law, and the provider provides documentation to the
commissioner, upon request, of the steps being taken.

(b) The commissioner may temporarily suspend payments to the provider according to
section 256B.04, subdivision 21, paragraph (d), if the provider does not meet the requirements
in paragraph (a). Payments withheld from the provider must be made once the commissioner
determines that the requirements in paragraph (a) are met.

deleted text begin (c) For substance use disorder services under section 254B.05, subdivision 5, paragraph
(b), clause (8), provided on or after July 1, 2020, payment rates must be increased by 25
percent over the rates in effect on December 31, 2019.
deleted text end

deleted text begin (d) deleted text end new text begin (c) new text end For substance use disorder services under section 254B.05, subdivision 5,
paragraph (b), deleted text begin clauses deleted text end new text begin clause new text end (1), deleted text begin (6), and (7) deleted text end new text begin items (ii) and (iii) new text end , and adolescent treatment
programs that are licensed as outpatient treatment programs according to sections 245G.01
to 245G.18, provided on or after January 1, 2021, payment rates must be increased by 20
percent over the rates in effect on December 31, 2020.

deleted text begin (e) deleted text end new text begin (d) new text end Effective January 1, 2021, and contingent on annual federal approval, managed
care plans and county-based purchasing plans must reimburse providers of the substance
use disorder services meeting the criteria described in paragraph (a) who are employed by
or under contract with the plan an amount that is at least equal to the fee-for-service base
rate payment for the substance use disorder services described in paragraphs (c) and (d).
The commissioner must monitor the effect of this requirement on the rate of access to
substance use disorder services and residential substance use disorder rates. Capitation rates
paid to managed care organizations and county-based purchasing plans must reflect the
impact of this requirement. This paragraph expires if federal approval is not received at any
time as required under this paragraph.

deleted text begin (f) deleted text end new text begin (e) new text end Effective July 1, 2021, contracts between managed care plans and county-based
purchasing plans and providers to whom paragraph (e) applies must allow recovery of
payments from those providers if, for any contract year, federal approval for the provisions
of paragraph (e) is not received, and capitation rates are adjusted as a result. Payment
recoveries must not exceed the amount equal to any decrease in rates that results from this
provision.

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 256B.0911, subdivision 24, is amended to read:

Subd. 24.

Remote reassessments.

(a) Assessments performed according to subdivisions
17 to 20 and 23 must be in person unless the assessment is a reassessment meeting the
requirements of this subdivision. Remote reassessments conducted by interactive video or
telephone may substitute for in-person reassessments.

(b) For services provided by the developmental disabilities waiver under section
256B.092, and the community access for disability inclusion, community alternative care,
and brain injury waiver programs under section 256B.49, remote reassessments may be
substituted for two consecutive reassessments if followed by an in-person reassessment.

(c) For services provided by alternative care under section 256B.0913, essential
community supports under section 256B.0922, and the elderly waiver under chapter 256S,
remote reassessments may be substituted for one reassessment if followed by an in-person
reassessment.

new text begin (d) For personal care assistance provided under section 256B.0659 and community first
services and supports provided under section 256B.85, remote reassessments may be
substituted for two consecutive reassessments if followed by an in-person reassessment.
new text end

deleted text begin (d) deleted text end new text begin (e) new text end A remote reassessment is permitted only if the lead agency provides informed
choice and the person being reassessed or the person's legal representative provides informed
consent for a remote assessment. Lead agencies must document that informed choice was
offered.

deleted text begin (e) deleted text end new text begin (f) new text end The person being reassessed, or the person's legal representative, may refuse a
remote reassessment at any time.

deleted text begin (f) deleted text end new text begin (g) new text end During a remote reassessment, if the certified assessor determines an in-person
reassessment is necessary in order to complete the assessment, the lead agency shall schedule
an in-person reassessment.

deleted text begin (g) deleted text end new text begin (h) new text end All other requirements of an in-person reassessment apply to a remote
reassessment, including updates to a person's support plan.

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. 19.

Minnesota Statutes 2022, section 256B.4905, subdivision 12, is amended to read:

Subd. 12.

Informed choice deleted text begin in deleted text end new text begin and new text end technology new text begin prioritization in new text end implementation for
disability waiver services.

The commissioner of human services shall ensure that:

(1) disability waivers under sections 256B.092 and 256B.49 support the presumption
that all adults who have disabilities and children who have disabilities may use assistive
technology, remote supports, or both to enhance the adult's or child's independence and
quality of life; and

(2) each individual accessing waiver services is offered, after an informed
decision-making process and during a person-centered planning process, the opportunity
to choose assistive technology, remote support, or both new text begin prior to the commissioner offering
or reauthorizing services that utilize direct support staff new text end to ensure equitable access.

Sec. 20.

Minnesota Statutes 2023 Supplement, section 256B.4906, is amended to read:

256B.4906 SUBMINIMUM WAGES IN HOME AND COMMUNITY-BASED
SERVICES REPORTING.

new text begin Subdivision 1. new text end

new text begin Data reporting. new text end

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

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

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

(b) The report required under paragraph (a) must include the following data about each
individual being paid subminimum wages:

(1) name;

(2) date of birth;

(3) identified race and ethnicity;

(4) disability type;

(5) key employment status measures as determined by the commissioner; and

(6) key community-life engagement measures as determined by the commissioner.

(c) The information in paragraph (b) must be submitted in a format determined by the
commissioner.

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

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

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

new text begin Subd. 2. new text end

new text begin Prohibition of subminimum wages. new text end

new text begin A provider of home and community-based
services must not pay a person with a disability a wage below the highest applicable minimum
wage on the basis of the person's disability. A special certificate authorizing the payment
of less than the highest applicable minimum wage to a person with a disability issued
pursuant to a law of this state or to a federal law is without effect as of August 1, 2028.
new text end

Sec. 21.

Minnesota Statutes 2023 Supplement, section 256B.4914, subdivision 4, is
amended to read:

Subd. 4.

Data collection for rate determination.

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

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

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

(1) shared staffing hours;

(2) individual staffing hours;

(3) direct registered nurse hours;

(4) direct licensed practical nurse hours;

(5) staffing ratios;

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

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

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

(9) service hours provided through monitoring technology.

(d) Updates to individual data must include:

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

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

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

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

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

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

new text begin EFFECTIVE DATE. new text end

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

Sec. 22.

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

256C.21 DEAF new text begin , DEAFBLIND, new text end AND HARD-OF-HEARING SERVICES ACT;
CITATION.

Sections 256C.21 to deleted text begin 256C.26 deleted text end new text begin 256C.261 new text end may be cited as the "Deaf new text begin , DeafBlind, new text end and
Hard-of-Hearing Services Act."

new text begin EFFECTIVE DATE. new text end

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

Sec. 23.

Minnesota Statutes 2022, section 256C.23, subdivision 1a, is amended to read:

Subd. 1a.

Culturally affirmative.

"Culturally affirmative" describes services that are
designed and delivered within the context of the culture, new text begin identity, new text end language, new text begin communication,
new text end and life experiences of deleted text begin a person deleted text end new text begin persons new text end who deleted text begin is deleted text end new text begin are new text end deaf, deleted text begin a person deleted text end new text begin persons new text end who deleted text begin is deleted text end new text begin are
new text end deafblind, and deleted text begin a person deleted text end new text begin persons new text end who deleted text begin is deleted text end new text begin are new text end hard-of-hearing.

new text begin EFFECTIVE DATE. new text end

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

Sec. 24.

Minnesota Statutes 2022, section 256C.23, is amended by adding a subdivision
to read:

new text begin Subd. 1b. new text end

new text begin Linguistically affirmative. new text end

new text begin "Linguistically affirmative" describes services
that are designed and delivered within the context of the language and communication
experiences of persons who are deaf, persons who are deafblind, and persons who are
hard-of-hearing.
new text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 25.

Minnesota Statutes 2022, section 256C.23, subdivision 2, is amended to read:

Subd. 2.

Deaf.

"Deaf" means a hearing loss deleted text begin of such severity that the individual must
depend deleted text end new text begin where the person communicates new text end primarily deleted text begin on visual communication such as deleted text end new text begin through new text end
American Sign Language or deleted text begin other deleted text end new text begin another new text end signed language, deleted text begin visual and manual means of
communication such as deleted text end signing systems in English deleted text begin or deleted text end new text begin , new text end Cued Speech, new text begin reading and new text end writing,
speech reading, deleted text begin and gestures deleted text end new text begin or other visual communication new text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 26.

Minnesota Statutes 2022, section 256C.23, subdivision 2a, is amended to read:

Subd. 2a.

Hard-of-hearing.

"Hard-of-hearing" means a hearing loss deleted text begin resulting in a
functional loss of hearing, but not to the extent that the individual must depend deleted text end new text begin where the
person does not communicate new text end primarily deleted text begin upon deleted text end new text begin through new text end visual communication.

new text begin EFFECTIVE DATE. new text end

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

Sec. 27.

Minnesota Statutes 2022, section 256C.23, subdivision 2b, is amended to read:

Subd. 2b.

Deafblind.

"Deafblind" means any combination of vision and hearing loss
deleted text begin which interferes with acquiring information from the environment to the extent that
compensatory deleted text end new text begin where the person uses visual, auditory, or tactile new text end strategies and skills deleted text begin are
necessary deleted text end new text begin such as the use of a tactile form of a visual or spoken language new text end to access deleted text begin that deleted text end new text begin
communication, information from the environment, new text end or other information.

new text begin EFFECTIVE DATE. new text end

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

Sec. 28.

Minnesota Statutes 2022, section 256C.23, subdivision 2c, is amended to read:

Subd. 2c.

Interpreting services.

"Interpreting services" means services that include:

(1) interpreting between a spoken language, such as English, and a visual language, such
as American Sign Language new text begin or another signed language new text end ;

(2) interpreting between a spoken language and a visual representation of a spoken
language, such as Cued Speech deleted text begin and deleted text end new text begin or new text end signing systems in English;

(3) interpreting within one language where the interpreter deleted text begin uses natural gestures and deleted text end
silently repeats the spoken message, replacing some words or phrases to deleted text begin give higher visibility
on the lips deleted text end new text begin make the message more readable new text end ;

(4) interpreting using low vision or tactile methods new text begin , signing systems, or signed languages new text end
for persons who deleted text begin have a combined hearing and vision loss or deleted text end are deafblind; and

(5) interpreting from one communication mode or language into another communication
mode or language that is linguistically and culturally appropriate for the participants in the
communication exchange.

new text begin EFFECTIVE DATE. new text end

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

Sec. 29.

Minnesota Statutes 2022, section 256C.23, subdivision 6, is amended to read:

Subd. 6.

Real-time captioning.

"Real-time captioning" means a method of captioning
in which deleted text begin a caption is deleted text end new text begin captions are new text end simultaneously prepared and displayed or transmitted at
the time of origination by specially trained real-time captioners.

new text begin EFFECTIVE DATE. new text end

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

Sec. 30.

Minnesota Statutes 2022, section 256C.23, subdivision 7, is amended to read:

Subd. 7.

Family and community intervener.

"Family and community intervener"
means a deleted text begin paraprofessional, deleted text end new text begin person who is new text end specifically trained in deafblindness deleted text begin , who deleted text end new text begin and new text end
works one-on-one with a child who is deafblind to provide critical deleted text begin connections deleted text end new text begin access new text end to
new text begin language, communication, new text end people new text begin , new text end and the environment.

new text begin EFFECTIVE DATE. new text end

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

Sec. 31.

Minnesota Statutes 2022, section 256C.233, subdivision 1, is amended to read:

Subdivision 1.

Deaf new text begin , DeafBlind, new text end and deleted text begin Hard-of-Hearing deleted text end new text begin Hard of Hearing State new text end Services
Division.

The commissioners of new text begin commerce, new text end education, employment and economic
development, and health shall deleted text begin advise deleted text end new text begin partner with new text end the commissioner of human services on
the new text begin interagency new text end activities of the Deaf new text begin , DeafBlind, new text end and deleted text begin Hard-of-Hearing deleted text end new text begin Hard of Hearing
State new text end Services Division. This division deleted text begin addresses the developmental and social-emotional
needs of deleted text end new text begin provides services for new text end persons who are deaf, persons who are deafblind, and persons
who are hard-of-hearing through a statewide network of new text begin programs, new text end services new text begin , new text end and new text begin supports.
This division also new text end advocates on behalf of and provides information and training about how
to best serve persons who are deaf, persons who are deafblind, and persons who are
hard-of-hearing. The commissioner of human services shall coordinate the work of the
interagency deleted text begin advisers and deleted text end new text begin partners, new text end receive legislative appropriations for the division new text begin , and
provide grants through the division for programs, services, and supports for persons who
are deaf, persons who are deafblind, and persons who are hard-of-hearing in identified areas
of need such as deafblind services, family services, interpreting services, and mental health
services new text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 32.

Minnesota Statutes 2022, section 256C.233, subdivision 2, is amended to read:

Subd. 2.

Responsibilities.

The Deaf new text begin , DeafBlind, new text end and deleted text begin Hard-of-Hearing deleted text end new text begin Hard of Hearing
State new text end Services Division shall:

(1) establish and maintain a statewide network of regional culturally new text begin and linguistically
new text end affirmative services for Minnesotans who are deaf, Minnesotans who are deafblind, and
Minnesotans who are hard-of-hearing;

(2) work across divisions within the Department of Human Services, as well as with
other agencies and counties, to ensure that there is an understanding of:

(i) the communication new text begin access new text end challenges faced by persons who are deaf, persons who
are deafblind, and persons who are hard-of-hearing;

(ii) the best practices for accommodating and deleted text begin mitigating deleted text end new text begin addressing new text end communication new text begin
access new text end challenges; and

(iii) the legal requirements for providing access to and effective communication with
persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing;

(3) assess the supply and demand statewide for deleted text begin interpreter deleted text end new text begin interpreting new text end services and
real-time captioning services, implement strategies to provide greater access to these services
in areas without sufficient supply, and deleted text begin build the base of deleted text end new text begin partner with interpreting new text end service
providers new text begin and real-time captioning service providers new text end across the state;

(4) maintain a statewide information resource that includes contact information and
professional deleted text begin certification credentials deleted text end new text begin certifications new text end of interpreting service providers and
real-time captioning service providers;

(5) provide culturally new text begin and linguistically new text end affirmative mental health services to persons
who are deaf, persons who are deafblind, and persons who are hard-of-hearing who:

(i) use a visual language such as American Sign Language new text begin , another sign language, new text end or a
tactile form of a new text begin visual new text end language; or

(ii) otherwise need culturally new text begin and linguistically new text end affirmative deleted text begin therapeutic deleted text end new text begin mental health new text end
services;

(6) research and develop best practices and recommendations for emerging issues; new text begin and
new text end

(7) provide as much information as practicable on the division's stand-alone website in
American Sign Language deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (8) report to the chairs and ranking minority members of the legislative committees with
jurisdiction over human services biennially, beginning on January 1, 2019, on the following:
deleted text end

deleted text begin (i) the number of regional service center staff, the location of the office of each staff
person, other service providers with which they are colocated, the number of people served
by each staff person and a breakdown of whether each person was served on-site or off-site,
and for those served off-site, a list of locations where services were delivered and the number
who were served in-person and the number who were served via technology;
deleted text end

deleted text begin (ii) the amount and percentage of the division budget spent on reasonable
accommodations for staff;
deleted text end

deleted text begin (iii) the number of people who use demonstration equipment and consumer evaluations
of the experience;
deleted text end

deleted text begin (iv) the number of training sessions provided by division staff, the topics covered, the
number of participants, and consumer evaluations, including a breakdown by delivery
method such as in-person or via technology;
deleted text end

deleted text begin (v) the number of training sessions hosted at a division location provided by another
service provider, the topics covered, the number of participants, and consumer evaluations,
including a breakdown by delivery method such as in-person or via technology;
deleted text end

deleted text begin (vi) for each grant awarded, the amount awarded to the grantee and a summary of the
grantee's results, including consumer evaluations of the services or products provided;
deleted text end

deleted text begin (vii) the number of people on waiting lists for any services provided by division staff
or for services or equipment funded through grants awarded by the division;
deleted text end

deleted text begin (viii) the amount of time staff spent driving to appointments to deliver direct one-to-one
client services in locations outside of the regional service centers; and
deleted text end

deleted text begin (ix) the regional needs and feedback on addressing service gaps identified by the advisory
committees.
deleted text end

new text begin EFFECTIVE DATE. new text end

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

Sec. 33.

Minnesota Statutes 2022, section 256C.24, subdivision 1, is amended to read:

Subdivision 1.

Location.

The Deaf new text begin , DeafBlind, new text end and deleted text begin Hard-of-Hearing deleted text end new text begin Hard of Hearing
State new text end Services Division shall establish at least six regional service centers for persons who
are deaf new text begin , persons who are deafblind, new text end and persons who are hard-of-hearing. The centers shall
be distributed regionally to provide access for persons who are deaf, persons who are
deafblind, and persons who are hard-of-hearing in all parts of the state.

new text begin EFFECTIVE DATE. new text end

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

Sec. 34.

Minnesota Statutes 2022, section 256C.24, subdivision 2, is amended to read:

Subd. 2.

Responsibilities.

Each regional service center shall:

new text begin (1) employ qualified staff to work with persons who are deaf, persons who are deafblind,
and persons who are hard-of-hearing;
new text end

deleted text begin (1) deleted text end new text begin (2) new text end establish connections and collaborations deleted text begin and explore colocating deleted text end with other public
and private entities providing services to persons who are deaf, persons who are deafblind,
and persons who are hard-of-hearing in the region;

deleted text begin (2) deleted text end new text begin (3) new text end for those in need of services, assist in coordinating services between service
providers and persons who are deaf, persons who are deafblind, and persons who are
hard-of-hearing, and the persons' families, and make referrals to the services needed;

deleted text begin (3) employ staff trained to work with persons who are deaf, persons who are deafblind,
and persons who are hard-of-hearing;
deleted text end

(4) if adequate new text begin or accessible new text end services are not available from another public or private
service provider in the region, provide individual new text begin culturally and linguistically affirmative
new text end assistance to persons who are deaf, persons who are deafblind, and persons who are
hard-of-hearing, and the persons' families deleted text begin . Individual culturally affirmative assistance may
be provided using technology only in areas of the state where a person has access to sufficient
quality telecommunications or broadband services to allow effective communication. When
a person who is deaf, a person who is deafblind, or a person who is hard-of-hearing does
not have access to sufficient telecommunications or broadband service, individual assistance
shall be available in person deleted text end ;

(5) identify regional training new text begin and resource new text end needs deleted text begin , work with deaf and hard-of-hearing
services training staff, and collaborate with others to deleted text end new text begin and new text end deliver training new text begin and resources new text end for
persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing, and
the persons' families, and other service providers about subjects including the persons' rights
under the law, American Sign Language, and the impact of hearing loss and options for
accommodating it;

(6) have a mobile or permanent lab where persons who are deaf, persons who are
deafblind, and persons who are hard-of-hearing can try a selection of deleted text begin modern deleted text end assistive
technology new text begin , telecommunications equipment, new text end and new text begin other technology and new text end equipment to
determine what would best meet the persons' needs;

(7) collaborate with deleted text begin the Resource Center for the Deaf and Hard-of-Hearing Persons,
other divisions of deleted text end the Department of Education and local school districts to deleted text begin develop and
deliver programs and services for deleted text end new text begin provide information and resources to new text end families with children
who are deaf, children who are deafblind, or children who are hard-of-hearing and to deleted text begin support deleted text end
school personnel serving these children;

(8) provide training new text begin , resources, and consultation new text end to deleted text begin the social service or income
maintenance staff employed by counties or by organizations with whom counties contract
for services to ensure that deleted text end new text begin human services providers about new text end communication deleted text begin barriers which
prevent deleted text end new text begin access and other needs of new text end persons who are deaf, persons who are deafblind, and
persons who are hard-of-hearing deleted text begin from using services are removed deleted text end ;

deleted text begin (9) provide training to human service agencies in the region regarding program access
for persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing;
deleted text end

deleted text begin (10) deleted text end new text begin (9) new text end assess the ongoing need and supply of services for persons who are deaf, persons
who are deafblind, and persons who are hard-of-hearing in all parts of the state deleted text begin , deleted text end new text begin ; new text end annually
consult with the division's advisory committees to identify regional needs and solicit feedback
on addressing service gaps deleted text begin , deleted text end new text begin ; new text end and deleted text begin cooperate deleted text end new text begin collaborate new text end with public and private service
providers deleted text begin to develop these services deleted text end new text begin on service solutions new text end ;

deleted text begin (11) deleted text end new text begin (10) new text end provide culturally new text begin and linguistically new text end affirmative mental health services to
persons who are deaf, persons who are deafblind, and persons who are hard-of-hearing who:

(i) use a visual language such as American Sign Language new text begin , another sign language, new text end or a
tactile form of a new text begin visual new text end language; or

(ii) otherwise need culturally new text begin and linguistically new text end affirmative deleted text begin therapeutic deleted text end new text begin mental health new text end
services; and

deleted text begin (12) deleted text end new text begin (11) new text end establish partnerships with state and regional entities statewide deleted text begin that have the
technological capacity deleted text end to provide Minnesotans with virtual access to the division's services
and deleted text begin division-sponsored deleted text end training deleted text begin via deleted text end new text begin through new text end technology.

new text begin EFFECTIVE DATE. new text end

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

Sec. 35.

Minnesota Statutes 2022, section 256C.24, subdivision 3, is amended to read:

Subd. 3.

Advisory committee.

The director of the Deaf new text begin , DeafBlind, new text end and deleted text begin Hard-of-Hearing deleted text end new text begin
Hard of Hearing State new text end Services Division shall appoint eight advisory committees of up to
nine persons per advisory committee. Each committee shall represent a specific region of
the state. The director shall determine the boundaries of each advisory committee region.
The committees shall advise the director on the needs of persons who are deaf, persons who
are deafblind, and persons who are hard-of-hearing and service gaps in the region of the
state the committee represents. Members shall include persons who are deaf, persons who
are deafblind, and persons who are hard-of-hearing, persons who have communication
disabilities, parents of children who are deaf new text begin , parents of children who are deafblind, new text end and
parents of children who are hard-of-hearing, parents of children who have communication
disabilities, and representatives of county and regional human services, including
representatives of private service providers. At least 50 percent of the members must be
deaf or deafblind or hard-of-hearing or have a communication disability. Committee members
shall serve for a three-year term deleted text begin , and may be appointed to deleted text end new text begin . Committee members shall serve
no more than three new text end consecutive terms new text begin and no more than nine years in total new text end . Each advisory
committee shall elect a chair. The director of the Deaf new text begin , DeafBlind, new text end and deleted text begin Hard-of-Hearing deleted text end new text begin
Hard of Hearing State new text end Services Division deleted text begin shall deleted text end new text begin may new text end assign staff to serve as nonvoting members
of the committee. Members shall not receive a per diem. Otherwise, the compensation,
removal of members, and filling of vacancies on the committee shall be as provided in
section 15.0575.

new text begin EFFECTIVE DATE. new text end

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

Sec. 36.

Minnesota Statutes 2022, section 256C.26, is amended to read:

256C.26 EMPLOYMENT SERVICES.

The commissioner of employment and economic development shall work with the Deaf new text begin ,
DeafBlind, new text end and deleted text begin Hard-of-Hearing deleted text end new text begin Hard of Hearing State new text end Services Division to develop and
implement a plan to deal with the underemployment of new text begin persons who are new text end deaf, new text begin persons who
are new text end deafblind, and new text begin persons who are new text end hard-of-hearing deleted text begin persons deleted text end .

new text begin EFFECTIVE DATE. new text end

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

Sec. 37.

Minnesota Statutes 2022, section 256C.261, is amended to read:

256C.261 SERVICES FOR PERSONS WHO ARE DEAFBLIND.

(a) The commissioner of human services shall use at least deleted text begin 35 deleted text end new text begin 60 new text end percent of the deafblind
services biennial base level grant funding for new text begin programs, new text end services new text begin , new text end and deleted text begin other deleted text end supports for deleted text begin a
child deleted text end new text begin adults who are deafblind and for children new text end who deleted text begin is deleted text end new text begin are new text end deafblind and the deleted text begin child's family deleted text end new text begin
children's families new text end . deleted text begin The commissioner shall use at least 25 percent of the deafblind services
biennial base level grant funding for services and other supports for an adult who is deafblind.
deleted text end

The commissioner shall award grants for the purposes of deleted text begin :
deleted text end

deleted text begin (1) deleted text end providing new text begin programs, new text end services new text begin , new text end and supports to persons who are deafblind deleted text begin ; and deleted text end new text begin .
new text end

deleted text begin (2) developing and providing training to counties and the network of senior citizen
service providers. The purpose of the training grants is to teach counties how to use existing
programs that capture federal financial participation to meet the needs of eligible persons
who are deafblind and to build capacity of senior service programs to meet the needs of
seniors with a dual sensory hearing and vision loss.
deleted text end

(b) The commissioner may make grants:

(1) for services and training provided by organizations new text begin to persons who are deafblind new text end ;
deleted text begin and
deleted text end

(2) to develop and administer consumer-directed services deleted text begin . deleted text end new text begin for persons who are deafblind;
and
new text end

new text begin (3) to develop and provide training to counties and service providers on how to meet
the needs of persons who are deafblind.
new text end

(c) Consumer-directed services deleted text begin shall deleted text end new text begin must new text end be provided in whole by grant-funded
providers. deleted text begin The Deaf and Hard-of-Hearing Services Division's regional service centers shall
not provide any aspect of a grant-funded consumer-directed services program.
deleted text end

deleted text begin (d) Any entity that is able to satisfy the grant criteria is eligible to receive a grant under
paragraph (a).
deleted text end

deleted text begin (e) deleted text end new text begin (d) new text end Deafblind service providers may, but are not required to, provide deleted text begin intervenor deleted text end new text begin
intervener new text end services as part of the service package provided with grant funds under this
section. Intervener services include services provided by a family and community intervener
as described in paragraph deleted text begin (f) deleted text end new text begin (e) new text end .

deleted text begin (f) deleted text end new text begin (e) new text end The family and community intervener, as defined in section 256C.23, subdivision
7, provides services to open channels of communication between the child and others;
facilitates the development or use of receptive and expressive communication skills by the
child; and develops and maintains a trusting, interactive relationship that promotes social
and emotional well-being. The family and community intervener also provides access to
information and the environment deleted text begin , deleted text end and facilitates opportunities for learning and development.
A family and community intervener must have specific training in deafblindness, building
language and communication skills, and intervention strategies.

new text begin EFFECTIVE DATE. new text end

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

Sec. 38. new text begin PHASE-OUT OF USE OF SUBMINIMUM WAGE FOR MEDICAL
ASSISTANCE DISABILITY SERVICES.
new text end

new text begin The commissioner must seek all necessary amendments to Minnesota's federally approved
disability waiver plans to require an individual receiving prevocational or employment
support services be compensated at or above the highest applicable minimum wage no later
than August 1, 2028.
new text end